DOPS EXAM; Revision Orthopaedic Testing; Hip

NAME
FABER

INDICATION
- Hip Joint / SIJ Dysfunction
- Tight Iliopsoas

METHOD
- Pt; Supine
- Foot over contralateral Knee
- Lower knee towards table
- Pt; Standing
- Pt. raises one foot off floor
- Observe Pelvis
- Pt; Squat
- Instruct Pt. on technique

TRENDELENBURG
S

Glute Medius Weakness

SQUAT

LEX Function; Hip, Knee &

Ankle

TRUE LEG
LENGTH

Leg Length

WEBER
BARSTOW

Leg Length; Tibia Vs. Femur

Pt; Supine
Reset Pelvis; Glute Bridge
Tape Measure; ASIS --> Lateral
Malleolus
Pt; Supine
Reset Pelvis; Glute Bridge
Assess malleoli & knees from
front & side for asymmetry

POSITIVE
- Knee remains above opposite
straight leg
- Pain
- Pelvis on the LIFTED leg side drops /
shifts
-

Observation of Mechanics
Quality of Movement
Asymmetry
1 1.5cm is normal
Can still cause symptoms

Different levels indicate asymmetry /

leg length discrepancy
Vertical Discrepancy
(Front View) = Tibia
Horizontal Discrepancy
(Lateral View) = Femur
Discrepancy in thumb height

PRONE KNEE
FLEXION

LONG SITTING
TEST

SIGN OF THE
BUTTOCK

Leg Length; Tibia

Confirmation of Weber
Barstow
Pelvic Dysfunction
Muscle Tightness or
Pathology
Ischial Bursitis
Hip Pathology

Pt; Prone Knees Flexed to 90*

Compare heights of Pt. feet

Supine to Sit Test

Pt. actively sits up

Leg shifting proximally to opposite

leg

Pt; Supine
Perform a SLR
If Limitation = Flex Knee

SD/Lesion in Buttock or Hip

NAME
THOMAS TEST

INDICATION
- Hypertonic Vastus Lateralis
or VMO

KENDALL TEST

Hypertonic Rectus Femoris

ELYS TEST

Hypertonic Rectus Femoris

FAIR TEST

Hypertonic Piriformis
Sciatic Nerve Impingement

90 90 SLR

Hypertonic / Shortened
Hamstrings
Nerve Root

HIP QUADRANT

Hip Pathology or
Impingement

METHOD
- Pt; Sitting on edge of table
- Pt. bring leg up towards chest
- Guide pt. safely back into supine
position whilst maintaining leg
against chest
- Pt; Sitting on edge of table, 1
inch gap between calf & table
- Pt. bring leg up towards chest
- Guide Pt. safely back into supine
position whilst maintaining leg
against chest
- Pt; Prone
- Passively flex the Pt. knee,
bringing heel toward the buttock
- Pt; Sidelying
- Upper Hip flexed to 60*
- Lower Leg in Full Extension
- Stabilise hip with one hand over
Iliac Crest / Greater Trochanter
- Caudad hand exerts mild
downwards pressure on upper leg
at knee
- Pt; Supine
- Pt. asked to grasp both legs
behind the knees to stabilise hip
- Pt. asked to ACTIVELY extend one
leg at a time
- Pt; Supine
- Start with Hip in Flexion & ADD
- Passively take Hip into Abduction

POSITIVE
- Extension of Contralateral Knee =
Tight Rec Fem
- Contralateral Thigh rising off the
table = Tight Iliopsoas
-

Knees should remain at 90*

If not = +ve
Tight Rectus Femoris

Pt. ASIS rises off the table as the

knee is flexed

Pain
Sciatica

Inability to extend within 20* of full

extension
Radicular symptoms

Pain
Apprehension

whilst maintaining flexion

Apply compressive force

DOPS EXAM; Revision Orthopaedic Testing; Knee

NAME
ANTERIOR DRAW

INDICATION
- Primary; ACL
- Other; MCL, ITB, Posterolateral
Capsule

POSTERIOR DRAW

PCL

LACHMAN TEST

ACL
Considered most reliable test
for ACL injury

SLOCUM

Step #1; Anterolateral stability

o Injury to ACL, LCL, PCL,
ITB, Posterolateral
capsule
Step #2; Anteromedial
stability

