VALGUS STRESS TEST

(Knee)

​• Test positioning

The client lies supine with the knee in full extension.

The therapist stands with the distal hand on the client's medial ankle and the proximal hand on the knee (laterally).

​• Action

With the ankle stabilized, apply a valgus force at the knee with the proximal hand.

This is performed with the knee in full extension and repeated with the knee in 20 to 30-degrees of flexion.

​• Positive finding

Medial knee pain and/or increased valgus movement with a diminished or absent endpoint as compared to the uninvolved knee is indicative of damage to primarily the MCL, PCL, and posteromedial capsule when found in full extension, and MCL when tested in 20 to 30-degrees of flexion.

​• Special considerations & comments

The therapist must avoid allowing the femur to internally or externally rotate during this test, as this may give the illusion of increased valgus movement.

This may be accomplished by using the treatment table to help stabilize the client's femur.

The Valgus Stress Test is based on the work of Dr. James Cyriax in orthopedic manual therapy, with further contributions from Dr. Hughston in assessing medial collateral ligament (MCL) integrity.