1. SPECIAL TESTS

2. CERVICAL

3. Foraminal Compression Test
Px: Sitting
(+) sign: pain radiates to arm toward which head is side flexed
Significance: Cervical Nerve Root Compression
Procedure:
First Phase: compress with head in neutral position
Second Phase: compress with head extended
Third Phase: compression with head extended and rotated to
unaffected side.
Othes name: Spurling’s Test

4. Shoulder Depression Test
Px: sitting
(+) sign: increase pain
Significance: Nerve Root Compression
Procedure:
side flex patient’s head on unaffected side then
apply a downward pressure on the opposite
shoulder (affected side).

5. Shoulder Abduction Test
Px: sitting
(+) sign: relief of symptoms
Significance: Nerve Root Compression
Procedure:
abduct patients arm then rest hand or forearm on
top of the head.

6. Distraction Test
Px: Sitting
(+) sign: relief of Pain
Significance: Pressure on the Nerve Roots
Procedure:
place one hand under the patient’s chin and the
other around the occiput. Slowly lift the head,
applying traction to the cervical spine.

7. Lhermitte’s Sign
Px: Long Sitting position
(+) sign: pain radiating down the spine
Significance: Dural or Meningeal Irritation
Procedure:
Flex the patient’s head and one hip simultaneously
with the leg kept straight.

8. Jackson’s Test
Px: sitting
(+) sign: Pain Radiates into the arm
Significance: Cervical Nerve Root Compression
Procedure:
Rotates patient’s head to one side and apply a
downward pressure on the head.

9. Scalene Cramp Test
Px: sitting
(+) sign: increase pain
Significance: Plexopathy / Thoracic Outlet Syndrome
Procedure:
Patient actively rotates the head to the affected side
and pulls chin down into the hollow above the
clavicle by flexing the cervical spine

10. Valsalva Test
Px:
(+) sign: increase pain
Significance: increase intrathecal pressure
Procedure:
Patient takes a deep breath and hold it while
bearing down, as if moving bowels

11. Tinel’s Sign
Px: sitting with neck slightly flexed
(+) sign: localized pain
Significance: cervical plexus lesion
Procedure:
Tap the area of the Brachial Plexus with a finger
along the nerve trunks.

12. Brachial Plexus Compression Test
Px: sitting
(+) sign: pain radiates into the shoulder
Significance: Mechanical cervical lesions having a
mechanical component
Procedure:
Apply firm compression to the brachial plexus by
squeezing the plexus under the thumb or fingers

13. Upper Limb Tension Test 1
(ULTT1)

14. Upper Limb Tension Test 2
(ULTT2)
Shoulder: Depression and abduction (10⁰)
Elbow: Extension
Forearm: Supination
Wrist: Extension
Fingers and Thumb: Extension
Shoulder: Lateral Rotation
Cervical Spine: Contralateral side flexion
Nerve Bias: Median Nerve, Axillary Nerve,
Musculocutaneous Nerve

15. Upper Limb Tension Test 3
(ULTT3)
Shoulder: Depression and abduction (10⁰)
Elbow: Extension
Forearm: Pronation
Wrist: Flexion and Ulnar deviation
Fingers and Thumb: Flexion
Shoulder: Medial Rotation
Cervical Spine: Contralateral side flexion
Nerve Bias: Radial Nerve

16. Upper Limb Tension Test 4
(ULTT4)
Shoulder: Depression and abduction (90⁰)
Elbow: Flexion
Forearm: Supination
Wrist: Extension and Radial deviation
Fingers and Thumb: Extension
Shoulder: Lateral Rotation
Cervical Spine: Contralateral side flexion
Nerve Bias: Ulnar Nerve, Nerve Roots C8 and T1

17. Romberg’s Test
Px: Standing
(+) sign: Swaying
Significance: Upper Motor Neuron Lesion (UMNL)
Procedure:
Patient stands and is asked to close their eyes and
hold the position for 20-30 seconds.

18. Vertebral Artery Test
Px: Supine
(+) sign: Dizziness / Nystagmus
Significance: Compression of Vertebral Arteries
Procedure:
Move patient’s head out and neck into extension
and side flexion. Rotate patient’s head to the same
side and hold for 30 seconds.

19. Naffziger’s Test
Px: Sitting
(+) sign: Pain
Significance: Nerve Root problem or Space Occupying
Lesion
Procedure:
Compress patient’s jugular veins for 30 seconds
then ask the patient to cough.

20. Caloric Test
Px:
(+) sign: Vertigo
Significance: Inner ear problem
Procedure:
Alternately apply hot and cold test tubes several
times just behind the patient’s ear on the side of the
head.

21. Sharp Purser Test
Px:
(+) sign: PT feels the head slide backwards during the
movement
Significance: Subluxation of the atlas on the axis
Procedure:
Place one hand over the patient’s forehead while
the thumb of the other hand is placed over the
spinous process of the axis to stabilize it. Patient
slowly flexes the head while PT presses backward
with the palm.

22. SHOULDER

23. Load and Shift Test
Px: sitting relaxed on the chair
(+) sign:
a.
b.
c.
d.
Normal Laxity = 1-25%
Grade 1 = head rides over the glenoid rim (25-50%)
Grade 2 = head over rides the rim but reduces (>50%)
Grade 3 = head over riding the rim and remains dislocated
Significance: traumatic problems at the glenohumeral Joint
Procedure:
Grasp the humeral head and stabilize the shoulder. Seat the
humerus on the glenoid fossa and puch anteriorly and
posteriorly to check for instability.

24. Apprehension Test
Px: supine; shoulder abducted 90 and externally
rotated
(+) sign: pain and apprehension
Significance: for traumatic instability problems
Procedure:
Slowly apply lateral rotation on shoulder.
Other name: Crank Test

25. Fulcrum Test
Px: supine; shoulder abducted 90 and externally
rotated
(+) sign: pain and apprehension
Significance: for traumatic instability problems
Procedure:
Place a hand under the Glenohumeral Joint then
apply lateral rotation.
* a modification of Crank Test

26. Fowler Sign
Px: supine; shoulder abducted 90 and externally rotated
(+) sign: relief of pain and apprehension
Significance: posterior internal impingement / traumatic
instability problems
Procedure:
Apply a posterior directed force to the head of the humerus
then further external rotation becomes possible
Other name: Jobe Relocation Test

27. Surprise Test
Px: supine; shoulder abducted 90 and externally rotated
(+) sign: pain and forward translation of the humeral head
Significance: for traumatic instability problems
Procedure:
Perform “Fowler’s Sign”, after further external rotation,
release the posterior force
Other name: Anterior Release Test

28. Rockwood Test
Px: sitting
(+) sign:
90⁰ - marked apprehension
45⁰ & 120⁰ - some uneasiness and pain
Significance: Anterior Instability
Procedure:
shoulder is abducted to 45⁰, 90⁰, then 120⁰. Then
apply external rotation to each angle.

29. Rowe Test
Px: Supine; hand behind the head
(+) sign: apprehension (Pain) | clunk or grinding sound
Significance: Anterior Instability | Torn anterior labrum
Procedure:
place clenched fist on the posterior humeral head
then apply downward force while arm extends.

30. Andrew’s Anterior Instability Test
Px: supine; shoulder abducted 130⁰, external 90⁰
(+) sign: apprehension (Pain) | clunk or grinding sound
Significance: anterior instability | anterior labral tear
Procedure:
stabilize elbow and humerus then grasp the humeral
head and lift it forward.

31. Anterior Drawer Test
Px: supine; abducted 80⁰ - 120⁰, flexed 20⁰, externally
rotated 30⁰, hand on PT’s axilla
(+) sign: apprehension (Pain) | click sound
Significance: anterior instability | anterior labral tear
Procedure:
stabilize scapula, pushing the spine forward using
index and middle finger. Apply a counter pressure
on the coracoid then draw the humerus forward

32. Protzman Test
Px: sitting; abducted 90⁰, supported on the PT’s hip
(+) sign: pain
Significance: Anterior Instability
Procedure:
Palpate anterior head with one hand, other hand on
patient’s axilla. Push humerus anteriorly and
inferiorly.

33. Dugas Test
Px: sitting
(+) sign: Pain / inability to do the command of the PT
Significance: Anterior Dislocation
Procedure:
Ask patient to place one hand on opposite shoulder
and to lower the elbow to the chest.

34. Posterior Apprehension Test
Px: supine; elevate shoulder to 90⁰
(+) sign: Apprehension
Significance: Posterior Shoulder Instability
Procedure:
Apply posterior force on the elbow then horizontally
adduct and internally rotate the shoulder.
Other name: Stress Test

35. Push-Pull Test
Px: supine; shoulder abducted 90⁰, flexed 30⁰
(+) sign: >50% translation, pain/apprehension
Significance: Posterior Instability
Procedure:
Hold patient’s arm on the wrist and humerus. Pull
on the arm at the wrist while pushing down on the
humerus with the other hand.

