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Orthopedic Tests
Name, what for, and how to perform
| Question | Answer |
|---|---|
| What is the Thompson's orthopedic test for? | Testing for a third degree strain or rupture in the Achilles tendon. |
| How do you perform the Thompson's test? | Place client in supine position with feet over the edge of the table, squeeze the affected gastrocs/soleus. |
| What is a positive result for the Thompson's test? | The absence of plantar flexion when the gastroc/soleus are squeezed. |
| What conditions can the Thompson's test be used for? | Strain or Tendinitis. |
| What does the 'Drop Arm' test for? | The integrity of the rotator cuff, especially the supraspinatus muscle or tendon. |
| How is the 'drop arm' test performed? | Place client in seated position, abduct arm to 90 degrees and instruct client to hold this position, then ask client to slowly adduct the arm back to the starting point. |
| What indicates a positive 'drop arm' test? | It is positive if the client is unable to return the arm smoothly and slowly to the side or there is pain on the attempt. |
| What conditions can be tested with the 'drop arm test'? | Strain and tendinitis. |
| What is the purpose of the Spurlings test? | To assess the compression of a cervical nerve root or for facet joint irritation in the lower cervical spine. |
| How do you perform the Spurlings test? | Client seated, stand behind the client, instruct the client to slowly extend side bend and rotate to the affected side, carefully apply pressure downward on the clients head. |
| What is a positive indicator of the Spurlings test? | Radiating pain or other neurological signs on teh affected side. IF there is pain local to the neck it means facet joint irritation. |
| For what conditions would you use the Spurlings test? | Headaches, Whiplash, Torticollis, Frozen Shoulder. |
| What is the vertebral artery test used for? | To assess for circulation deficiency of the vertebral artery at the transverse foreman. |
| How do you perform the vertebral artery test? | Client is in the seated position, instruct the client to rated head fully to one side then extend the neck and hold for 30 seconds. Repeat on other side. |
| What indicates a positive vertebral artery test? | It is positive for ischemia or circulation deficiency if the client complains of feel dizzy or gets a circular motion in the eyes. |
| Which conditions can you test with the vertebral artery test? | Whiplash. |
| What is the swallowing test used for? | To determine whether pain in swallowing is due to pain in the SCM muscle trigger point. |
| How do you perform the swallowing test? | Place client in seated position, palpate the SCM in a pincer grasp and maintain pressure at a tender point, instruct the client to swallow. |
| What indicates a positive test for the swallowing test? | If the pain diminishes while the client swallows the test is positive for TP as the cause of the pain. |
| What conditions do the swallowing test work for? | Whiplash. |
| What is the anterior-posterior drawer test used for? | Cruciate ligaments. |
| How do you perform the a/p drawer test? | Place client in supine position, affected knee at 90 degrees, the hip flexed to 45 degrees and foot flat. Sit on the table anchoring the foot under your thigh. Grasp the tibia with thumbs at the tibial plateau, asses the acl by pulling the tibia towards u |
| What is a positive indication of the A/P test? | IF the tibia moves anteriorly more then 6mm it is positive for ACL and posterior jt capsule damage. |
| How do you use the A/P test to test the posterior cruciate ligament? | Use the same placement at the ACL test but push posteriorly. Excessive motion of the tibia posteriorly = positive for PCL injury. |
| What test can be used to assess for a meniscal injury? | Apley's compression test. |
| How is the Apley's Compession test performed? | Place client in prone position with affected knee at 90 degrees, compress the flexed knee jt and the menisci by pushing the clients foot and tibia down into the table followed by int/ext rotation. |
| What is a positive indication of the Apley's compression test? | If the client reports pain on the medial aspect of the joint the test is positive for medial meniscus damage, if on lateral side = positive for lateral meniscal injury. |
| What test can be used to test Plantar Fascitis?) | Length test for gastrocs and soleus. |
| How do you perform the gastoc length test? | Place client supine with knee is fully extended and heel over the edge of the table, grasp the calcaneous with one hand and stabilize the lateral plantar surface in the other, apply traction with dorsiflexion (prevent evert/invert). |
| What is a positive indication of the gastroc length test? | Reduced dorsiflexion and shortened gastroc. |
| What test can be used to test tendinitis? | If it is rotator cuff - drop arm test. If it is achilles then the Thompson's test. |
| What does the Thompson's test test for? | A third degree strain or rupture of the achilles tendon. |
| How do you perform the Thompson test? | Client supine with feet over the edge of teh table and leg muscles relaxed. Squeeze the affected gastrocs and soleus. |
| What is a positive outcome for the Thompson test? | Absense of plantar flexion when the muscles are squeezed. |
| How do you perform the drop arm test? | Place client in seated position, abduct arm to 90 degrees and instruct the client to slowly adduct. |
| What is a positive outcome for the drop arm test? | If the client is unable to return the arm slowly and smoothly to their side. |
| What does the drop arm test for? | To assess the integrity of the rotator cuff, especially the supraspinatus muscles and tendons. |
