Orthopedic Exam / Special Tests for Physical Therapy: KNEE
Apley’s Distraction Test Overview: Collateral Ligament Injuries
The knee is the largest joint in your body and one of the most complex. It is also vital to movement. Your knee ligaments connect your thighbone to your lower leg bones. Knee ligament sprains or tears are a common sports injury. Athletes who participate in direct contact sports like football or soccer are more likely to injure their collateral ligaments.
Three bones meet to form your knee joint: your thighbone (femur), shinbone (tibia), and kneecap (patella). Your kneecap sits in front of the joint to provide some protection.
Bones are connected to other bones by ligaments. There are four primary ligaments in your knee. They act like strong ropes to hold the bones together and keep your knee stable.
Cruiciate ligaments are found inside your knee joint. They cross each other to form an “X” with the anterior cruciate ligament in front and the posterior cruciate ligament in back. The cruciate ligaments control the back and forth motion of your knee.
Collateral ligaments are found on the sides of your knee. The medial or “inside” collateral ligament (MCL) connects the femur to the tibia. The lateral or “outside” collateral ligament (LCL) connects the femur to the smaller bone in the lower leg (fibula). The collateral ligaments control the sideways motion of your knee and brace it against unusual movement.
Special Test: Apley’s Distraction Test
- To test for the integrity of the Collateral Knee Ligaments
Video Demo Instructions, Procedure, Positive Test:
Special Test: Apleys Distraction Test Video Demo (Procedure below)
Special Test: Apleys Distraction Test: PROCEDURE:
• Patient is prone, with their affected knee flexed 90°
• Therapist places their own knee on patient’s posterior thigh to stabilize
• Therapist grasps patient’s leg proximal to the ankle
• Therapist applies traction to the tibia towards the ceiling (this distracts the knee joint) –then apply internal and external rotation of the tibia while tractioning.
Special Test: Apley’s Distraction Test:Positive Sign:
- Pain on the medial side = medial collateral ligament damage/ injury
- Pain on the lateral side = lateral collateral ligament damage/ injury