36. Jerk Test
Px: sitting, shoulder flexed 90⁰ and internally rotated
(+) sign: Sudden jerk or clunk
Significance: Recurrent Posterior Instability
Procedure:
Grasp patient’s elbow and axially load the humerus
proximally. Maintain axial load then move arm to
horizontal arm to horizontal adduction with internal
rotation.

37. Inferior Shoulder Instability Test
Px: standing relaxed
(+) sign: sulcus sign
+1 = <1cm
+2 = 1-2cm
+3 = >2cm
Significance: inferior instability / glenohumeral laxity
Procedure:
grasp the patient’s elbow then pull it distally.
Other name: Sulcus Sign

38. Feagin Test
Px: standing; shoulder abducted 90⁰ on PT’s shoulder
(+) sign: Presence of sulcus on coracoid process /
apprehension
Significance: Multidirectional Instability
Procedure:
close hands over the humerus and push down and
forward.

39. Rowe Test for Multidirectional Instability
Px: stands forward flexed 45⁰ at the waist with arms pointing to
the floor.
(+) sign: sulcus sign
Significance: Multidirectional Instability
Procedure: hand on the px’s shoulder index and middle finger
(anterior) thumb (posterior)
Anterior: Shoulder extended 20⁰-30⁰, then push anteriorly
Posterior: Shoulder flexed 20⁰-30⁰, then push posteriorly
Inferior: Shoulder flexed 20⁰-30⁰, then push posteriorly and
apply traction

40. Clunk Test
Px: supine
(+) sign: clunk / grinding sound
Significance: Tear of the Labrum (Bankart)
Procedure:
One hand on posterior aspect of shoulder, one hand
holds the humerus above elbow. Fully abduct arm
over the px’s head. Push anteriorly with the hand
over the humeral head (place a fist under the GH
joint) . Other hand rotates the humerus into lateral
rotation.

41. Biceps Tension Test
Px: standing; shoulder abducted 90⁰, elbow extended;
forearm supinated
(+) sign: reproduction of symptoms
Significance: SLAP lesion
Procedure:
apply eccentric adduction force

42. Biceps Load Test
Px: supine; shoulder abducted 90⁰ and external rotate;
elbow flexed 90⁰; forearm supinated
(+) sign: Apprehension does not disappear
Significance: integrity of superior labrum
Procedure:
Fully externally rotate shoulder until apprehension,
stop external rotation and hold the position. Then
patient resist elbow flexion at the wrist.

43. SLAP Prehension Test
Px: sitting
(+) sign:
first = painful
second = relief of pain
Significance: SLAP Lesion
Procedure:
Patient actively abducts shoulder 90⁰; Forearm pronated
then horizontally adducts.
Then abducts shoulder 90⁰; Forearm supinated,
horizontally adducted

44. Lateral Scapular Slide Test
Px: sitting / standing with arms at the side
(+) sign: >1-1.5cm difference from the original
measure
Significance: Scapular Instability
Procedure:
Measure distance from spine to scapula to T2/T3,
inferior angle to T7-T9 or superior angle to T2
* Test patient in shoulder abd: 45⁰, 90⁰, 120⁰ and 150⁰

45. Wall Push Up Test
Px: standing, arms length on the wall
(+) sign: winging within 5-10reps of push-up
Significance: weakness of scapular muscles
Procedure:
ask patient to do 15-20 wall push ups

46. Closed Kinetic Chain Upper Extremity Stability Test
Px: prone; on the floor at arms length with hands 36
inches apart.
(+) sign: winging of the scapula
Significance: weakness of scapular muscles
Procedure:
patient touches the other hand then returns to
original position. This is done for 15 seconds while
PT counts how many reps the patient is able to do.

47. Acromioclavicular Shear Test
Px: Sitting
(+) sign: abnormal movement of at the AC joint
Significance: Acromioclavicular joint Pathology
Procedure:
Cup hands over the deltoid, one on the clavicle and
one on the scapula. Squeeze both hands together.

48. Ellman’s Compression Rotary Test
Px: side lying on unaffected side
(+) sign: pain reproduction
Significance: Glenohumeral Arthritis
Procedure:
Compress humeral head while patient rotates the
shoulder medially and laterally.

49. Speed’s Test
Px: Standing
(+) sign: Pain on Bicipetal Groove | Pain | weakness
Significance: Bicipital Tendonitis | SLAP II | rupture
biceps
Procedure:
Resist shoulder extension by patient first in
supination then in pronation with elbow extension.
Other names: Biceps Test / Straight Arm Test

50. Yergason’s Test
Px: sitting/standing; elbow 90⁰, forearm pronated
(+) sign: pain/tenderness | popping out of goove
Significance: Bicipital Tendonitis | torn transverse
humeral ligament
Procedure:
resist supination while px externally rotates
shoulder.

51. Ludington’s Test
Px: sitting; clasp hands behind head
(+) sign: no contraction evident/palpable
Significance: torn Long Head of Biceps
Procedure:
ask px to contract the biceps.

52. Gilchrest’s Test
Px: Standing
(+) sign: pain on Bicipital Groove
Significance: Bicipital Paratendonitis
Procedure:
ask px to lift 2-3kg/5-7lbs of weight over head with
the arm in external rotation.

53. Lippman’s Test
Px: sitting/standing
(+) sign: sharp pain on the bicipital groove
Significance: Bicipital Tendonitis
Procedure:
Hold px arm and flex to 90⁰ with one hand, other
hand palpates the biceps tendon 7-8cm below the
glenohumeral joint. Then move the biceps tendon
side to side.

54. Heuter’s Sign
Px: sitting; Forearm pronated
(+) sign: absence of elbow supination
Significance: ruptured distal biceps tendon
Procedure:
Resist elbow flexion with the forearm pronated.

55. Supraspinatus Test
Px: standing; shoulder is abducted 90⁰
(+) sign: pain | weakness
Significance: torn supraspinatus | neuropathy of
suprascapular nerve
Procedure:
shoulder is internallyy rotated and angled forward
30⁰, thumb pointing to the floor, then resist.
Other names: Empty Can Test / Jobe Test

56. Drop Arm Test
Px: standing; shoulder abducted 90⁰
(+) sign: inability to return arm to side slowly
Significance: Rotator Cuff Tear
Procedure:
ask px to slowly lower arms to the side with some
arc movements.
Other Names: Codman’s Test

57. Lateral Rotation Lag Sign
Px: seated/standing; arms at the side
(+) sign: cannot hold the position | pain | increase
internal rotation on affected side.
Significance: torn supraspinatus, infraspinatus and
subscapularis
Procedure:
passively abducts shoulder to 90⁰, elbow flexed to
90⁰ and externally rotate. Px holds the position.
Other Names: Infraspinatus “Spring Back” Test

58. Hornblower’sTest
Px: standing; shoulder flexed to 90⁰, elbow flexed to
90⁰
(+) sign: inability to external rotate the shoulder
Significance: tear on the teres minor
Procedure:
px external rotates with resistance.

59. Infraspinatus Test
Px: standing, arm on the side with elbow 90⁰
(+) sign: pain / inability to resist internal rotation
Significance: infraspinatus strain
Procedure:
Apply a internal rotation force that the px resist.

60. Teres Minor Test
Px: prone; with one hand on the iliac crest
(+) sign: pain and weakness
Significance: Teres Minor strain
Procedure:
ask px to extend and adduct shoulder against
resistance.

61. Pectoralis Major Contracture Test
Px: supine; hands clasps behind head
(+) sign: elbows do not reach the table
Significance: Tight Pectoralis Major
Procedure:
Lower arm until elbows tough the table

62. Lift Off Sign
Px: standing; dorsum of hand on back pocket
(+) sign: inability to lift hand off back
Significance: Subscapularis Lesion
Procedure:
ask px to lift hand away from the back.

63. Neer-Impingement Test
Px: sitting
(+) sign: Pain
Significance: overuse injury to the supraspinatus
muscle
Procedure:
Px arm is passively and forcibly fully elevated and
shoulder is internally rotated.

64. Hawkin’s Kennedy Impingement Test
Px: standing / sitting
(+) sign: pain
Significance: supraspinatus tendonitis
Procedure:
flex shoulder to 90⁰ then medially rotate the
shoulder

65. Coracoid Impingement Test
Px: standing / sitting
(+) sign: pain
Significance: supraspinatus tendonitis
Procedure:
flex shoulder to 90⁰, horizontally adduct to 10⁰-20⁰
then medially rotate the shoulder
*a modification of Hawkin’s Kennedy Test

66. Yocum Test
Px: standing / sitting
(+) sign: pain
Significance: supraspinatus tendonitis
Procedure:
Px places hand on the opposite shoulder then PT
elevates the elbow.
*a modification of Hawkin’s Kennedy Test

67. Tinel’s Sign at the Shoulder
Px: sitting
(+) sign: tingling sensation
Significance: Peripheral Nerve Injury
Procedure:
tap on the scalene triangle on the area of the
brachial plexus

68. Adson’s Maneuver
Px: sitting with head on the ipsilateral
(+) sign: disappearance of pulse
Significance: Thoracic Outlet Syndrome
Procedure:
Locate radial pulse, external rotate and extend the
shoulder and instruct px to take a deep breath and
hold it.