METHOD
- Pt; Supine; Knee & Hip Flexed
- Place both hands around tibia
- Place thumbs over Tibial
Tuberosity
- Tibia drawn forward (anterior)
- Pt; Supine; Knee & Hip Flexed
- Place both hands around tibia
- Place thumbs over Tibial
Tuberosity
- A P force on Tibia (posterior)
- Supine; Hip Flexed; Knee
Flexed 30*
- Stabilise Femur with caudal
hand
- Grasp behind proximal tibia
- P A force to proximal tibia
whilst simultaneously
applying an A P force on
Femur
- Pt; Supine; Hip & Knee Flexed
- Sitting on Pt. foot to stabilise
- Step #1; Foot placed in 30* of
IR
- Step #2; Foot placed in 15* of
ER

POSITIVE
- Tibia moves forward > 6mm
- Excessive anterior motion

Excessive posterior motion

Laxity of Ligament

Excessive Anterior Translation

End Feel is soft or mushy

Step #1 Lateral aspect of knee

moves forward more than the
medial

Step #2 Medial aspect of knee

moves forward more than the

Injury to ACL, MCL,

Posteromedial capsule
Injury to MCL
+ve in Full Ext = Major
Disruption of Knee Joint
o

MEDIAL / VALGUS
STRESS TEST

Draw the Tibia Forward

Pt; Supine
Caudad hand holding the
ankle
Step #1; Knee in Full
Extension
Step #2; Knee in 20 30*
Flexion
Caudal hand applies Valgus
Stress force to lateral aspect
of knee

NAME
LATERAL / VARUS
STRESS TEST

GAPPING

INDICATION
- Injury to LCL
- +ve in Full Ext = Major
disruption of Knee Joint

Integrity of Collateral
Ligaments
Integrity of Lateral / Medial
Joint Capsules

METHOD
- Pt; Supine
- Standing on the inside of Pt.
leg
- Caudad hand holding ankle
- Step #1; Knee in Full
Extension
- Step #2; Knee in 20 30*
Flexion
- Caudal Hand applies Varus
Stress Force to medial aspect
of knee
- Pt; Supine
- Hold pt. ankle between waist
& forearm
- Grasp medial & lateral knee
with both hands
- Palpate joint line with thumbs
- Apply a varus and valgus side
to side motion across joint

lateral
-

Excessive movement of Tibia

moving away from Tibia
20 30* Flexion = MCL, PCL, PM
capsule, posterior oblique
ligament
Full Extension = MCL, ACL, PCL,
PM capsule

POSITIVE
- Excessive movement of tibia
away from the femur
- 20 30* Flexion = ICL, ITB,
Biceps Femoris Tendon, PL
capsule
- Full Extension = LCL, ACL, PCL,
Biceps Femoris Tendon, PL
capsule

Excessive Motion
Pain

MCMURRAYS TEST
(Lateral)

Lateral Meniscus

MCMURRAYS TEST
(Medial)

Medial Meniscus

NAME
APLEYS COMPRESSION

INDICATION
- Non Specific Meniscus

line
Pt; Supine; Heel to Bum
(Flexion)
Leg & Knee into maximal
flexion
IR the tibia with distal hand
Apply a Varus force to the
knee with the proximal hand
Maintaining these forces,
extend the leg in a smooth
motion
Pt; Supine; Heel to Bum
(Flexion)
Leg & knee into maximal
flexion
ER the tibia with distal hand
Apply a valgus force to the
knee with the proximal hand
Maintaining these forces,
extend the leg in a smooth
motion

METHOD
- Pt; Prone; Knee Flexed 90*
- Anchor Pt. thigh to table by
resting your knee on the
thigh
- Grasp Pt. foot in both hands
- Apply a compression force
directly down through heel

