Week 1: Lab Ligament Testing

what to avoid with ligament testing

gaurding or mm spasm endfeel

are ligament testing more accurate for chronic or acute

chronic because acute still has the swelling and muscle spasms

feeling if ligament is intact

abrupt stop or firm end feel

feeling if ligament is lax

soft or indistinct end of motion

grading scale for ligament testing

normal

grade1: pain

grade 2: pain, increased laxicty

grade 3: no pain, more laxity

to feel laxity

slower

to feel stiffness

faster

LCL of elbow test

push into varus

MCL of elbow test

push into valgus

for stress testing where are hands

one proximal for stability, other hand is putting pressure distally

MCL in full extension looks for

more joint concruency

mcl in slight flexion looks for

3 bands are tight in different positions

moving valgus test

for MCL, shoulder abducted to 90, putting elbow into valgus and extension to 30

positive findings for moving valgus test

medial elbow pain max at 120-70 flexion

Knee MCL stress test: gapping

supine, one hand on ankle other on lateral joint.

-push into valgus

-tested at 0 and 30 flex

Knee LCL stress test: gapping

supine, one hand on ankle other on medial joint

-push into varus

-tested in 0 and 30 flex

Knee anterior drawer test purpsoe

test integrity of ACL (especially anteromedial bundle)

Anterior drawer test procedure

supine wiht knee bent to 90 hip at 45, sit on foot, hand around tibia to ensure hamstrings are relaxed, pull forward

positive anterior drawer test

more than 6mm

Lachmans test purpsoe

tests ACL integrity (posterolateral band)

lachmans test

supine, knee between extension and 30 flex. push into anterior and lateral force

positive lachmans

soft or lack of end feel, increased translation

posterior drawer test purpose

test integrity of pcl

posterior drawer procedure

after anterior drawer test. same as anterior just pushing posterior and medial on femur

postive posterior drawer test

lack of end feel

reverese lachmans test

for PCL, have them supine, push laterally and posterior

Ankle anterior drawer purpose

ankle ligaments (anterior talofibular)

ankle anterior drawer procedure

supine or sitting, stabilize leg and draw tibia forward (20 degrees of PF)- may want ot put knee in flexion to put pressure on achilles tendon

positive anterior drawer test ankle

anterior translation on lateral side

for anterior drawer test make sure you dont

DF ankle

some translation is

ATFL

greater translation is

ATFL and CFL

straight translation is

medial and lateral ligament insufficiencies

talar tilt purpose inversion

test injury of lateral ankle ligaments, CFL

talar tilt procedure inversion

supine, seated or sidelying. may flex knee to relax gastroc. foot is at 90 to bring CFL perpendicular to talus. , tilt to inversion. more PF would test ATFL

talar tilt purpose eversion

medial ankle ligament injury, aka deltoid lig

talar tilt eversion procedure

everts and abducts heal while stabilizing distal tib

complete tear end feel with eversion test

spongy or indefinite end feel

eversion tests what ligaments specifically

deltoid (tibionavicular, tibiocalcaneal, posterior talofibular)