practical special tests

Windlass/Supple Pes Planus Test: (FOOT)

If pt. Has arch in seated position and then loses arch while standing =functional pes planus, if pt. Has pain when they go on their toes = plantar fasciitis

Interdigital Neuroma Test: (FOOT)

Pain between metatarsal heads= neuroma

Thumb Index Finger Squeeze: (FOOT)

Pain between metatarsal heads =neuroma 

Tinel’s Test: (FOOT)

Pain or tingling that radiates along the path of nerve =tarsal tunnel

Long Bone Compression Test: (FOOT)

Pain at site of injury = fx

Torque Test: (FOOT)

Pain at site of injury = fx

Tap Test: (FOOT)

Increased pain = fx metatarsal or phalange (depends where pain is)

Bump/Percussion Test: (FOOT)

 Pain at site of injury = fx (the vibration will exaggerate the pain)

Anterior Drawer Test: (ANKLE)

Increased anterior translation = ATFL sprain (compare bilaterally to see if truly positive)

Inversion Talar Tilt: (ANKLE)

Increased inversion ROM compared to other side = CFL sprain or involvement

Posterior Drawer Test: (ANKLE)

 Increased posterior translation= PTFL sprain

Eversion Talar Tilt: (ANKLE)

Increased eversion ROM compared to other side = Deltoid ligament

Kleiger’s Test: (ANKLE)

Increased laxity with foot in neutral position= deltoid ligament sprain; increased laxity with foot in dorsiflexion =syndesmotic ankle sprain

Cotton’s Test: (ANKLE)

Increased motion laterally compared to other side= syndesmotic ankle sprain

Bump/Percussion Test: (ANKLE)

Pain at site of injury = fx (the vibration will exaggerate the pain)

Squeeze Test: (ANKLE)

Pain above and below squeeze may indicate fx (can be right on squeeze)

Thompson Test: (ANKLE)

Lack of plantar flexion = ruptured achilles tendon

Homan’s Test: (ANKLE)

Increased pain in calf with passive stretch= thrombophlebitis or Deep vein thrombosis (DVT) 

Sweep Test: (KNEE)

Fluid accumulation =  intracapsular swelling

Ballotable Patella: (KNEE)

Downward movement of patella followed by rebound =moderate to severe joint effusion

Bounce Home Test: (KNEE)

Knee bouncing out of extension = effusion in knee

Girth Measurements: (KNEE)

 Injured leg bigger than contralateral limb = swelling; injured limb smaller than contralateral limb = atrophy

Valgus Stress Test: (KNEE)

Laxity at 0 = capsule involvement, laxity at 30 = ligamentous (MCL). Look for laxity, pain, and guarding

Varus Stress Test: (KNEE)

Laxity at 0 = capsule involvement, laxity at 30 = ligamentous (LCL). Look for laxity, pain, and guarding

Posterior Drawer Test: (KNEE)

Increased posterior translation of tibia compared to other side = PCL

Posterior Lachman’s: (KNEE)

 Increased posterior translation of tibia compared to other side = PCL

Godfrey’s 90/90: (KNEE)

One tibia resting more inferiorly than the other side = PCL

Posterior Sag: (KNEE)

Posterior translation of the tibia while patient actively contracts the quads = PCL

Leli’s Test: (KNEE)

If downward force on distal femur does not result in the heel lifting = ACL rupture

Anterior Drawer Test: (KNEE)

Increased anterior translation of tibia compared to other side = ACL

Anterior Lachman’s: (KNEE)

Increased anterior translation of tibia compared to other side = ACL

Thessaly Test: (KNEE)

Medial or lateral joint pain or sensations of clicking or locking = meniscal tear

Steinman’s Tenderness Test: (KNEE)

Lack of full knee flexion or pain during rotational movement = meniscus pathology

McMurray’s Test: (KNEE)

Pain, catching, locking or clicking = meniscus pathology

Apley Compression Test: (KNEE)

Pain, clicking, and/or restriction = meniscus pathology

Pinch Test: (KNEE)

Pain as the knee is moved from flexed to extended position = meniscus pathology 

Duck Walk: (KNEE)

Pain in joint line when getting into the position, increased pain with duck walk, or inability to get into position = meniscus pathology

Patella Tendon Length TesT: (KNEE)

Ratio of less than 1 = patella alta; Ratio of greater than 1 = patella baja

Patellar Apprehension: (KNEE)

If patient is apprehensive about the movement or contracts the quads to protect against subluxation

Patellar Grind: (KNEE)

Pain with movement of patella or inability to complete test = chondromalacia

Renne’s Test: (KNEE)

Pain on lateral aspect of knee at 30 degrees of flexion = ITB syndrome

Nobel’s Test: (KNEE)

Pain on lateral aspect of knee at 30 degrees of flexion = ITB syndrome

Hip Scouring: (HIP)

Pain indicated labral pathology

Torque Test: (HIP

Pain deep within femur = stress fx

90/90 Straight Leg Test: (HIP)

 If full extension does not occur (or flexion of greater than 20 degrees) = hamstring tightness

Patrick FABER Test: (HIP)

If knee remains above opposite leg = SI joint involvement

Trendelenburg's Test: (HIP)

Pelvis on unsupported limb drops = Weak glut medius or hip instability 

Ober’s Test: (HIP)

 Pt. not being able to adduct (lower leg) = tight IT band

Piriformis Test: (HIP)

Tightness or pain in hip or butt = piriformis syndrome

Thomas Test: (HIP)

Lack of hip extension with knee flexion greater than 45 degrees = psoas tightness,; full hip extension with knee flexion less than 45 degrees = rectus femoris; lack of hip extension with knee flexion less than 45 degrees = both 

Measuring for Leg Length: (PELVIS)

Side by side difference of more than 1cm = leg length discrepancy 

Gapping (compression) test: (PELVIS)

Pain in SI or gluteal region = SI dysfunction

Long Sit Test: (PELVIS)

If injured leg was longer when supine and becomes shorter when sitting = anteriorly rotated ilium; if injured leg was shorter in a supine position and become longer during sitting = posteriorly rotated ilium 

• Longer to shorter = anterior

• Shorter to longer = posterior 

McBurney’s Test: (PELVIS)

Pain with rebound (when you remove your fingers) = appendicitis