Pain in Knee or along Joint Line

Snapping or Clicking within the
Knee

Pain in the Knee or along Joint

Line
Snapping or Clicking within the
Knee

POSITIVE
- Pain
- Clicking, Popping, Crepitus

APLEYS DISTRACTION

Relief of Pain = +ve Meniscus

Pain with Distraction =
Ligamentous Lesion

BOUNCE TEST

Torn Meniscus

PATELLA GLIDE

Patellofemoral Syndrome

PATELLA TILT

Patellofemoral Syndrome

into knee
IR and ER rotate tibia
Pt; Prone; Knee Flexed 90*
Anchor Pt. thigh to table by
resting your knee on the
thigh
Grasp Pt. foot in both hands
PULL the Pt. tibia in an
upwards direction towards
the ceiling (traction)
IR and ER rotate the tibia
Pt; Supine; Knee FULLY flexed
Pick up Pt. leg and cup their
heel in your hand
Allow Pt. knee to passively
extend
Pt; Supine; Knee Full
Extension
Ask pt. to keep quadriceps
relaxed
Move patella medially,
laterally, superiorly and
inferiorly
Make sure you dont tilt the
patella as you move it
Pt; Supine; Knee Full
Extension
Lift Lateral aspect of patella
away from lateral femoral
condyle
Ensure not to push medially
or laterally, ensuring it stays

Pain
Clicking, Popping, Crepitus
Excessive Laxity (ligaments)

Extension has a rubbery end feel

Springy

Assess amount of movement

possible in relation to distal
femur
Assess quality of movement
Assess for any pain or
tenderness

Normal angle is 15*

Males have an angle 5* less than
Females
+ve = Decreased Angle

within the trochlear groove

NAME
PATELLA GRIND

INDICATION
- Patellofemoral Syndrome

PATELLA
APPREHENSION

Patella Dislocation

PATELLA TAP TEST

Swelling

MEDIOPATELLA PLICA
TEST

BULGE TEST

Pinching of PLICA between

medial femoral condyle &
patella
Swelling

METHOD
- Supine; Knee Fully Extended
- Cup around the knee,
proximal to patella with web
of your hand
- Press downwards towards the
table
- Maintain the force
- Pt. actively contracts
Quadriceps whilst
maintaining force
- Perform test in different
degrees of flexion as well as
in full extension
- Pt; Supine; Knee Flexed 30*
- Using both thumbs, carefully
and slowly push patellar
laterally as far as possible
- Careful not to dislocate
patella
- Pt; Supine; Knee Extended
- Apply a slight tap or pressure
over the patella with two
fingers
- Supine; Knee Flexed 30*
- Move patella medially with
your thumb
- Pt; Supine; Knee Flexed 30*
- Begin just below joint line on
medial side of patella

POSITIVE
- Retropatellar Pain
- Pt. cannot hold contraction
- Apprehension

Contraction of Quadriceps
Apprehension of Pt.

Floating Patella
Swelling

Pain

Fluid wave at the medial knee

Stroking proximally towards

patient hip as far as the
suprapatellar pouch, 2 3
times with palm and fingers
With opposite hand, stroke
down the lateral side of
patella

DOPS EXAM; Revision Orthopaedic Testing; Ankle

NAME
DORSIFLEXION
MANOUVRE

INDICATION
- Separation of Distal Tibia and Fibula

FIBULAR
TRANSLATION

ANTERIOR DRAW

ATFL

METHOD
- Pt; Supine
- Stabilise distal leg with
caudad hand
- Passive DF of Foot
- Pt; Sidelying
- Grab 2 3 inches
superior to lateral
malleoli with both
thumbs
- Apply an AP force on
Fibula at level of
syndesmosis
- Pt; Supine
- Stabilise distal aspect
of leg
- Grasp Pt. heel and
position ankle 10 15*

POSITIVE
- Pain

Excessive Motion
Pain

Excessive Anterior displacement

Pain
Laxity

HOMANS TEST

DVT

CALCANEAL TILT

TALAR TILT & ROCK

Calcaneofibular Ligament
ATFL
Deltoid Ligament (Abduction)

PF
Apply a superior P A
force
Pt; Supine
Passively take Pt. into
DF with Knee Extended
Not performed for
safety reasons
Pt; Supine
Grasp calcaneus & foot
in both hands
Foot in Neutral
Take calcaneus into
Inversion (adduction)

Pt. Sidelying; Foot in

Neutral
Sitting with back to
patient
Part #1; Talar Tilt
o Grasp between
Pt. malleoli with
both hands
o Move Talus and
Foot into
Adduction /
Abduction
Part #2; Talar Rock
o Distract Foot,
move it into DF /

