Knee tests
Clark´s sign test
The test is used to assess chondromalacia patella and other patellofemoral syndromes.
Patient position:
The patient must be examined in supine position on the examination table with fully extended knee and relaxed leg.
Therapist position:
The therapist stands besides the affected knee placing the first interdigital space space around the upper pole of the patella.
Action test:
The patient performs an isometric muscular quadriceps contraction while the therapist puts a resistance to upward movement of the patella.
Positive test:
Retropatellar pain and disability to perform muscular contraction.
Special considerations:
Based on scientific studies it is not recommend use of the Clarke sign to diagnose any patellofemoral syndrome1.
1. Scott T Doberstein, Richard L Romeyn, David M Reineke. The Diagnostic Value of the Clarke Sign in Assessing Chondromalacia Patella. J Athl Train. 2008 Mar-Apr; 43(2): 190–196.
Apley´s test
The Appley's test is used to evaluate individuals for problems of the meniscus in the knee.
Patient position:
The patient is placed in the prone position with the knee flexed to 90 degree.
Therapist position:
Therapist stands by patient stabilizing femur´s patient with his own leg and holding patient´s foot with both hands.
Action test:
The examiner laterally and medially rotates the tibia, combined first with distraction, while noting any excessive movement, restriction or discomfort. The process is then repeated using compression instead of distraction.
Positive result:
If rotation plus distraction is more painful or shows increased rotation relative to the normal side, the lesion is most likely to be ligamentous. If the rotation plus compression is more painful or shows decreased rotation relative to the normal side, the lesion is most likely to be a meniscus injury.
Anterior drawer test
The anterior drawer test is used by therapists to detect rupture of the anterior cruciate ligament in the knee.
Patient position:
The patient should be supine with the hips flexed to 45 degrees, the knees flexed to 90 degrees and the feet flat on table.
Therapist position:
Therapist sits on the examination on the patient´s feet. He grasps tibia´s patient by popliteal fossa.
Action test:
The therapist grasps the patient's tibia and pulls it forward.
Positive result:
If the tibia pulls forward more than normal, the test is considered positive.
Posterior drawer test
The posterior drawer test is used by therapists to detect rupture of the posterior cruciate ligament in the knee.
Patient position:
The patient should be supine with the hips flexed to 45 degrees, the knees flexed to 90 degrees and the feet flat on table.
Therapist position:
Therapist sits on the examination on the patient´s feet. He grasps tibia's patient by anterior part of the tibia.
Action test:
The therapist grasps the patient's tibia and push it forward.
Positive result:
If the tibia pushes forward more than normal, the test is considered positive.
Patellar aprehension test
The Patellar Apprehension Test evaluates for patellar subluxation or dislocation.
Patient position:
The patient should be supine with knee slightly flexed 30˚ and relaxed quadriceps.
Therapist position:
The therapist stands by examination table placing a hand in medial patellar border.
Action test:
The examiner pushes medially and laterally on the patella in attempt to sublux the patella.
Positive result:
Painful apprehension requesting to stop the test is a positive test.
McMurray´s test
The McMurray test is used to evaluate individuals for tears in the meniscus of the knee.
Patient position:
Patient is supine in examination table with 90˚ flexion on knee and hip assessed.
Therapist position:
Therapist stands by patient holding the knee by one hand and the foot by the other hand.
Action test:
To perform the test, the knee is held by one hand, which is placed along the joint line, and flexed to complete flexion while the foot is held by the sole with the other hand. The examiner then places one hand on the lateral side of the knee to stabilize the joint and provide a valgus stress in order to identify a valgus deformity. The other hand rotates the leg externally while extending the knee.
Positive result:
If pain or a "click" is felt, this constitutes a "positive McMurray test" for a tear in the medial meniscus.