Although an Athletic Trainer may perform many other tests for the Knee, the focus of our activity will be on the following: Anterior and Posterior Tests and the Valgus/Varus Test.
The evaluation scheme is divided into four broad categories: history, observation, palpation and special tests. (HOPS)
History: Present Injury, Mechanism of Injury, Injury Location, Pain Characteristics, Joint Responses, Determining chronic vs. acute, history of injury
Observation: Is there deformity? Limp? Are movements slow, jerky, asynchronous? Is the patient unable to move the body part? Are there unnatural protrusions or lumps? Postural malalignment?
Palpation: Done by a licensed athletic trainer. Bony palpation, soft tissue palpation, movement assessments, goniometric measurements (done today in class), manual muscle testing, Neurological tests: sensory, reflex, projected vs. referred pain, motor testing
Joint Stability Testing: Accessory, Functional Performance, (done in class today) Postural Examination, Anthropometric and Volumetric measurements.
Special Questions (Region‐specific historical examination)
- Any back or leg pain? (Is pain in a dermatomal region – pain in the knee can be referred from the back)
- Is there hip or ankle pain? (Knee pain can be referred from the hip or biomechanically affected by the ankle)
- Did the patient hear a pop/click at time of injury?
- Does the knee give way? (instability/rupture of ligaments)
- Does the knee lock? (meniscus, true locking associated with bucket handle tears)
- Did the knee swell? How quickly? Where is the swelling? (Intra articular/ extra articular; immediate swelling usually indicates trauma within the knee such as ligament damage)
- Was there bruising? (Immediate bruising indicates significant trauma
- Cough/sneeze cause pain?
- Age – The following conditions are not exclusive to these age groups but a higher prevalence is noted in these populations (elderly – OA?, young – osgoods schlatters, middle aged- meniscal).
- Type of shoes ( wear patterns/age of shoes/proper design)
1. After reviewing the video (provided above), working with a partner, perform the four special tests demonstrated: Anterior/Posterior Tests, and the Valgus/Varus Tests.
2. Discuss your findings with your partner and work collectively to complete your assignment below.
3. Type your answers and submit individually. Describe the technique for each test performed, when the test is used, the ligament the special test is designed to evaluate and discuss the evidence of the result (positive or negative). Please submit your answers to these questions for each of the four (4) tests performed.