Pain in Calf
Pallor, Sweating in Leg
Absence of Dorsalis Pedis pulse

Pain

Pain

PF
Assess for
mobility
Pt; Prone
Feet over edge of table
Squeeze Calf (firm)
Observe for PF of Foot
o

THOMPSONS TEST

Achilles Tendon

Lack of Plantarflexion

DOPS EXAM; Revision Orthopaedic Testing; Shoulder

NAME
NEERS IMPINGEMENT

HAWKINS KENNEDY

INDICATION
- Impingement Syndrome
- SS / Bicipital Tendinopathy

SS Tendinopathy or

METHOD
- Pt; Seated
- Passively raise Pt. UEX
into forced flexion with
arm pronated
- Pt; Seated

POSITIVE
- Anterior / Deep Shoulder Pain

Pain

Impingement

YOCUM

SS Tendinopathy or
Impingement

CROSS BODY ADDUCTION

AC Joint Dysfunction
o Sprain, Arthritis,
Separation

EMPTY CAN

SS Tendinopathy

NAME
DROP ARM

INDICATION
- SS Dysfunction

Passively introduce
flexion of shoulder &
elbow to 90*
- Apply forced IR
- Pt; Seated
- Place Pt. hands to rest
on opposite shoulder
- Lift the elbow towards
the ceiling into
elevation
- Pt; Seated
- Take Pt. shoulder into
90* Flexion
- Passively adduct the
arm horizontally across
chest
- Palpate AC Joint
- Pt; Seated
- Pt. arm abducted 90*
- Resistance to
abduction provided by
examiner
- Pt. shoulder then
medially rotated and
angled forward to 30*
so that thumb points
downwards
- Resistance to
abduction again
provided by examiner
METHOD
- Pt; Standing

Pain

Pain at AC Joint

Weakness / Pain in resisted

Abduction with arm medially
rotated

POSITIVE
- Arm Drop to side of dysfunction

SUBSCAPULARIS LIFT OFF

SS Dysfunction

OBRIEN TEST

Labral Dysfunction

ANTERIOR SLIDE

SLAP Lesion
Superior Labrum Anterior
Posterior

Passively abduct Pt.

shoulder to maximal
range
(Painful Arc)
Ask Pt. to slowly lower
arms to waist
Pt; Standing
Ask pt. to place back of
their hand against their
Lx. spine
Ask pt. to lift hand off
the back as far as they
can
Arm fully flexed to 90*,
elbow extended and
horizontally adducted
to
10 15*
(STARTING POSITION)
Arm is then IR so
thumb faces downward
Examiner applies
downward force
Return to STARTING
position but have palm
supinated
Examiner again
provide downward
force
Pt; Seated
Instruct Pt. to put both
hands on hips

Pt. unable to lift off or maintain

the lift

Part #1; Pain, clicking inside the

shoulder
Part #2; Pain diminished in part
2

Pain

NAME
BELLY PRESS

SERRATUS ANTERIOR
WEAKNESS

INDICATION
- SS Dysfunction

Serratus Anterior; Weak /

Paralysed

WALL PUSH UP

Weakness; Rotator Cuff

Weakness; Serratus Anterior
Instability of Scapular

SPEEDS TEST

Bicipital Tendinopathy

Stabilise scapular with

one hand over
acromion
Load the GH in an
anterior & superior
direction

METHOD
- Pt; Supine
- Ask Pt. to place palm
against their belly
- Place your hand under
their hand
- Ask Pt. to push firmly
into their belly whilst
maintaining arm
straight
- Pt; Standing
- Pt. arm taken into 90&
flexion
- Examiner applies
posterior force to arm
- If Serratus Dysfunction
is present, medial
border of scapular will
wing
- Pt; Standing
- Ask pt. to do a wall
push up
- Complete 5 10 reps
- Pt; Seated
- Step #1; Perform

POSITIVE
- SS weakness
- Inability to press
- Dropping of Elbow
- Pain

Pain
Medial border of scapular
winging
Upper Trap compensation to try
to induce elevation

Winging of Scapular
Pain
Inability to perform

Pain over Bicipital Groove

SULCUS SIGN

NAME
SHOULDER APPREHENSION

LOAD & SHIFT

Shoulder Inferior Instability

INDICATION
- Instability of Shoulder

Anterior Instability due to

tight Posterior Capsule

resisted shoulder
flexion with forearm
supinated & then
pronated with elbow
fully extended
Step #2; Perform
above but this time
with shoulder at 90*
flexion
Pt; Seated
Examiner tractions the
Humerus Inferiorly