| What test can be used to test Bursitis? | The ober's test = Pelvis and the shoulder = Painful arc. |
| What is the purpose of the Ober's test? | To test the length of the ITB and TFL by stretching these structures. |
| How is the Ober's test performed? | Client is sidelying with affected leg up, place affected knee in full extension, and abduction instruct client to relax fully. Allow leg to lower. |
| What is a positive indication of the Ober's test? | If the leg remains abducted past anatomical position. |
| What is the painful arc test used for? | To test for subacromial impingement of the supraspinatus tendon. |
| How is the painful arc test performed? | Instructing the client to slowly abduct the humerus to full range. |
| What is a positive result for the painful arc test? | Pain starting at about 70 degrees of abduction and eases off at about 130 degrees. |
| What tests can be used for Frozen shoulder? | Apleys scratch, Spurlings. |
| What is the Apley scratch test used for? | To assess combined movements of thfushoulder. |
| How is the Apley's scratch test performed? | Client seated, instruct the client to reach behind the head and touch as far down the spine as possible, also reach up the back - then reverse. |
| Is there a positive test for Apley's? | No, but if the hands don't touch it could mean there is restricted movement. |
| What does the Spurling's test do? | Test for compression of a cervical nerve root or for facet joint irritation in the lower c-spine. |
| How do you perform the Spurling's test? | Instruct the client to extend, side bend, and rotate head to affected side. Carefully compress downward. |
| What is a positive indication for Spurlings? | Radiating pain or neurological signs on the affected side. |
| What tests can be used for torticollis? | Compression/distraction and Spurlings. |
| When do you use a cervical compression test? | When the client cannot rotate or extend the head. |
| How is the cervical compression test performed? | Seated, stand behind, when client is in neutral carefully apply compression downward onto the clients head. |
| What is a positive indication of the C-compression test? | Radiating pain or other neurological signs in the affected arm. |
| What is the purpose of the cervical distraction test? | To relieve pressure of the cervical nerve root if there is radiating pain. |
| How is the cervical distraction test performed? | Client is seated, hold head at the occiput and chine, pull up for 30 seconds and then allow cervical muscles to relax. |
| What is a positive result of the cervical distraction test? | If the clients pain is relieved, which indicates reduction of facet joint pressure or muscle spasms. |
| What is a test for pes planus? | Morton's neuroma. |
| How do you perform the test for Morton's neuroma? | Place client seated, compress medial and lateral aspects of the foot at the MTP joints. |
| What is a positive result for Morton's neuroma? | Sharp pain at the location of the neuroma. |
| What are the tests used for ITB contracture? | Ober's and Thomas. |
| How do you perform the Thomas test? | Have client supine with gluteal fold at the end of the table, have a hand at the lumbar spine, have them flex unaffected knee and hip hold and then flex affected knee and hip, hold with both hands. Instruct the client to slowly extend affected leg. |
| What is a positive indication of the Thomas test? | If the client cannot fully touch the table at the posterior knee it is a sign of hip flexor shortness. |
| What are tests for scoliosis? | The functional or structural scoliosis test. |
| What is the purpose of the functional or structural scoliosis tests? | To determine whether spinal curves are structural or functional. |
| How is the functional structural scoliosis test performed? | Have client in standing position, therapist observes as the client AF ROM of the spine lateral bending both sides and flexion. |
| What is a positive indication of structural scoliosis? | IF the curve does NOT correct during lateral bending and is symmetrical. |
| What is a positive indication of functional scoliosis? | The curve CORRECTS when the client bends towards the convex side. |
| What is a test for pes planus? | Morton's neuroma. |
| How do you perform the test for Morton's neuroma? | Place client seated, compress medial and lateral aspects of the foot at the MTP joints. |
| What is a positive result for Morton's neuroma? | Sharp pain at the location of the neuroma. |
| What are the tests used for ITB contracture? | Ober's and Thomas. |
| How do you perform the Thomas test? | Have client supine with gluteal fold at the end of the table, have a hand at the lumbar spine, have them flex unaffected knee and hip hold and then flex affected knee and hip, hold with both hands. Instruct the client to slowly extend affected leg. |
| What is a positive indication of the Thomas test? | If the client cannot fully touch the table at the posterior knee it is a sign of hip flexor shortness. |
| What are tests for scoliosis? | The functional or structural scoliosis test. |
| What is the purpose of the functional or structural scoliosis tests? | To determine whether spinal curves are structural or functional. |
| How is the functional structural scoliosis test performed? | Have client in standing position, therapist observes as the client AF ROM of the spine lateral bending both sides and flexion. |
| What is a positive indication of structural scoliosis? | IF the curve does NOT correct during lateral bending and is symmetrical. |
| What is a positive indication of functional scoliosis? | The curve CORRECTS when the client bends towards the convex side. |
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