Skills Diary - Week One - KNEE & HIP

Week 1 Skills Diary
KNEE & HIP

KNEE TESTS

NAME OF SKILL

Lateral Ligament Stress Test

WHEN WOULD YOU CHOOSE TO USE IT?

When there is a suspected injury to the later collateral ligament

WHEN WOULD YOU CHOOSE NOT TO USE IT?

If there is a lot of swelling, or the patient is unable to relax due to pain

DESCRIBE HOW TO APPLY THIS SKILL

Complete test at both 0 and 30 degrees knee flexion. Apply a varus stress force at the knee

WHAT ARE THE ANTICIPATED OUTCOMES?

ROM affected, pain and end feel

GRADE 1: pain but no increase in ROM, distinct end feel

GRADE 2: pain and increases laxity, distinct end feel

GRADE 3: pain, gross laxity, no distinct end feel

SUMMARISE OR ATTACH FEEDBACK:

REFLECTION:

NAME OF SKILL

Media Ligament Stress Test

WHEN WOULD YOU CHOOSE TO USE IT?

When there is a suspected injury to the medial collateral ligament

WHEN WOULD YOU CHOOSE NOT TO USE IT?

When there is a lot of swelling, or the patient was in too much pain

DESCRIBE HOW TO APPLY THIS SKILL

Complete test at both 0 and 30 degrees knee flexion. Apply a valgus stress force to the knee

WHAT ARE THE ANTICIPATED OUTCOMES?

ROM affected, pain and end feel

GRADE 1: pain but no increase in ROM, distinct end feel

GRADE 2: pain and increases laxity, distinct end feel

GRADE 3: pain, gross laxity, no distinct end feel

SUMMARISE OR ATTACH FEEDBACK:

REFLECTION:

NAME OF SKILL

Posterior Draw Test

WHEN WOULD YOU CHOOSE TO USE IT?

When there is a suspected PCL injury

WHEN WOULD YOU CHOOSE NOT TO USE IT?

Suspected fracture, patient in too much pain, if there is already a clear tibial sag when knee put into flexion

DESCRIBE HOW TO APPLY THIS SKILL

Place knee in 90 degrees flexion and stabilise foot. Use both hands and apply a firm force to direct the tibia posteriorly (must allow movement through the joint line) Compare left and right/affected and unaffected

WHAT ARE THE ANTICIPATED OUTCOMES?

Visible and palpable posterior translation of the tibia

SUMMARISE OR ATTACH FEEDBACK

REFLECTION:

NAME OF SKILL

Anterior Draw Test

WHEN WOULD YOU CHOOSE TO USE IT?

When there is a suspected ACL injury

WHEN WOULD YOU CHOOSE NOT TO USE IT?

Suspected fracture, patient in too much pain

DESCRIBE HOW TO APPLY THIS SKILL

Place knee in 90 degrees flexion, stabilise foot. Ensure hamstrings remain relaxed. Firmly apply a force that will direct the tibia anteriorly (must allow movement through the joint line). Compare left and right/affected and unaffected

WHAT ARE THE ANTICIPATED OUTCOMES?

Visible and palpable anterior translation of the tibia

SUMMARISE OR ATTACH FEEDBACK

REFLECTION:

NAME OF SKILL

Posterior Sag Test

WHEN WOULD YOU CHOOSE TO USE IT?

When there is a suspected PCL injury, if a posterior draw test cannot be completed due to patient pain or anxiety or suspected fracture

WHEN WOULD YOU CHOOSE NOT TO USE IT?

If there was a suspected fracture, patient in too much pain

DESCRIBE HOW TO APPLY THIS SKILL

Place both knees in 90 degrees flexion, stabilise feet. Observe positions of tibial tuberosities in relation to femoral condyles. Compare left and right/affected and unaffected

WHAT ARE THE ANTICIPATED OUTCOMES?

Posterior displacement of the tibia on affected side

SUMMARISE OR ATTACH FEEDBACK

REFLECTION:

HIP TESTS:

NAME OF SKILL:

FABER

WHEN WOULD YOU CHOOSE TO USE IT?

These tests are more provocative so good to use when you have no other findings from the hip joint.

WHEN WOULD YOU CHOOSE NOT TO USE IT?

If the patient cannot lie in supine, don’t use irritable joints or when other findings have already concluded the diagnosis.

DESCRIBE HOW TO APPLY THE SKILL

Passively take hip into flexion, abduction and external rotation. Stabilise pelvis.

WHAT ARE THE ANTICIPATED OUTCOMES?

Limited ROM, pain, resistance, non-specific pain in buttock, pain over greater trochanter

SUMMARISE OR ATTACH FEEDBACK

REFLECTION

NAME OF SKILL:

Thomas Test

WHEN WOULD YOU CHOOSE TO USE IT?

These tests are more provocative so good to use when you have no other findings from the hip joint.

WHEN WOULD YOU CHOOSE NOT TO USE IT?

If the patient cannot lie in supine, don’t use irritable joints or when other findings have already concluded the diagnosis.

DESCRIBE HOW TO APPLY THE SKILL

Patient is supine at the end of the bed, with ischial tuberosities on the edge, lay them down so their legs are of the end of the bed. Slowly raise the bed so legs are now suspended off the ground. Ask the client to raise and hug one knee close to their chest. If needed, the other leg can be put into hip extension to test for muscle length.

WHAT ARE THE ANTICIPATED OUTCOMES?

Limits to hip extension, pain

SUMMARISE OR ATTACH FEEDBACK

REFLECTION

NAME OF SKILL:

Flexion/Abduction of the hip - Quadrant test

WHEN WOULD YOU CHOOSE TO USE IT?

These tests are more provocative so good to use when you have no other findings from the hip joint.

WHEN WOULD YOU CHOOSE NOT TO USE IT?

If the patient cannot lie in supine, don’t use irritable joints or when other findings have already concluded the diagnosis.

DESCRIBE HOW TO APPLY THE SKILL

Passively move the hip into flexion and adduction, can add a little bit of internal rotation

WHAT ARE THE ANTICIPATED OUTCOMES?

Limited ROM, pain

SUMMARISE OR ATTACH FEEDBACK

REFLECTION