METHOD
- Pt; Supine
- Passively abduct & ER
the pt. arm in a slow
controlled manner
whilst other hand
stabilises posterior
aspect of shoulder
- Pt; Seated
- Standing behind Pt.
stabilise shoulder with
one hand over clavicle,
scapula
- Opposite hand
grasping head of
humerus
- LOAD the GH joint by
moving the humeral

Excessive Inferior displacement

of Humeral Head

POSITIVE
- Resistance to further movement
- Apprehension
- Pain

Excessive Movement
Laxity
Pain

head AP
SHIFT the Humeral
head by pushing it
anteriorly and
posteriorly
- Note the amount of
translation and end
feel
- Pt; Supine
- Support pt. hand in
their axilla
- Grip proximal humerus,
while stabilising
scapula with thumb
over coracoid and
fingers over spine of
scap
- Arm should be relaxed;
80 120* abduction, 0
20* flexion and 0
20* ER
- Examiner draws
humerus forward while
holding scapula still
METHOD
- Pt; Supine
- Support pt. hand in
their axilla
- Grip pt. shoulder with
fingers over spine of
scap and thumb placed
lateral to coracoid
-

ANTERIOR DRAWER

NAME
POSTERIOR DRAWER

INDICATION

Excessive forward displacement

of humeral head
Occasionally accompanies by an
audible click and apprehension

POSITIVE
- Excessive backward
displacement of humeral head

DAWBORN

Subacromial Bursitis

YERGASONS

Bicipital Tendinopathy
Transverse Humeral Ligament

NAME
JOBE RELOCATION

INDICATION
- GH instability
- Subluxation, Dislocation

process
IR the pt. arm, flex GH
to
60-80* while pushing
posteriorly with thumb
on humeral head and
stabilising scapula
Pt; Seated
Pt. arm at the side of
the body
Press just lateral and
inferior to acromion
Abduct arm past 90*
Pt; Seated
Elbow flexed to 90*
and held against
thorax, forearm
pronated
Grasp pt. wrist and
support elbow
Ask Pt. to supinate the
forearm and flex the
elbow against your
resistance

METHOD
- Pt; Supine
- Perform apprehension

Pain on pressing down decreases

or disappears once arm is
abducted

Pain over bicipital groove

Clicking

POSITIVE
- Pain decreases during
manoeuvre

Impingement
-

INFRASPINATUS / TERES
MINOR TEST

Infraspinatus / Teres Minor

dysfunction or weakness

test
Apply a posterior
translation stress to
the head of humerus to
relocate humeral head
into correct position in
the glenoid
Pt; Seated
Resisted Mm. testing
(ER)
Ask Pt. to flex elbow
with arm by their side
Ask Pt. to push against
your resistance

Weakness
Inability
Pain

DOPS EXAM; Revision Orthopaedic Testing; Elbow

NAME
TINELS SIGN

ELBOW FLEXION TEST

INDICATION
- Nerve Compression (Ulnar
Nerve)
- Neuroma

PINCH GRIP TEST

MILLS TEST

- Determine presence of
Cubital Tunnel Syndrome
Ulnar Nerve compromise

Anterior Interosseous Nerve

compromise (branch of
median)
Indicates entrapment of the
Anterior IO nerve as it passes
through two heads of
Pronator Teres
Lateral Epicondylitis
Radial Nerve

METHOD
- Pt; Seated
- Tap over the ulnar
nerve in groove
between Olecranon
and Medial Epicondyle
- Pt; Seated
- Ask Pt. to actively
perform full flexion of
elbow with extension
of wrist, shoulder
girdle abduction &
depression
- Hold position for 3 5
minutes
- Pt; Seated
- Ask Pt. to pinch the
tips of the Index finger
& thumb together
- Normal = Tip to Tip

Pt; Seated
Palpate Lateral
Epicondyle
Passively pronate
forearm, flex wrist &
fingers and extend the

POSITIVE
- Tingling down forearm in Ulnar
Distribution of hand (medial two
fingers)