69. Allen Maneuver
Px: sitting with head on the contralateral side
(+) sign: disappearance of pulse
Significance: Thoracic Outlet Syndrome
Procedure:
Elbow is flexed to 90⁰, shoulder is extended and
externally rotated horizontally, palpate the radial
side.

70. Halstead Maneuver
Px: neck is hyper extended rotated on contralateral
side
(+) sign: disappearance of Radial Pulse
Significance: Thoracic Outlet Syndrome
Procedure:
Find the radial pulse, apply downward traction on
the extremity.

71. Roos Test
Px: shoulder abducted 90⁰; elbow flexed 90⁰,
externally rotate
(+) sign: ischemic pain, heaviness, weakness
Significance: Thoracic Outlet Syndrome
Procedure:
ask px to close and open hands for 3mins
Other names: Aer Test / Hands-up Test

72. Wright Test
Px: shoulder hyper abducted, elbow extended and
externally rotated
(+) sign: Disappearance of pulse
Significance: Thoracic Outlet Syndrome
Procedure:
Instruct px to take a deep breath while palpating for
the radial pulse.

73. Costoclavicular Test
Px:
(+) sign: disappearance of pulse
Significance: Thoracic Outlet Syndrome
Procedure:
Locate radial pulse, draw shoulder down and back.
Other Name: Military Base

74. ELBOW

75. Ligamentous Valgus Instability
Test
Px: sitting; elbow flexed 90⁰
(+) sign: decrease laxity / pain
Significance: Valgus Instability (medial collateral
ligament)
Procedure:
Stabilize elbow with 1 hand and above px’s wrist
with the other. Apply an abd. Force to the distal
forearm.

76. Milking Maneuver
Px: sitting; elbow flexed 90⁰, forearm supinated
(+) sign: Reproduction of Symptoms
Significance: Partial tear to the medial collateral
ligament
Procedure:
Graps the px’s thumb and pull it importing a valgus
stress to the elbow

77. Ligamentous Varus Instability Test
Px: elbow slightly flexed
(+) sign: laxity, soft end feel
Significance: injury to the lateral collateral ligament
Procedure:
Stabilize arm and apply varus force to the distal
forearm.

78. Posterolateral Rotary Drawer Test
Px: supine, arm over head; elbow flexed 40⁰ - 90⁰
(+) sign: reproduction of symptoms
Significance: tear on the lateral collateral ligament /
posterolateral instability at the elbow
Procedure:
Stabilize the humerus, radius and ulna is pushed
posterolaterally.

79. Stand-Up Test
Px: seated on a chair w/ no arm rests; forearm
supinated
(+) sign: reproduction of symptoms
Significance: injury to the posterior band of medial
collateral ligament
Procedure:
instruct px to lift bottom off of the seat using
his/her arms.

80. Lateral Epicondylitis (Method 1) Test
Px: sitting; elbow flexed 90⁰; forearm supinated
(+) sign: pain
Significance: Tennis Elbow Epicondylitis
Procedure:
Palpate the lateral epicondyle. Ask the px to make a
fist , pronate forearm, radially deviate and extend
the wrist while PT resist the motion.
Other names: Tennis Elbow or Cozen’s Test

81. Lateral Epicondylitis (Method 2) Test
Px: sitting; elbow flexed 90⁰; forearm supinated
(+) sign: pain
Significance: Tennis Elbow Epicondylitis
Procedure:
Palpate the lateral epicondyle. Passively pronate the
px’s forearm; flex the wrist fully and extend the
elbow.
Other names: Tennis Elbow or Mill’s Test

82. Lateral Epicondylitis (Method 3) Test
Px: sitting; elbow flexed 90⁰; forearm pronated
(+) sign: pain
Significance: Tennis Elbow Epicondylitis
Procedure:
Resist the extension of the 3rd digit of the hand.
Distal to proximal interphalangeal joints.
Other names: Tennis Elbow Test

83. Medial Epicondylitis Test
Px: sitting; elbow flexed 90⁰; forearm pronated
(+) sign: pain
Significance: Golfer’s elbow medial epicondylitis
Procedure:
Palpate the medial epicondyle. Px’s forearm is
passively supinated and the PT extends the elbow
and wrist.
Other names: Golfer’s Elbow

84. Tinel’s Sign at the Elbow
Px: sitting with the elbow flexed
(+) sign: Tingling Sensation
Significance: Regeneration of Fibers
Procedure:
tap the ulnar nerve.

85. Wartenberg’s Sign
Px: sitting with hands resting on the table
(+) sign: Inability to squeeze little finger
Significance: Ulnar Nerve Neuropathy
Procedure:
Passively spread the fingers apart and ask the
patient to them together

86. Elbow Flexion Test
Px:
(+) sign: Tingling or paresthesia in the ulnar nerve
distribution of the forearm and
Significance: Cubital Tunnel Syndrome
Procedure:
Fully flex the elbow, wrist extended, shoulder is
abducted and depressed. Hold this position for 3-5
minutes.

87. Test for Pronator Teres Syndrome
Px: sitting; elbow flexed 90⁰
(+) sign: Tingling or paresthesia in the median nerve
distribution
Significance: Pronator Teres Syndrome
Procedure:
Resist pronation and the patient extends.

88. Pinch Grip Test
Px:
(+) sign:
Normal: tip-to-tip
Abnormal: pulp-to-pulp
Significance: Entrapment of the Anterior Interosseous
nerve
Procedure:
ask the patient to pinch the tips of the index and
thumb together.

89. FOREARM, WRIST &
HAND

90. Test for Tight Retinacular
Ligament
Px: PIP joint is in neutral | PIP joint is flexed
(+) sign: (-) flexion | (+) flexion
Significance: Collateral ligaments or Capsule is tight |
Only the collateral ligament is tight
Procedure:
Flex the distal interphalengeal joint.
Other Name: Haines-Zancolli Test

91. Lunotriquetral Ballottement Test
Px:
(+) sign: Pain, Laxity, Crepitus
Significance: Lunotriquetral Instability
Procedure:
Grasp the triquetrium and lunate. Move the lunate
anteriorly and posteriorly.
Other Name: Reagan’s Test

92. Finger Extension Test
Px: Sitting; wrist in flexion
(+) sign: Pain
Significance: Radiocarpal or midcarpal instability,
scaphoid instability, inflammation, Kienböck’s
Disease
Procedure:
Hold the px’s wrist and ask the px to extend the
fingers. Resist movement at he radiocarpal joints.
Other Name: Shuck Test

93. Murphy’s Sign
Px:
(+) sign: 3rd MCP joint is in line with and 2nd and 4th MCP
joint.
Significance: Lunate Dislocation
Procedure:
Ask the px to make a fist.

94. Watson Test
Px: Sitting; Forearm is pronated on the lap
(+) sign: Pain
Significance: Scaphoid Subluxation
Procedure:
Ulnar deviate the wrist with slight extension.
Stabilize the scaphoid. Radially deviate and slightly
flex the hand.
Other Name: Scaphoid Shift Test

95. Piano Keys Test
Px: sitting; forearm pronated
(+) sign: Difference in Mobility, pain and tenderness
Significance: Distal radioulnar joint instability
Procedure:
Push down the distal ulna

96. Finkestein Test
Px: Make a fist with the thumb inside the fingers
(+) sign: pain over the abductor pollicis longus and
extensor pollicis brevis tendons
Significance: Hoffmann’s disease, de Quervain’s
disease, paratendonitis in the thumb
Procedure:
Stabilize forearm and ulnar deviate the wrist.

97. Sweater Finger Sign
Px:
(+) sign: (-) flexion of one of the distal phalanx
Significance: Ruptured flexor digitorum profundus
tendon
Procedure:
Instruct px to make a fist

98. Test for Extensor Hood Rupture
Px: Flex PIP of finger 90⁰ at the edge of the table
(+) sign: Little Pressure from the middle phalanx
Significance: Torn Central Extensor Hood
Procedure:
Ask the px to extend the proximal interphalangeal
joint while PT palpates for the middle phalanx

99. Boyes Test
Px:
(+) sign: Unable to flex DIP joints
Significance: torn central extensor hood
Procedure:
Hold finger in slight extension at the PIP joint. Ask px
to flex the DIP joint.

100. Bunnel – Littler Test
Px: a. extend MCP jt.
b. slight flexed MCP jt.
(+) sign: a. (-) flexion
b. fully flexed
c. not fully flexed PIP jt.
Significance:
a. tight intrinsic muscles or contracture of joint capsule
b. intrinsic muscles tightness
c. Contracture of joint capsule
Procedure:
Flex PIP joint.
Other name: Intrinsic Plus , Finochietto – Bunnel

101. Linburg’s Sign
Px:
(+) sign: Loss of Motion, Pain
Significance: Tendinitis at the interconnection
between flexor pollicis longus and flexor indices
Procedure:
Fully flex the thumb then extend the index finger

102. Tinel’s Sign at the Wrist
Px:
(+) sign: Tingling or Paresthesia in the median nerve
distribution
Significance: Carpal Tunnel Syndrome
Procedure:
tap over the carpal tunnel at the wrist.

