OPP Lower Extremity

Tests
FABERE/Patrick
(osteoarthritis, sacroiliac dysfunction, iliopsoas spasm)
-Pt supine, stand on side to be tested, move hip into:
-Flexion, ABduction, External Rotation, then Extension
-place hand on knee with downward force and other hand
stabilizing pelvis of ASIS (figure 4 test)

FADIR
(labral tear, early osteoarthritis & femoroacetabular
impingement)
-Pt supine, Dr on side to be tested, move hip into:
-Flexion, ADduction, and Internal Rotation

Thomas
(contracture of iliopsoas muscle)
-pt supine, flex knees and hips, DR places hands on knees
and allows one leg to return back to table while the other
is stabilized.
-if leg doesn’t lay flat to table, positive test for contracture

Ober
(tight iliotibial band or tensor fascia lata)
-pt lateral recumbent, DR behind, grasp pt leg with caudal
hand and stabilize @ hip w/ cephalic hand.
-flex pt’s knee and extend hip, then have pt drop knee.
-Positive if they remain
abducted (don’t fall
towards midline)

Trendelenberg

(gluteus medius weakness)

-observe pt from behind, have pt stand on one leg

and watch hip on non-standing side,

-NEGATIVE (left): should rise above pelvis or stay

even to the stance
-POSITIVE (right): non-stance hip will drop because the gluteus
medius contralateral to lifted foot can’t pelvis up

Lachman
(Evaluates ACL integrity)
Pt supine, DR on side to test facing head, bend knee to 20-30º with cephalad hand
on distal thigh and caudal hand on calf below knee joint. stabilize posterior distal
femur w/one hand
Pull anteriorly on the proximal tibia anteriorly w/ the other hand
-laxity = positive test

Knee Anterior Drawer

ACL evaluation. Bend the knee to 90 degrees
stabilize the ankle w/your hip or thigh and
pull anteriorly on the proximal tibia

Knee Posterior Drawer

Evaluate PCL, Pt supine, knee flexed to 90, foot stabilized.
Push superiorly on proximal tibia. Watch for Dropback
Phenomenon-tibia subluxes posteriorly(concave
appearance)

Godfrey
PCL evaluation. Hip and knee flexed to 90
Tibia will fall posteriorly with PCL tears

Patellar Grind
(Assessment of Post. patella articulatory surface)
(+) test indicates: Chondromalacia patellae, Patellofemoral
Syndrome Passive- Apply Ant—> Post pressure on patella and
rock the patella across the femoral condyles. Pain is (+)
Patellar Grind w/patient assist- Active, apply AP pressure on patella and instruct pt
to contract quads. this pulls the patella superior across
the condyles. Pain is (+)

Bulge
W/ cephalad hand superior to the patella, compress
tissues inferiorly toward knee.
-Fluid will bulge, creating a positive test

Ballotment
Apply downward(A to P)
compression to the patella.
In a normal knee patella moves directly onto
the femoral condyle. In knee w/effusion patella is floating
and ballotment results in boggy sensation.

Apley Compression/Distraction
Compression
Assesment of torn meniscus
compression w/internal or external rotation

Distraction
Assessment of ligamentous disorder
Traction w/internal or external rotation

Varus/Valgus
Varus
Assessment of MCL
Valgus
Assessment of LCL

McMurray
Assessment for Medial and Lateral mesiscal tears
Medial:
begin w/tibia externally rotated, hip abducted and flexion.
Adduct and extend hip and knee while applying a valgus force with the cephalad
hand and maintaining tibia external rotation for medial meniscus tears.
ER of the tibia move medial meniscus anteriorly making it more vulnerable, while
the adduction and valgus stress open the medial joint line. The extension then

closes the joint line to try to clasp down on a piece of torn meniscus.

Lateral:
begin with tibia internally rotated, hip adducted and flexed. Abduct and extend hip
and knee applying a varus force with the cephalad hand while maintaining tibial
internal rotation for lateral meniscus tears.
IR of the tib moves the lateral meniscus anteriorly,
making it vulnerable, while the abduction and varus

stress open the lateral joint line. The extension then closes the joint line to try to
clasp down on a piece of torn meniscus.

Thompson
Pt prone
knee flexed to 90
Calf muscle mass squeezed and the ankle will plantar flex
if the achilles tendon is ruptured when the calf musculature is squeezed plantar
flexion will be absent

Ankle Anterior Drawer

slight plantar flexion
Cephalad hand stabilizes leg
Caudad hand translates foot forward from the
calcaneous
Translation > 8mm (+)
Talar Tilt
Slight plantar flexion
Cephalad hand on proximal leg
Caudad hand on hind foot
Apply an inversion force to the ankle
(+) test shows lack of normal joint end feel

Morton Squeeze
Pressure applied across
the metatarsals of the
affected foot in an effort to impinge the neuroma
Pain or reproduction of sx is (+) test