Orthopedic Exam / Special Tests for Physical Therapy: KNEE
Apley’s Compression Test:
Each of our knees has two menisci — C-shaped pieces of cartilage
that act like a cushion between our shinbone and our thighbone. A torn
meniscus causes pain, swelling and stiffness. There might also be
trouble extending the knee fully.
Meniscal injuries may be the most common knee injury. Meniscus tears are sometimes related to trauma, but significant trauma is not necessary. A sudden twist or repeated squatting can tear the meniscus. A torn meniscus is one of the most common knee injuries. Any activity
that causes you to forcefully twist or rotate your knee, especially when
putting the pressure of your full weight on it, can lead to a torn
Signs & Symptoms:
Most meniscal injuries can be diagnosed by obtaining a detailed history. Important points to address include the following:
- Mechanism of injury (eg, twisting, squatting, changes in position)
- Pain (commonly intermittent and usually localized to the joint line)
- Mechanical complaints (eg, clicking, catching, locking, pinching, or a sensation of giving way)
- Swelling (usually delayed, sometimes absent; degenerative tears often manifest with recurrent effusions)
Physical findings that are significant in the examination of a patient with a possible meniscus injury include the following:
- Joint line tenderness (77-86% of patients with a meniscal tear)
- Effusion (~50% of patients presenting with a meniscal tear)
- Impaired range of motion – A mechanical block to motion or frank locking can occur with displaced tears; restricted motion commonly results from pain or swelling
Provocative maneuvers that may elicit characteristic results in the presence of a meniscal tear include the following:
- Apley’s Test – Pain at the medial or lateral joint
- McMurray test – Pain or a reproducible click
- Steinmann test – Asymmetric pain with external (medial meniscus) or internal (lateral meniscus) rotation
- Thessaly test – Pain or a locking or catching sensation at the medial or lateral joint line. http://emedicine.medscape.com/article/90661
Special Test: Apley’s Compression Test
- Testing for Meniscal Injury
Video Demo Instructions, Procedure, Positive Test:
Special Test: Apley’s Compression Test Video Demo (Procedure below)
Special Test: Apley’s Compression Test: PROCEDURE:
• Patient is prone.
• Patient then flexes affected knee to 90°
• Therapist’s one hand grasps patient’s heel and ankle while the other hand stabilizes the leg.
•Therapist compresses the flexed knee joint and the menisci –by pushing the patient’s foot and tibia down into the table, followed by internal and external rotation of the tibia.
Special Test: Apley’s Compression Tes: POSITIVE SIGN:
- Pain on the medial aspect = medial meniscus damage/injury
- Pain on the lateral aspect = lateral meniscus injury/damage
*** Conservative treatment — such as rest, ice and medication — is
sometimes enough to relieve the pain of a torn meniscus and give the
injury time to heal on its own. In other cases, however, a torn meniscus
requires surgical repair.