103. Phalen’s Test
Px:
(+) sign: tingling or paresthesia in the median nerve
distribution
Significance: Carpal Tunnel Syndrome
Procedure:
Flex the wrist maximally and hold for 1 minute.

104. Reverse’s Phalen’s Test
Px:
(+) sign: Tingling or Paresthesia in the median nerve
distribution
Significance: Carpal Tunnel Syndrome
Procedure:
Extend wrist maximally and press the carpal tunnel
for 1 minute.
Other Name: Prayer Test

105. Carpal Compression Test
Px: supinated
(+) sign: tingling or paresthesia in the median nerve
distribution
Significance: Carpal Tunnel Syndrome
Procedure:
Grasp hand then apply direct pressure over the
carpal tunnel for 30 seconds
*a modification of Reverse Phalen’s Test

106. Froment’s Sign
Px: Grasp a piece of paper between thumb and index
(+) sign: thumb flexion | thumb hyperextension
Significance: paralysis of adductor pollicis | Jeanne’s
Sign (Ulnar Nerve Paralysis)
Procedure:
Pull paper away from patient

107. Egawa’s Sign
Px: Flex middle digit
(+) sign: unable to do the motion
Significance: Ulnar Nerve Palsy
Procedure:
Ask the patient to alternately ulnar deviate and
radial deviate the finger

108. Wrinkle Test
Px:
(+) sign: no wrinkling
Significance: Denervated
Procedure:
Place patient’s fingers in warm water for 5-20
minutes

109. Ninhydrin Sweat Test
Px: wait for clean hand to sweat
(+) sign: no color change (Normal: White – purple)
Significance: Nerve Lesion
Procedure:
Moderately press against good quality bond paper
for 15 seconds. Trace with pencil and spray the
paper with triketohydrindene (Ninhydrin) spray.
Leave for 24 hrs to dry.

110. Dellon’s Moving 2-point Discrimination Test
Px: Eyes are closed and the hand is cradled in the
examiners hand
(+) sign: 10 mm difference between the right and left
hand
Significance: measures the quickly adapting
mechanoreceptor system
Procedure:
move 2 blunt points from proximal to distal along the
long axis of the limb or digit, starting with a distance of
8mm b/n the points

111. Allen Test
Px: open and close hand several times.
(+) sign: flushing of the hand
Significance: Patency of the radial and ulnar arteries
(which artery provides the major blood supply to
the hand)
Procedure:
Compress radial and ulnar arteries. Px opens their
hand while pressure is maintained. Release one
artery at a time.

112. Hand Volume Test
Px:
(+) sign: 30-50mL difference between right and left
hands. (Normal = 10mL)
Significance: Swelling, edema (Normal = dominant)
Procedure:
Use a volumeter.

113. THORACIC &
LUMBAR

114. Slump Test 1 (ST1)
Cervical Spine: Flexion
Thoracic & Lumbar Spine: Flexion (slump)
Hip: Flexion (90⁰+)
Knee: Extension
Ankle: Dorsiflexion
Foot: --Toes: --Nerve Bias: Spinal Cord, Cervical and Lumbar Nerve
Roots, Sciatic Nerve

115. Slump Test 2 (ST2)
Cervical Spine: Flexion
Thoracic & Lumbar Spine: Flexion (slump)
Hip: Flexion (90⁰+), Abduction
Knee: Extension
Ankle: Dorsiflexion
Foot: --Toes: --Nerve Bias: Obturator Nerve

116. Side Lying Slump Test (ST3)
Cervical Spine: Flexion
Thoracic & Lumbar Spine: Flexion (slump)
Hip: Flexion (20⁰)
Knee: Flexion
Ankle: Plantar flexion
Foot: --Toes: --Nerve Bias: Femoral Nerve

117. Long Sitting Slump Test (ST4)
Cervical Spine: Flexion, Rotation
Thoracic & Lumbar Spine: Flexion (slump)
Hip: Flexion (90⁰+)
Knee: Extension
Ankle: Dorsiflexion
Foot: --Toes: --Nerve Bias: Spinal Cord, Cervical and Lumbar Nerve
Roots, Sciatic Nerve

118. Straight Leg Raising Test (SLR Basic)
Hip: Flexion + Adduction
Knee: Extension
Ankle: Dorsiflexion
Foot: --Toes: --Nerve Bias: Sciatic Nerve and Tibial Nerve
Other Name: Lasegue’s Test

119. Straight Leg Raising Test 2 (SLR2)
Hip: Flexion
Knee: Extension
Ankle: Dorsiflexion
Foot: Eversion
Toes: Extension
Nerve Bias: Tibial Nerve

120. Straight Leg Raising Test 3 (SLR3)
Hip: Flexion
Knee: Extension
Ankle: Dorsiflexion
Foot: Inversion
Toes: --Nerve Bias: Sural Nerve

121. Straight Leg Raising Test 4 (SLR4)
Hip: Flexion and Medial Rotation
Knee: Extension
Ankle: Plantar Flexion
Foot: Inversion
Toes: --Nerve Bias: Common Peroneal Nerve

122. Cross Straight Leg Raising Test (SLR5)
Hip: Flexion
Knee: Extension
Ankle: Dorsiflexion
Foot: --Toes: --Nerve Bias: Nerve Root (disc prolapse)

123. Basic Prone Knee Bending Test (PKB1)
Cervical Spine: Ipsilateral Rotation
Thoracic & Lumbar Spine: Neutral
Hip: Neutral
Knee: Flexion
Ankle: --Foot: --Toes: --Nerve Bias: Femoral Nerve, L2-L4 nerve roots

124. Prone Knee Bending Test (PKB2)
Cervical Spine: Ipsilateral Rotation
Thoracic & Lumbar Spine: Neutral
Hip: Extension, Adduction
Knee: Flexion
Ankle: --Foot: --Toes: --Nerve Bias: Lateral Femoral Cutaneous Nerve
Other Name: Nachlas Test

125. Prone Knee Extension Test (PKE)
Cervical Spine: --Thoracic & Lumbar Spine: Neutral
Hip: Extension, Abduction, Lateral Rotation
Knee: Extended
Ankle: Dorsiflexion
Foot: Eversion
Toes: --Nerve Bias: Saphenous Nerve

126. Sitting Root Test
Px: Short sitting, neck flexed
(+) sign: Arch back, pain on the buttock, posterior
thigh, and calf.
Significance: Tension on Sciatic Nerve, True Sciatic pain
Procedure:
Passively extend the knee
* a modification of Slump Test

127. Bechterewis Test
Px: Flex neck, extend knee
(+) sign: Pain in the back or leg
Significance: Sciatica
Procedure:
Ask the patient to extend the knee one at a time,
and then both.
* A modification of Sitting Root Test

128. Bowstring Test
Px: Supine or Sitting
(+) sign: Radicular pain (sciatic tension test or
Deyerle’s Sign)
Significance: Sciatica
Procedure:
Flex the hip at pain range, then flex the knee at 20⁰,
apply presure on the popliteal area.
Other Name: Cram Test, Popliteal Pressure Sign.

129. Compression Test
Px: Supine; hip flex (100⁰); knee flex
(+) sign: Radicular Pain on Posterior Leg
Significance: Disc Herniation
Procedure:
Apply axial compression to the spine by applying
direct pressure on the patient’s feet or buttocks.

130. Flip Sign
Px: sitting, then supine
(+) sign: Pain (on both tests)
Significance: Sciatice
Procedure:
Px in sitting: extend knee
Px in supine: unilateral straight leg raising test

131. Babinski Test
Px:
(+) sign: Extension of big toe and abduction of the
other toes.
Significance: Upper Motor Neuron Lesion
Procedure:
Run a pointed object along the plantar aspect of the
px’s foot.

132. Oppenheim Test
Px:
(+) sign: Extension of big toe and abduction of the
other toes
Significance: Upper Motor Neuron Lesion
Procedure:
Run a fingernail along the crest of the tibia

133. Gluteal Skyline Test
Px: Prone; head straight; arms at the side
(+) sign: Flat gluteus muscle=atrophied | less contraction
Significance: damage to the Inferior Gluteal nerve,
pressure on L5, S1 or S2 nerve roots.
Procedure:
Stand on the px’s feet and observe the buttock. Then
ask the px to contract the buttocks

134. H & I Stability Test
Px: Standing
(+) sign: pain on at least 2 segments on the same quadrant | Pain
on 1 segment only and 1 quadrant
Significance: Hypomobile | Instability
Procedure:
Stabilize the pelvis and other hand in shoulder.
“H”: side-flex, forward flex then extend, neutral, repeat with other
side.
“I”: Forward flex, side bending, neutral, repeat with extension.