Tingling or Numbness in the

Ulnar nerve distribution of
forearm and hand

Pad to Pad

Pain over Lateral Epicondyle

MIDDLE FINGER EXTENSION

TEST

NAME
MEDIAL EPICONDYLITIS TEST

Extensor Digitorum Mm. and

Tendon which inserts into
Lateral Epicondyle via
common extensor tendon
Lateral Epicondylitis

INDICATION
- Medial Epicondylitis

VALGUS TEST

Integrity of the MCL

VARUS TEST

Integrity of the LCL

elbow
One smooth motion
Pt; Seated;
Forearm Pronated
Resist Extension of 3rd
digit, proximal to IP
joint

METHOD
- Pt; Seated
- Palpate Medial
Epicondyle
- Passively Supinate the
forearm and extend
the elbow & wrist
- One smooth motion
- Pt; Seated
- Elbow in 20 30*
Flexion
- Stabilise Pt. arm with
one hand at Elbow and
other above wrist
- Apply an Abduction
force to Distal Forearm
- Pt; Seated
- Elbow in 20 30*
Flexion
- Stabilise Pt. arm with
one hand at Elbow and
other above wrist
- Apply an ADDuction

Pain over Lateral Epicondyle

POSITIVE
- Pain over Medial Epicondyle

Laxity
Decreased Mobility
Pain

Laxity
Decreased Mobility
Pain

COZENS TEST

Lateral Epicondylitis

force to the Distal

Forearm
Pt; Seated
Stabilise Pt. elbow with
your thumb, by resting
it on Lateral
Epicondylitis
Ask your Pt. to make a
fist
Ask Pt. to pronate
forearm, radially
deviate and extend the
wrist
Resist this motion

Sudden, Severe Pain in the

region of the Lateral Epicondyle

DOPS EXAM; Revision Orthopaedic Testing; Wrist & Hand

NAME
TINELS SIGN

FINKELSTEIN

INDICATION
- Carpal Tunnel Syndrome

METHOD
- Pt; Seated
- Tap over Volar Carpal
Ligament
-

Pt; Seated
Ask Pt. to make a fist
with thumb enclosed
within
Stabilise forearm and
passively deviate wrist

POSITIVE
- Pain or Paraesthesia may be
produced over distribution of
Median Nerve
- Lateral 2 digits
- Pain over APL and EPD Tendons

MURPHYS SIGN

Lunate Dysfunction

TRIANGULAR
FIBROCARTILAGE LOAD TEST
(TFCC)

Integrity of TFCC complex

PHALENS TEST

Carpal Tunnel Syndrome

REVERSE PHALENS TEST

Carpal Tunnel Syndrome

Wrist Extension may
demonstrate larger increase
in Intracarpal Canal pressure
compared to wrist flexion
More accurate

into Ulnar Deviation

Pt; Seated
Ask Pt. to make a fist
Pt; Seated
Ulnar Deviate the wrist
and axially passively
load wrist
Move the Joint into AP
shear
Pt; Seated
Pt. flexes wrist and
presses back of hands
together
Position held for 1
minute
Pt; Seated
Pt. flexes Elbow, places
palms of hands
together whilst
extending wrist
Prayer Position
Position head for 1
minute

If the head of 3rd MC is level with

the 2nd and 4th MC
Pain
Clicking
Crepitus

Inability to complete 60 seconds

Pain, paraesthesia etc.

Inability to complete 60 seconds

Pain, paraesthesia etc.

DOPS EXAM; Revision Orthopaedic Testing; Lumbar Spine

NAME
SLUMP TEST

INDICATION
- Pt. with suspected Neural

METHOD
- Pt. Seated (edge of

POSITIVE
- Pain or Symptoms decrease once

Involvement
Sciatica, IVD Injury etc.

1.
2.
3.
-

VALSALVA TEST

Pt. with suspected Neural

Involvement
Sciatic, IVD Injury etc.

