is indicated if the client experiences pain down the leg not being raised. A sciatic nerve impingement is indicated by pain down the client’s leg when the leg is lowered while the foot is Supine to sit test Tests for leg length discrepancy. The client is supine on the table with both legs fully extended. The massage therapist makes a note of each ankle’s malleolus in relation to each other. Client is then asked to sit up while the therapist takes note of any changes in malleolus position. An anterior hip rotation is Thomas test Tests for hypertonicity of the hip flexors. The client will lie supine on the table with their legs fully extended. The client raises the unaffected side into flexion and holds themselves at the knee once they’re at the end of their ROM. Hypertonicity of rectus femoris of the quadriceps group, TFL, sartorius or the iliopsoas Trendelenburg sign test Tests for the strength of the gluteus maximus muscle. The client should be standing for this test. The massage therapist notes the client’s bilateral PSIS and iliac crests. Then the client is asked Ely’s test Tests for hypertonicity of the rectus femoris muscle of the quadriceps group. The client will be in the prone position on the table. The massage therapist passively moves one of the client’s knees into flexion, attempting to touch the client’s heel to their Hamstring length test Tests for the location of a hamstring strain. The client will be in a prone position on the table with their knees flexed to approximately 70 degrees. To assess the medial hamstring muscles, the massage therapist stabilizes the client at the affected side’s hip and heel, then bring the client’s thigh into medial rotation and knee extension while the client resists the movement. Deep pain indicates an injury of the Noble’s test Tests for hypertonicity of TFL and the IT band as a cause of friction against the greater trochanter. The client is in the supine position on the table with their hip and knee both flexed to 90 degrees on the side being tested and asked to hold this position. The massage therapist compresses the area just Anterior and posterior gravity drawer tests Tests for the integrity of the knee’s posterior crucial ligament/ PCL. The client should be in the supine position with their hip flexed to 45 degrees and knees flexed to 90 degrees, feet flat on the table for the knee being tested. The massage therapist places their fingers behind the knee and their thumbs in front of the knee. Then the therapist provides a short and sudden Waldron’s test Tests for patellofemoral pain syndrome aka runner’s knee. The client is asked to stand. The massage therapist palpates the knee being tested while the client goes into and returns from a squatting position. Patella pain syndrome is indicated by pain, crepitus or poor tracking at the patella. Runner’s knee is typically Patellofemoral pain syndrome compression test Tests for patellofemoral pain syndrome aka runner’s knee. The client should be supine on the table with their legs fully extended. The massage therapist compresses the top of the affected patella posteriorly and inferiorly while asking the client Major effusion test Tests for increased synovial fluid or blood under the knee cap. The client should be seated at the edge of the table with lower legs dangling. The client is asked to bring their affected leg into full extension (straight legged). If client is unable to complete the extension, the massage therapist will continue to extend
dorsiflexed. If a herniated disc is the source of dysfunction, the therapist will not attempt to correct the hernia and will not move the client through any ROM at their hips.
indicated on the leg side that becomes longer while a posterior hip rotation is indicated on the leg side that becomes shorter. Treat hip flexors for the longer leg and extensors of the spine, such as the erector spinae group, for the shorter leg.
is indicated if the client’s knee on the side being tested raises off the table. Hypertonicity of the iliopsoas is further indicated by a resting anterior tilt to the pelvis, while hypertonicity of TFL may be indicated by the leg being tested going into abduction.
to stand on one leg of the side being tested. A weak gluteus maximus muscle is indicated if the PSIS or iliac crest of the side being tested moves inferiorly.
gluteal muscles. A hypertonic rectus femoris muscle is indicated if the hip on the side being testing goes into flexion during the test. The AIIS and the patellar tendon should be checked for hypertonicity in addition to the muscle belly. semimembranosus muscle while superficial pain indicates and injury to the semitendinosus muscle. To assess the lateral hamstrings, the therapist will bring the client’s thigh into lateral rotation and knee extension while the client resists the movement. Deep pain indicates an injury to the short head of the biceps femoris while superficial pain indicates an injury to the long head of the biceps femoris. proximal to the greater trochanter of the affected hip. The client slowly lowers their thigh and leg, controlling their hip and knee during extension. Friction against the greater trochanter is indicated by pain at the greater trochanter when the hip and leg are at or below 30 degrees from the table top.
ORTHOPEDIC TESTS FOR THE KNEE
draw of the leg anteriorly. An injured PCL is indicated by posterior knee pain during the movement or by more than a few millimeters of movement of the tibia as it is drawn forward. This test can be conducted by pushing the leg posteriorly in the same manner with the same results indicating an injury to the PCL. caused by damage to the articulating cartilage underneath the patella or the tendon surrounding the patella. Hypertonicity of the quadriceps may be a factor in this condition but is rarely the source of the chronic pain commonly associated with runner’s knee.
to contract their quadriceps. Apprehension, pain, crepitus or the inability to complete the test on the client’s knee indicate a positive sign for patellofemoral pain syndrome.
the knee to completion. If the patella “pops” onto the femur and then into a floating position – confirmed by palpation – this constitutes fluid beneath the patella and is considered a medical emergency. The client should be referred to their physician immediately.
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