Patient Position
- Supine (or seated)
Procedure Steps
Supine testing
- Stand to the outside of the patient.
- Drop the leg off the table and flex the knee to 30°.
- Put fingers of proximal hand over the medial joint line.
- Place your hip against the lateral knee and use it as a fulcrum to apply a valgus force at the knee (distal hand at the foot/ankle).
- Compare to the opposite, unaffected side.
Seated testing
- Flex the involved knee to 30°
- Support the medial ankle with one hand
- Apply a valgus force (lateral to medial) at the knee – check for pain
- Put your fingers along the medial joint line while applying the force to feel for gapping or a soft end-feel
- Compare to the opposite, unaffected side.
Positive Sign / Significance
- Significantly increased medial joint space gapping (compared to other side) = Medial collateral ligament tear (grade 3 complete tear)
- Increased medial knee pain with valgus pressure = MCL sprain
