Orthopedic Exam / Special Tests for Physical Therapy: KNEE
McMurray’s Test
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
meniscus.
Signs and Symptoms:
Most meniscal injuries can be diagnosed by obtaining a detailed history. Important points to address include: 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).
Provocative maneuvers that may elicit characteristic results in the presence of a meniscal tear include the following:
- Apley test – Pain at the medial or lateral joint
- McMurrays test – Pain or a reproducible click
Special Test: McMurray’s Test
PURPOSE:
- Testing for Injury to the Menisci
Video Demo Instructions, Procedure, Positive Test:
Special Test: McMurrays Test Video Demo (Procedure below)
Special Test: McMurray’s Test: PROCEDURE:
• Patient is supine, their affected hip and knee are flexed
• Therapist cups one hand over the patient’s knee ( palm over the patella and fingers/thumb over the joint line)
• Therapist grasps patient’s heel with the other hand
• Therapist slowly extends the patient’s knee, while applying different stresses ( #s 1 & 2 below) to check both menisci.
1: external rotation of the tibia and valgus stress on the knee to assess medial meniscus
2: internal rotation of the tibia and varus stress on the knee to assess lateral meniscus
Special Test: McMurrays Test: Positive Sign:
- Click or Catch in the extension of the knee. ( A negative test does not completely rule out meniscal tear).