135. Specific Lumbar Spine Torsion
Test
(example: left L5-S1)
Px: Right Side-Lying with slight extension of lumbar spine
(+) sign: minimal movement is felt, right capsular tissue stretch
Significance: Stress on the Specific Levels
Procedure:
Grasp the left arm then pull upward/forward (45⁰) then
stabilize L5 spinous process by holding the left shoulder back
with the PT’s elbow while rotating the pelvis and sacrum
forward until S1 starts to move with the opposite hand.

136. Farfan Torsion Test
Px: Prone
(+) sign: Reproduction of Symptoms
Significance: Stress the facet jt.. Jt. Capsule,
Interspine/supraspine ligament, neural arch,
longitudinal lig. and disc.
Procedure:
Stabilize the ribs and spine (T12), then the other
hand is placed on the anterior aspect of ilium

137. Pheasant Test
Px: Prone
(+) sign: Pain
Significance: Lumbar Spine Instability
Procedure:
Apply pressure on the lumbar spine, then passively
flex the knee until the heel touches the buttocks.

138. One Leg Standing Lumbar Extension Test
Px: One leg stand
(+) sign: Pain
Significance: Spondylolisthesis
Procedure:
Instruct px to extend the spine while balancing on one
leg.
*If rotation is combined with extension = Facet Joint pathology on which the
rotation occurs.
Other Name: Stork Standing Test

139. Quadrant Test
Px: Standing
(+) sign: Pain or Reproduction of Symptoms
Significance: Facet Joint Pathology
Procedure:
Extend the px’s spine, apply overpressure. Px side
flexes and rotates to the affected side.

140. Shober’s Test
Px: Standing
(+) sign: difference between the two measurements
Significance: Lumbar Spine Mobility
Procedure:
Mark the following points:
a. S2 – Point of reference
b. 5cm/2inches below
c. 10cm/4inches above
measure the distance between the 3 points. Ask px to forward
flex (fingers touching his toes), then measure the distance.

141. Yeoman’s Test
Px: Prone
(+) sign: Pain
Significance: Sacroiliac Joint Dysfunction
Procedure:
Stabilize the pelvis then extend the hip, with knee
flexed and extended

142. Milgram’s Test
Px: Supine
(+) sign: Cannot hold the position or Reproduction of
Symptoms
Significance: Sacroiliac Joint Dysfunction
Procedure:
Instruct px to lift his legs from the table ~ 2-4in (510cm) and hold the position for 30 secs.

143. Beevor’s Sign
Px: Supine, hands behind the head
(+) sign: The umbilicus does not remain in a straight
line
Significance: Abdominal Muscle Paralysis
Procedure:
Px flexes the head against resistance, coughs, or
attempts to sit up.

144. Stoop Test
Px: Sitting or Standing
(+) sign: Relief of Pain
Significance: Neurogenic Intermittent Claudication
Procedure:
After brisk walking, px feels pain in the buttock and
lower limb. Px flexes forward

145. Treadmill Test
Px: on the treadmill
(+) sign: severe symptoms
Significance: Intermitent Claudication
Procedure:
Two trials are conducted:
a. 1.2mph
b. Preferred walking speed
Px walks upright on the treadmill for 15mins/onset of symptoms.
Time to 1st symptoms, total ambulatory time, and precipitating symptoms are
recorded

146. Hoover’s Test
Px: Supine
(+) sign: If the opposite hand doesn’t feel any pressure
Significance: Malingering
Procedure:
Place 1 hand under each calcaneus and ask the px to
lift one leg off of the table

147. Burn’s Test
Px: Kneeling on the chair
(+) sign: Unable to do / overbalances
Significance: Malingering
Procedure:
Bend forward to touch the floor with the fingers

148. Sign of the Buttock
Px: Supine
(+) sign: Hip flexion doesn’t increase
Significance: Pathology in the buttock (tumor, bursitis,
abcess)
Procedure:
Perform passive unilateral straight leg raising test
until restriction. Then Flex the px’s knee

149. PELVIS

150. Straight Leg Raising Test
Px: Supine
(+) sign: Pain >70⁰ | > 120⁰ (hypermobile)
Significance: Sacroiliac Joint Pathology
Procedure:
Flex the px’s hip with the knee extended
Other Name: Lasѐgue’s Test

151. Prone Knee Bending Test
Px: Prone
(+) sign: Pain in:
a. Front of the Thigh
b. Lumbar Spine
c. < 90⁰
Significance:
a. Rectus Femoris Tightness
b. L3 nerve root lesion
c. Sacroiliac Jt. Pathology
Procedure:
Flex the knee until the heel touches the buttocks
Other Name: Nachlas Test

152. Flamingo Test
Px: One Leg Standing
(+) sign: Pain on Pubic Symphysis or SI joint
Significance: Lesion on the Structure
Procedure:
Ask the px to do a one leg stand.
*px may hop, increasing the stress on pubic
symphysis = Stress X-ray

153. Gaenslen’s Test
Px: Side-lying or Supine
(+) sign: Pain
Significance: Ipsilateral Sacroiliac joint lesion, Hip Pathology,
L4 nerve root lesion
Procedure:
Px holds the lower leg flexed against the chest. Stabilize
the hip while hyper extension on the upper leg.

154. Gillet’s Test
Px: Standing
(+) sign: SI jt moves minimally or up
Significance: Hypomobile
Procedure:
Palpate PSIS and ask px to stand on one leg while pulling the
opposite knee towards the chest
Other Name: Sacral Fixation Test

155. Yeoman’s Test
Px: Prone
(+) sign: Pain on SI jt. | Lumbar Pain | Ant. Thigh
Paresthesia
Significance: Anterior SI lig. | Lumbar Pathology |
Femoral Nerve Stretch (L2-L4)
Procedure:
Flex the knee to 90⁰, then extend the hip

156. Leg Length Test
Px: Supine
(+) sign: >1-1.3cm (0.5-1in)
Significance: Leg Length Discrepancy
Procedure:
True Leg Length = measure the ASIS to Lateral
Malleolus
ALL = measure umbilicus to Medial Malleolus

157. Functional Limb Length Test
Px: Standing
(+) sign: assymetry is corrected by correct positioning
Significance: Functional Leg Length Discrepancy
Procedure:
Palpate for the ASIS and PSIS and px is placed in “correct”
stance (subtalar joints neutral, knees fully extended, and
toes facing straight ahead)

158. Sign of the Buttock
Px: Supine
(+) sign: Hip flexion does not increase
Significance: Pathology in the Buttock (tumor, bursitis,
abscess)
Procedure:
Passive unilateral SLR until restriction, then flex the
knee

159. Trendelenburg’s Test
Px: One leg Stance
(+) sign: pelvis falls on the non stance stand
Significance: weakness of the gluteus medius muscle,
superior gluteal nerve lesion, L4-S1 lesion
Procedure:
ask the px to do a one leg stance. Observe the px

160. HIP

161. Ortolani’s Sign
Px: Supine
(+) sign: feels clunk, clink or jerk
Significance: Congenital Hip Dislocation
Procedure:
Grasp the thigh and leg with the thumb on the medial knee and
the fingers alongside the thigh and hip. Flex the hip to 90⁰, then
abduct while lifting it forward
*up to 12wks–6mos.

162. Barlow’s Test
Px: Supine
(+) sign: feels clunk, clink or jerk
Significance: Congenital Hip Dislocation
Procedure:
Grasp the thigh and leg with the thumb on the medial knee and
the fingers alongside the thigh and hip. Flex the hip to 90⁰, then
abduct then adduct while pushing downward
*up to 12wks–6mos.

163. Galeazzi Sign
Px: Supine
(+) sign: One knee is Higher
Significance: Unilateral Congenital Hip Dislocation
Procedure:
Hip and knee is flexed to 90⁰ with feet flat on the table
Other Name: Allis Test
*up to 3–18mos.

164. Telescoping Sign
Px: Supine; Hip and knee flexed to 90⁰
(+) sign: Excessive mov’t upon lifting up
(pistoning/telescoping)
Significance: Congenital Hip Dislocation
Procedure:
Femur is pushed down onto the table. Femur and leg is
then lifted up and away the from the table
Other Name: Piston Test, Dupuytren’s Test

165. Abduction Test
Px: Supine
(+) sign: Asymmetry or Limitation of Movement
Significance: Congenital Hip Dislocation
Procedure:
Hip and knee is flexed to 90⁰, then abducted
Other Name: Hart’s Sign

166. Patrick’s Test
Px: Supine
(+) sign: Test leg’s knee remains above the opposite straight leg
Significance: Hip jt. Pathology, Iliopsoas spasm, SI jt. pathology
Procedure:
Place the test leg on top of the other leg (FABER). Slowly
lower the knee of the test leg.
Other Name: Faber Test, Figure-Four Test, Jansen’s Test

167. Anterior Labral Tear Test
Px: supine
(+) sign: Pain with or without click
Significance: Hip Joint Pathology
Procedure:
Place hip into full FABER, then to EADIR
Other Name: FADDIR Test

168. Craig’s Test
Px: Prone with knee flexed 90⁰
(+) sign: > 15⁰
Significance: Anteversion of Hip
Procedure:
Palpate greater trochanter then medially and
laterally rotate the hip until the greater trochanter is
parallel to the examining table or it reaches it’s most
lateral position.
Other Name: Ryder Method

169. Torque Test
Px: Supine, with the test leg over the edge of the table
(+) sign: Yield
Significance: Hip Jt. Pathology
Procedure:
Extend the leg until the pelvis moves. Medially rotate up
to end range while applying a slow posterolateral
pressure along the line of the neck of the femur for
20secs.

