Used to assess for leg length discrepancy With the patient supine, the patient brings the knees so that they are equally flexed to 90 degrees with the hips at roughly 45 degrees of flexion If the heights vary, there may be a leg length discrepancy One leg more anterior on lateral view, […]
Category: Lower Limb
24 posts
Anatomy Function Quadricep muscles are hip flexors and knee extensors. Innervation The quadricep muscles are innervated by the femoral nerve (L2-L4). Prone Muscle Test Patient in prone with physician at side of table Monitor the pelvis at the PSIS so it does not rise Bring ankles toward the patient’s buttock, […]
Anatomy Function Hamstring muscles are hip extensors. Innervation The hamstring muscles are innervated by sciatic nerve (L5, S1-S2). Method One Patient supine with their hip flexed at a 90 degree angle and knee bent Attempt to straighten the knee out vertically with the hip still flexed at a 90 degrees […]
Overview Function Piriformis is a lateral/external rotator of the hip joint. Innervation Levels: L5, S1-S2 Sciatic nerve often runs through or behind the piriformis muscle Supine Muscle Testing Patient lies supine Grasp above the ankles bilaterally (important to grab above the ankle joint) Using the lower extremity, internally rotate each […]
A good mnemonic to remember: Feeling Extra Cold Today In Erie, Better ADd layers!” (note: Better is to remind you to ABduct before you ADduct!) Steps: Done in the specific order. Flexion (120°) Extension (30°) + support hip on other side Circumduction with compression: small circles → big circles (Counter-clockwise […]
Used to evaluate hypertonicity of the iliopsoas Begin with the patient supine, the patient takes both legs and passively flexes the knees and hip to flatten the lumbar lordosis. Remember to watch for increased lumbar lordosis (should not have this because it’s compensatory) – monitor this with placing your hand below […]
Used to test for hypertonicity of the quadriceps muscle, specifically the rectus femoris Similar to the Thomas Test, however this test is performed at the edge of the table Patient supine with gluteal crease near the edge of the table Have patient bring both knees to chest then let one leg […]
Used to assess for hypertonicity of the iliotibial band Begin with patient in the lateral decubitus position, passively abducted the leg with the knee flexed to 90 degrees while keeping hip joint in neutral position The leg is then released from abduction, while still supporting the calf/ankle – hold onto the […]
Used to determine the laterality of somatic dysfunction of the hip joint With the patient prone, the knee is passively flexed to 90 degrees and the hip abducted to 30-45 degrees. With the other hand, an anterior and slightly superior force is directed from just posterior to the greater trochanter, compressing the femoral head into the acetabulum Positive for […]
Evaluates gluteus medius Begin with the patient standing in front of you in normal stance, observe PSIS dimples and pelvic height Ask patient to raise one leg and observe dimples/pelvis A drop in height on the side of the lifted leg indicates a positive test for a weak gluteus medius of the stance leg […]
Used to detect somatic dysfunction of either the hip or the sacroiliac joint With the patient supine, the hip is flexed, abducted, and externally rotated. A posterior force is then placed on the ipsilateral knee and contralateral ASIS Test is considered to be positive if there is pain at the hip or SI joint
Used to assess for leg length discrepancy With the patient supine, the patient brings the knees so that they are equally flexed to 90 degrees with the hips at roughly 45 degrees of flexion If the heights vary, there may be a leg length discrepancy One leg more anterior on lateral view, […]
Used to assess for presence of an effusion (excess fluid) in the knee joint With the patient supine, the examiner passively flexes the leg being tested and lifts the ankle up off of the table. The examiner than releases the upper portion of the leg, allowing the knee to extend. Test is considered to be […]
Used to test for issues with patellar tracking or chondromalacia Doctor applies a compressive force to the proximal patella moving it into the trochlear groove. The patient is then instructed to activate the quadriceps muscle by contracting their quadriceps Test is considered to be positive when pain, crepitus, or grinding occurs
Used to differentiate the cause of knee pain between ligamentous and meniscus causes Compression: With the patient prone, flex the knee to 90 degrees, apply a moderate force to the knee into the table and internally and externally rotate If positive (pain produced) then there is either a ligamentous OR a meniscal cause Distraction: Hold the thigh […]
Purpose Assess for ligamentous laxity in the medial and lateral collateral ligaments of the knee Varus: Lateral Collateral Ligaments With the knee slightly flexed, stabilize the distal lower limb and apply a varus force to the knee, causing a stress to the LCL Positive Test = excessive gapping of the joint space Valgus: Medial […]
Used to assess for tears in the meniscus Positive Test = clicking (pain) Medial Meniscus: Externally rotate tibia Apply valgus stress Bring knee into extension Lateral Meniscus: Internally rotate tibia Apply varus stress Bring knee into extension
Used to assess the integrity of the Anterior Cruciate Ligament (ACL) Similar to the anterior drawer test but more sensitive – removes the hamstrings as a factor Patient is supine, knee flexed to 30 degrees – the flexion at 30 degrees is what removes the hamstrings as a factor in the test Physician places one hand around […]
Purpose Assess the integrity of the Posterior Cruciate Ligament (PCL) Steps The patient is supine and the knee flexed to 90 degrees For extra stability, doctor may stabilize the foot by sitting on it Apply a posteriorly directed force with one or both hands to the tibial portion of the knee Test is considered to be positive with […]
Purpose Assess the integrity of the Anterior Cruciate Ligament (ACL) Steps Have the patient in supine position and the knee flexed to 90 degrees Restrict the motion of the foot by sitting on it Apply an anterior force with one or both hands as necessary to the lower leg Test is considered to be positive with increased movement […]
Used to test the integrity of the Achilles tendon With the patient prone and the foot freely over-hanging the edge of the table, apply a “squeezing” force to the calf (gastrocnemius muscle) Positive if the foot does NOT plantar flex with squeezing motion, indicating a torn Achilles tendon
Used to assess for ligamentous laxity of the medial (deltoid) and lateral (ATF) ligaments Varus test (aka Talar Tilt Test): Supporting the proximal ankle, hold the talus and calcaneus as one unit and apply a varus force to the ankle, causing inversion Positive test when pain and ligamentous laxity are appreciated. May appreciate a “clunk” […]
Used to test the strength of the posterior talofibular ligament Performed by holding the patient’s posterior ankle while applying a posterior force on the foot – anterior force on the tibia Test is considered to be positive when foot moves posterior, pain may also be present. Always compare both sides by testing the non-injured ankle […]
Used to test the strength of the anterior talofibular ligament Performed by holding the patient’s foot behind the heel (calcaneus) and with the other hand applying a posterior force through the tibia Test is considered to be positive if pain is reproduced or foot moves anterior Always compare both sides by testing the non-injured ankle first.