170. Nelaton’s Line
Px: Supine
(+) sign: Greater trochanter is palpated above the line
Significance: Hip Dislocation or Coxa Vara
Procedure:
draw an imaginary line from the ischial tuberosity of the
pelvis to the ASIS of the pelvis on the same side.

171. Bryant’s Triangle
Px: Supine
(+) sign: Difference in measurement
Significance: Congenital Dislocation of Hip or Coxa Vara
Procedure:
Draw imaginary lines:
1st – perpendicular from the ASIS to the PSIS
2nd – tip of greater trochanter to ASIS

172. Rotational Deformities
Px: Supine
(+) sign: Face in | face up, out, away
Significance: Internal Rotation of femur or tibia |
External Rotation of femur or tibia
Procedure:
Observe the patella

173. Thomas Test
Px: supine
(+) sign: knee of the other leg rises of the table | abduction
of the other leg (“J” sign or Stroke)
Significance: Illiopsoas muscle contracture | Tight Iliotibial
Band
Procedure:
Flex hip bringing the knee to the chest.

174. Kendall’s Test
Px: Supine with knee bent over the edge of the table
(+) sign: slight extension of the other leg
Significance: Rectus Femoris muscle contracture
Procedure:
Px flexes one knee (90⁰) onto the chest and holds it
Other: Rectus Femoris Contracture Test (Method 1)

175. Ely’s Test
Px: Prone
(+) sign: Spontaneous ipsilateral hip flexion
Significance: Rectus Femoris Muscle Tightness
Procedure:
Passively flex the px’s knee
Other Name: Tight Rectus Femoris Test (Method 2)

176. Ober’s Test
Px: Side-lying with lower leg flexed
(+) sign:
a. Leg remain abducted (with knee extended)
b. Pain radiated (with knee flexed)
c. Localized pain
Significance:
a. Tenson Fascia Latae / Iliotibial Band Contracture
b. Femoral Nerve Involvement
c. Trochanteric Bursitis
Procedure:
Abduct and extend the upper leg with the knee flexed (90⁰) or extended, then slowly
lower the upper leg.

177. Adduction Contracture Test
Px: Supine
(+) sign: ASIS forms an angle < 90⁰, and Pelvis shifts up on
affected side
Significance: Adductor Muscles contracture (adductor
longus, brevis and magnus, pectineus, and gracilis)
Procedure:
Check for the assymetry of ASIS and balance the pelvis

178. Abduction Contracture Test
Px: Supine
(+) sign: ASIS forms and angle > 90⁰, and Pelvis shifts down
on the affected side
Significance: Abductor Muscles Contracture (Gluteus
Medius and Minimus
Procedure:
Check for the assymetry of ASIS and balance he pelvis

179. Prone Lying Test for ITB Contracture
Px: Prone
(+) sign: Firm End-feel
Significance: Iliotibial and Contracture
Procedure:
Stand on the opposite side. With one hand, hold the
ankle and maximally abduct while applying pressure to
the buttock with the other hand. Knee is flexed 90⁰,
adduct the hip.

180. Noble Compression Test
Px: Supine; Knee flexed 90⁰; Hip flexed 90⁰
(+) sign: Localized pain at 30⁰ knee flexion
Significance: Iliotibial Band Friction Syndrome
Procedure:
Apply pressure to the lateral femoral epicondyle or
1-2cm proximal to it while the px slowly extends the
knee

181. Piriformis Test
Px: Side-lying; upper leg in 60⁰ hip flexion; flex knee
(+) sign: Pain in groin | Pain in buttock
Significance: Piriformis muscle tightness | piriformis
syndrome
Procedure:
Stabilize pelvis with one hand and the other applies
downward pressure to the knee

182. 90-90 SLR Test
Px: Supine; hip and knee 90⁰ flexion
(+) sign: 20⁰- 0⁰ knee extend
Significance: Hamstrings muscle contracture, or sciatica
Procedure:
Px Alternately extends the knee
Other Name: Hamstring Contracture Test (Method 1)

183. Hamstring Contracture Test (Method 2)
Px: Long-sitting; 1 knee flexed against the chest
(+) sign: Unable to reach the toes
Significance: Tight Hamstrings muscle
Procedure:
Flex the trunk and touch the toes of the extended
lower limb.

184. Tripod Sign
Px: Short-sitting
(+) sign: Extension of the trunk
Significance: Hamstring muscles are tight, Sciatica
Procedure:
Passively extend the knee
Other Name: Hamstring Contracture Method 3

185. Phelp’s Test
Px: Prone
(+) sign: Abduction increases with knee extension
Significance: Gracilis muscle contracture
Procedure:
Passively abduct both leg as far as possible. Then
flex knees 90⁰ and try to abduct further.

186. Fulcrum Test
Px: Short-sitting
(+) sign: Sharp Pain and Apprehension
Significance: Femoral Shaft Stress, Fracture
Procedure:
Place an arm under px’s thigh to act as a fulcrum,
then apply pressure to distal femur.

187. KNEE

188. a. Abduction Test
Px: Short sitting
(+) sign: excessive gapping of the tibia and femur (medial condyle)
Significance: with knee extension, injury to these structures:
Procedure:
Fully extend the knee then apply valgus stress

189. b. Abduction Test
Px: Supine or Long sitting with the test leg over the edge of the table
(+) sign: excessive gapping of the tibia and femur (medial condyle)
Significance: knee flexed to 20⁰- 30⁰, injury to these structures:
Stress X-ray:
Gr.1: 5mm opening
Procedure:
Gr.2: 10mm opening
Fully extend the knee then place in 20⁰- 30⁰ flexion. Laterally rotate the knee
(lock knee) and then apply valgus stress
Gr.3: >10mm opening

190. c. Abduction Test
Px: Supine/Long sitting with the test leg over the edge of the table
(+) sign: excessive gapping of the tibia and femur (medial condyle)
Significance: knee flexed to 20⁰- 30⁰, injury to these structures:
Stress X-ray:
Procedure:
Gr.1: 5mm opening
Gr.2: 10mm opening
Fully extend the knee then place in 20⁰- 30⁰ flexion. Grasp the big toe (lock knee)
and then apply valgus stress
Gr.3: >10mm opening

191. a. Adduction Test
Px: short sitting
(+) sign: excessive gapping of the tibia and femur (Lateral condyle)
Significance: Knee extension, injury to these structures:
Procedure:
Fully extend the knee then apply a varus stress

192. b. Adduction Test
Px: Supine or long sitting with the test leg over the edge of the table
(+) sign: excessive gapping of the tibia and femur (Lateral condyle)
Significance: Knee in 20⁰- 30⁰ flexion, injury to these structures:
Stress X-ray:
Gr.1: 5mm opening
Procedure:
Gr.2: 8mm opening
Fully extend the knee then place in 20⁰- 30⁰ flexion. Apply varus stress on the knee
Gr.3: >8mm opening

193. Lachman Test
Px: Supine
(+) sign: Mushy or Soft End Feel
Significance: Injury to these structures:
a. Anterior Cruciate Ligament (posterolateral bundle)
b. Posterior Oblique Ligament
c. Arcuate-Popliteus Complex
Procedure:
Stabilize the anterior distal thigh and the posteromedial aspect of the
proximal leg. Fully extend the knee, then flex to 20⁰- 30⁰, laterally rotate
the leg and apply anterior tibial translation.

194. Lachman Test
Modification 1: Short-sitting
Modification 2: Supine with the test knee rests on PT’s knee (for small
hands)
Modification 3: Supine with the test leg between the arm and thorax
(not sufficient)
Modification 4: Supine, eye is level with the knee
Modification 5: Prone (difficult to determine the quality of the end feel
Modification 6 (active/no touch): Supine with PT’s arm under px’s knee
the ask to extend the knee.
Other Name: Ritchie Test, Trillat Test, Lachman Trillat Test

195. Drawer Sign
Px: Supine; hip flexed to 45⁰; knee flexed to 90⁰
(+) sign: Tibia Moves forward (>6mm on the femur)
Significance: Injury to these structures:
a.
b.
c.
d.
e.
f.
ACL
Posterolateral Capsule
Medial Collateral Ligament
Iliotibial Band
Posterior Oblique Ligament
Arcuate-Popliteus comlex injury
Procedure:
Sit on px’s foot with both hands clasp around the tibia, then translate it anteriorly.

196. Posterior Sag Sign
Px: Supine
(+) sign: Step-off sign, thumb sign
Significance: Injury to these structures:
a.
b.
c.
d.
Posterior Cruciate Ligament
Arcuate-Popliteus Complex
Posterior Oblique Ligament
Anterior Cruciate Ligament
Procedure:
Place the px in supine with the hips flexed to 45⁰ and knee flexed
to 90⁰

197. Reverse Lachman Test
Px: Prone
(+) sign: Mushy or Soft End feel
Significance: Posterior Cruciate Ligament Injury
Procedure:
Stabilize the anterior distal thigh and the anterior
proximal leg. Place the knee in full extension the
20⁰- 30⁰ flexion

198. Godfrey Test
Px: Supine
(+) sign: Poterior Sag of the tibia
Significance: Posterior Cruciate Ligament
Procedure:
Flex the hip and knee to 90⁰

199. a. Slocum Test
Px: Supine
(+) sign: Tibia moves forward (Anterolat. Translation)
Significance: Injury to these structures:
Procedure:
Flex the knee to 80⁰- 90⁰ with 45⁰ knee flexion, 30⁰ Medial rotation.
Sit on the px’s foot then draw the tibia forward

200. b. Slocum Test
Px: Supine
(+) sign: Tibia moves forward (Anteromedial translation)
Significance: Injury to these structures:
a.
b.
c.
d.
Medial Collateral Ligament
Posterior Oblique Ligament
Posteromedial Capsule
Anterior Cruciate Ligament
Procedure:
Flex the knee to 80⁰- 90⁰ with 45⁰ knee flexion, 15⁰ Lateral rotation. Sit on
the px’s foot then draw the tibia forward

201. Jerk Test of Hughston
Px: Supine
(+) sign: Clunk or jerk at 20⁰- 30⁰ of knee flexion
Significance: Injury to these structures:
a.
b.
c.
d.
e.
f.
ACL
Posterolateral capsule
Arcuate popliteus complx
Lat. Collateral ligament
PCL
Iliotibial Band
Procedure:
Flex the hip to 45⁰ and knee to 90⁰ then extend while maintaining medial rotation and a
valgus stress

202. Cross Over Test of Arnold
Px: Standing
(+) sign: “Giving Way”
Significance: Injury to these structures:
a.
b.
c.
d.
e.
f.
ACL
Posterolateral capsule
Arcuate popliteus complx
Lat. Collateral ligament
PCL
Iliotibial Band
Procedure:
Instruct px to cross the uninvolved leg in front of the test leg. Step on the involved led.
Asked the px to rotate the upper torso away from the uninvolved leg then is asked to
contract the quadriceps muscle.

203. Hughston’s Posteromedial and
Posterolateral Drawer Sign
Px: Supine; hip flexed to 45⁰; knee flexed to 80⁰- 90⁰
(+) sign: moves/rotates posteriorly on the medial aspect | moves/rotates
posteriorly on the lateral aspect
Significance: Injury to these structures:
a. PCL
b. POL
c. MCL
d. Semimembranosus mm
e. Posteromedial capsule
Procedure:
f. ACL
a.
b.
c.
d.
e.
f.
PCL
Arcuate-popliteus complex
LCL
Biceps fem tendon
Posterolat. Capsule
ACL
Sit on the px’s foot with both hands clasps around the tibia (slight medial rotation
| slight lateral rotation) then translate postriorly.

204. Loomer’s Test
Px: Supine
(+) sign: excess lateral rotation and posterior sag
Significance: Injury to these sturctures:
a.
b.
c.
d.
e.
f.
PCL
Arcuate-popliteus complex
LCL
Biceps Fem tendon
Posterolateral capsule
ACL
Procedure:
Flex the hip and knee to 90⁰, then maximally lateraly rotate both tibias.

205. Mcmurray Test
Px: Supine; knee fully flexed
(+) sign: snap/click with pain
Significance: Meniscus Injury
Procedure:
Medially Rotate the tibia – for lateral meniscus
Laterally Rotate the tibia – for medial meniscus
*modification:
same procedure but with knee extension.

206. Apley’s Test
Px: Prone; knee 90⁰ flexed
(+) sign: pain
Significance:
a. Ligamentous injury
b. Meniscus Injury
Procedure:
Stabilize thigh with PT’s knee.
a. Medially/laterally rotate the tibia with distraction
b. Medially/laterally rotate the tibia with compression

207. Bounce Home Test
Px: Supine; knee 90⁰ flexed
(+) sign: Rubbery end-feel, pain upon extension on jt.
line
Significance: Torn Meniscus
Procedure:
Cup the heel and allow it to extend passively

208. O’Donohue’s Test
Px: Supine
(+) sign: increase pain on rotation in either or both positions
Significance: Capsular irritation | Meniscus Tear
Procedure:
Flex hip and knee to 90⁰, medially/laterally rotate the
tibia twice, and then fully flex and rotate it both ways
again.

209. Modified Helfet Test
Px: Short Sitting
(+) sign: (-) patella goes laterally when standing
Significance: Cruciate injury | Quadriceps weakness
Procedure:
Examine the patella in sitting and standing positions.

210. Test For Retreating or Retracting Meniscus
Px: Supine
(+) sign: (-) appear/disappearing meniscus
Significance: Torn meniscus
Procedure:
Flex hip and knee to 90⁰ then medially and laterally
rotate the tibia.
Medial Rotation: Appearing
Lateral Rotation: Disappearing

211. Payr’s Test
Px: Supine
(+) sign: pain on the medial jt. line
Significance: Medial/posterior aspect of meniscus
lesion
Procedure:
Position test leg in figure-4 position

212. Bohler’s Sign
Px: Supine
(+) sign: pain
Significance: Meniscus Pathology
Procedure:
Apply valgus/varus stress on the knee

213. Bragard’s Sign
Px: Supine
(+) sign: increase/decrease pain upon doing the procedure
Significance: Meniscus Pathology
Procedure:
Place the px’s knee in flexion. Then laterally rotate the
tibia and extend the knee = pain and tenderness.
Medially rotate the tibia and flex the knee = decrease
pain.

214. Childress Sign
Px: Standing
(+) sign: Pain, clicking, snapping
Significance: Posterior lesion of meniscus
Procedure:
Instruct px to squat and do the “duck waddle”

215. Cabot’s Popliteal Sign
Px: Supine; Figure-4 position
(+) sign: Pain
Significance: Meniscus Pathology
Procedure:
Ask the px to isometrically straighten the knee while
applying resistance.

216. Mediopatellar Plica Test
Px: Supine
(+) sign: Pain
Significance: Pinching of the edge of the plica b/n the
medial femoral condyle and the patella
Procedure:
Flex the knee 30⁰ then push the patella medially with the
thumb
Other Name: Mital-Hayden Test

217. Plica “Stutter” Test
Px: Short-sitting
(+) sign: patella stutters or jumps b/n 60⁰ and 45⁰ of
flexion
Significance: Plica Syndrome
Procedure:
Plcae one finger over one patella and then ask the
px to slowly extend the knee

218. Hughston Test
Px: Supine
(+) sign: Popping of the plica band
Significance: Plica Syndrome
Procedure:
Flex the knee and medially rotate the tibia while pressing
the patella medially with the heel of the same hand on
the medial condyle. Passively flex and extend the knee

219. Brush, Stroke or Bulge Test
Px: Supine
(+) sign: Fluid wave bulge on the medial side of the patella
Significance: Swelling (4-8ml extra synovial fluid)
Procedure:
stroke medial side (upwards) of the patella with 1 hand and the
other hand on the lateral side (downward)
Other Name: Wipe Test

220. Fluctuation Test
Px: Supine
(+) sign: Synovial Fluids Fluctuate
Significance: Significant Effusion
Procedure:
place 1 hand above the patella (suprapatellar
pouch) and the other hand below the patella. Press
down with one hand and then the other hand.

221. Patellar Tap Test
Px: Supine
(+) sign: Dancing patella
Significance: Swelling
Procedure:
tap on the patella
Other Name: Ballotable Patella

222. Clarke’s Sign
Px: Supine
(+) sign: retropatellar pain / cannot hold the
contraction
Significance: Patellofemoral Dysfunction
Procedure:
Press down slightly proximal to the upper pole or
the base of the patella. Ask the px to contract the
quadriceps muscle while pressing down.

223. Waldron Test
Px: Standing
(+) sign: count the crepitus with pain (note the
amount, location and the ROM)
Significance: Patellofemoral Dysfunction
Procedure:
Palpate the patella and then instruct the patiene to
perform slow, deep knee bends.

224. Zohler’s Sign
Px: Supine
(+) sign: Pain
Significance: Chondromalacia Patellae
Procedure:
pulls the patella distally and ask the pt to contract
quadriceps muscle.

225. Frund’s Test
Px: Short SItting
(+) sign: Pain
Significance: Chondromalacia Patellae
Procedure:
taps the patella in various knee flexion

226. Q-angle Test
Px: Supine
(+) sign: a. < 13⁰ | b. > 18⁰
Significance: a. Chondromalacia patellae / patella alta | b.
Chondromalacia / subluxing patella, increase femoral anterversion, genu
valgum, lateral displacement of tibial tubercle, or increase lateral tibial
torsion
Procedure:
Imaginary lines are drawn:
1st line – from ASIS to midpoint of patella
2nd line – from tibial tubercle to midpoint of patella
Other Name: Patellofemoral angle

227. Wilson Test
Px: Short Sitting
(+) sign: pain lessened/diminished
Significance: Osteochondritis Dissecans of the medial
femoral condyle
Procedure:
Px extends the knee with internal rotation of the
leg. At 30⁰ of flexion, pain increases and the px is
asked to stop the movement and rotate the leg
laterally.

228. Fairbank’s Apprehension Test
Px: Supine; knee flexed to 30⁰
(+) sign: quadriceps muscle contract to bring patella
“into line”
Significance: Patellar dislocation
Procedure:
Carefully and slowly push the patella laterally and
distally

229. Noble Compression Test
Px: Supine
(+) sign: pain at 30⁰ of knee flexion
Significance: Iliotibial Band Syndrome
Procedure:
Flex the knee up to 90⁰ then press the lateral
femoral epicondyle with the thumb then extend the
knee.

230. ANKLE AND FOOT

231. Neutral Position Of Talus
(Weight Bearing Position)
Px: Standing
(+) sign: Bulging
Significance: Affectation of the Talus
Procedure:
Palpate for the talus (dorsal aspect) then ask the px
to rotate the trunk to the right and left
Tibia rotates medially and laterally
Talus pronates and supinates

232. Neutral Position of Talus (Prone)
Px: Prone with foot dangled over the edge of the table
(+) sign: Talar head bulges Laterally (Supination) /
Medially (Pronation)
Significance: Affectation of the Talus
Procedure:
Grasp over the 4th and 5th metatarsal heads. Palpate
for the talus (dorsal aspect) the passively Dorsiflex
the foot. Alternately move the foot to supination
then pronation.

233. Leg Heel Alignment
Px: Prone with foot dangled over the edge of the table
(+) sign: > 8⁰ of inversion of heel | Eversion of heel
Significance: Hindfoot varus | Hindfoot valgus
Procedure:
1st line - mark the midline of calcaneus
2nd line – 1cm distal to the 1st mark
3rd line – lower third midline of the leg

234. Coleman Block Test
Px: Standing
(+) sign: Heel is in neutral position | heel is still not in
neutral position
Significance: mobile hindfoot | fixed hindfoot
inversion
Procedure:
Place 2cm wooden block on the floor and ask the px
to stand with their heel and the lateral side of their
forefoot on the block

235. Too Many Toes Sign
Px: Standing
(+) sign:More toes can be seen on the affected side
Significance: Valgus deformity, Forefoot abducted,
increase lateral rotation of tibia
Procedure:
View the px from behind

236. Tibial Torsion (Sitting)
Px: Short-sitting
(+) sign: Lateral tibial torsion: > 18⁰ | < 13⁰
Significance: toe-out position | toe-in position
Procedure:
Draw imaginary Lines:
1st line – 2 epicondyles
2nd line – 2 malleoli

237. Tibial Torsion (Supine)
Px: Supine
(+) sign: Lateral tibial torsion: > 18⁰ | < 13⁰
Significance: toe-out position | toe-in position
Procedure:
Draw imaginary Lines:
1st line – 2 apices of malleoli
2nd line – heel parallel to the floor

238. Tibial Torsion (Prone)
Px: Prone; Knee flexed to 90⁰
(+) sign: Lateral tibial torsion: > 18⁰ | < 13⁰
Significance: toe-out position | toe-in position
Procedure:
Draw imaginary Lines:
1st line – heel parallel to the floor
2nd line – heel parallel to the thigh

239. a. Anterior Drawer Test Of the Ankle
Px: Supine; 20⁰ plantar flexion
(+) sign: suction sign (over the anterior talofibular
ligament) with minimal pain
Significance: Stress on anterior talofibular ligament
injury
Procedure:
Stabilize just above the ankle and draw the talus
forward

240. b. Anterior Drawer Test Of the
Ankle
Px: Supine; 20⁰ plantar flexion
(+) sign: greater anterior translation (on lateral die
only) = medial rotation of the talus
Significance: Stress on anterior talofibular ligament
injury and calcaneofibular ligament
Procedure:
Stabilize just above the ankle and draw the talus
forward + inversion

241. c. Anterior Drawer Test Of the Ankle
Px: Supine; 20⁰ plantar flexion
(+) sign: Greater Anterior Translation
Significance: Torn anterior talofibular ligament and
Calcaneofibular ligament
Procedure:
Stabilize just above the ankle and draw the talus
forward + dorsiflexion

242. Prone Anterior Drawer Test
Px: Prone with foot dangled over the edge of the table
(+) sign: Excessive anterior movement and “Sucking in”
at the Achilles Tendon
Significance: Ligamentous Instability (Anterior
Talofibular Ligament)
Procedure:
Push the heel steadily forward.

243. Talar Tilt
Px: Side-lying; knee flexed
(+) sign: Excessive Movement
Significance:
Adduction: stress on torn Calcaneofibular Ligament and/or
Anterior Talofibular Ligament
Abduction: stress on Deltoid Ligament (tibionavicular,
tibiocalcaneal, posterior tibiotalar ligament)
Procedure:
Tilt the talus from side to side (abduction and adduction)

244. Squeeze Test of The Leg
Px: Supine
(+) sign: Pain
Significance: Syndesmosis Injury/high ankle sprain
Procedure:
Grasp the lower leg at midcalf and squeeze the tibia
and fibula together

245. Kleiger Test
Px: Short-sitting
(+) sign: Pain with talus displacement (medial) | pain
over the anterior or posterior tibiofibular ligaments
Significance: Deltoid Ligament Tear | Syndesmosis
Procedure:
Apply passive lateral rotation to the foot.
Other Name: External Rotation Stress Test

246. Thompson’s Test
Px: Prone / kneels with feet over the edge of the table
(+) sign: absence of plantar flexion
Significance: Ruptured Achilles Tendon
Procedure:
Squeeze the calf muscle
Other Name: Simmond’s Test, Sign for Achilles Tendon
Rupture)

247. Test or Peroneal Tendon Dislocation
Px: Prone; knee flexed to 90⁰
(+) sign: Tendon subluxes from behind the lateral
malleolus
Significance: Peroneal Tendon Dislocation
Procedure:
Ask px to actively dorsiflex and plantar flex the ankle
along with eversion against resistance.

248. Feiss Line
Px: Standing but with non-weight bearing
(+) sign: a. Falls 1/3rd
b. Falls 2/3rd
c. Rests on the floor
Significance: a. 1st degree Flat Foot
b. 2nd degree Flat Foot
c. 3rd degree Flat Foot
Procedure:
Mark the apex of Medial Malleolus to plantar aspect of 1st
metatarsophalangeal jt. Then palpate the navicular tuberosity.
(Normally lies on/close to the line b/n the 2 points)

249. Hoffa’s Test
Px: Prone with feet over the edge of the table
(+) sign: feels less taut
Significance: Calcaneal Fracture
Procedure:
Palpate both the achilles tendon. Instruct px to
plantar flex and dorsiflex

250. Tinel’s Sign At The Ankle
Px:
(+) sign: Tingling Sensation
Significance: Peripheral Nerve Injury
Procedure:
Percuss at the anterior tibial branch of the Deep
Peroneal Nerve in front of the ankle or the Posterior
Tibial Nerve behind the medial malleolus.
Other Name: Percussion Sign

251. Duchenne Test
Px: Supine with legs straight
(+) sign: Only the Lateral Border plantar flexes
Significance: Lesion of the Superficial Peroneal Nerve,
L4-S1 nerve root
Procedure:
Push up on the head of the 1st metatarsal through
the sole (dorsiflex). Px tries to plantarflex

252. Morton’s Test
Px: Supine
(+) sign: Pain
Significance: Stress fracture or neuroma
Procedure:
Grasp the metatarsal heads and squeeze together

253. Homan’s Sign
Px: Supine
(+) sign: Pain in the calf, PALLOR, swelling in the leg,
loss of the dorsalis pedis pulse
Significance: Deep Vein Thrombosis
Procedure:
Passively dorsiflex with the knee extended

254. Buerger’s Test
Px: Supine and sitting
(+) sign: 1-2mins before the color comes back
Significance: Poor arterial blood supply
Procedure:
Elevate the leg at 45⁰ for at least 3 minutes, foot
blanches.
Px is then placed in short-sitting.