1.
2.

table)
Pt. asked to slump
forward
Maintain neck & chin in
neutral position
Pt. asked to bring chin
to chest
Active Knee Extension
Active Ankle
Dorsiflexion
These movements
increase Dural Tension
Pt; Seated
Pt. asked to breathe in
and hold it
Pt. asked to bear down
as if straining to
evacuate bowel
If Pt. is unable to do
this, test may be
modified by asking Pt.
to blow into a closed
fist as if inflating a
balloon

these movements are ceased

Nerve Tension
Pain

Increased Pain
Reproduction of familiar radicular
or LBP

NAME
SLR TEST

INDICATION
- Nerve Tension for Lx. Spine

CROSS SLR (Wells Test)

BRUDINSKI KERNIG TEST

IVD Injury, IVD Herniation

Nerve Root Compression
SLR stretches both the
Ipsilateral Nerve Root and
pulls laterally on the Dural
Sac, stretching the
contralateral nerve root
Nerve Root Involvement
Meningeal Irritation
Dural Irritation

METHOD
- Pt; Supine
1. Examiner passively
takes Pt. into full knee
extension
2. Foot is raised off table,
slowly raising leg to
90* Hip Flexion
3. Record angle at which
Pain occurs & site of
pain
4. SLR should be able to
reach 70 90* Hip
Flexion
5. Examiner slowly lowers
leg slightly until pain
ceases
6. Pt. is asked to actively
flex neck, bringing chin
to chest
- Pt; Supine
- Same process as SLR
Test

Pt; Supine
Hands cupped behind
head

POSITIVE
- Pain between 30 70* Hip
Flexion
- Pain ceases when leg is lowered
and begins again when neck
flexed
- Consider Hamstring Involvement
(tightness) with Hip Flexion

Pain experienced on
Contralateral side to tested side

If pain disappears on Knee

Flexion

1. Pt. asked to actively

flex head towards
chest
2. Pt. raises extended leg
by actively flexing hip
until pain is felt
3. Pt. flexes the knee

NAME
BRAGARDS TEST

SOTO HALL TEST

KEMPS TEST

INDICATION
- Neurological Tissue
involvement
- Sciatic Nerve

Neurological Tissue
involvement

Movement causes maximum

narrowing of Intervertebral

METHOD
- Pt; Supine
- SLR
- Once pain is reported,
leg is lowered until no
pain
- Practitioner then
passively dorsiflex the
Ipsilateral ankle,
Increasing tension of
Sciatic Nerve
distribution
- Pt; Supine
- SLR
- Once pain is reported,
leg is lowered until
pain ceases
- Pt. actively flex neck,
chin to chest
- Pt; Standing
- Ask Pt. to place hand

POSITIVE
- Pain returns with Dorsiflexion

Lumbar, Leg or Arm symptoms

are produced during neck flexion
Tension in Cervicodorsal Junction
is normal and should not be
considered reproduction of
symtpoms
Pain
Reproduction of Radicular or LBP

Foramen
Facet Sprain
PSIS region = SIJ Dysfunction
-

HIP DROP TEST

Lumbar / TL spine has

difficulty SB towards the
weightbearing side of the
body

NAME
THOMAS TEST

HOOVER TEST

INDICATION
- Tightness of Quadriceps / Hip
Flexors

Used to assess Malingering

LBP

on buttock and slide

palm down posterior
thigh
Extension, Rotation
and SB spine to
ipsilateral side
Pt; Standing
Ask Pt. to buckle one
knee allowing
ipsilateral hip drop
Notice amount of
Inferior movement on
unsupported side
Iliac Crest should
normally drop 25 30*
Should be a smooth
lumbar curve
TOWARDS the
weightbearing side

METHOD
- Pt; Sitting (edge of
table)
- Pt. bring one leg up
towards chest & hold it
- Guide Pt. safely back
into a supine position
whilst maintaining leg
against chest
- Pt; Supine
- One hand placed under
each Calcaneus

Iliac Crest DOES NOT drop 25

30* on the non weightbearing
side
Angled, uneven, poor lumbar
curve towards the weightbearing
side

POSITIVE
- Extension of Contralateral Knee
= Tight Rectus Femoris
- Contralateral Thigh rising off the
table
= Tight Iliopsoas

Does not lift leg

Examiner does not feel pressure
under opposite heel

Pt. asked to lift one leg

off the table, keeping
knee straight
If the lifted limb is
weaker, pressure under
the normal heel
increases due to
increased effort
needed to elevate limb

DOPS EXAM; Revision Orthopaedic Testing; Pelvis

NAME
STANDING FLEXION TEST

INDICATION
- Iliosacral Lesions
- Upslip, Downslip, Inflare,
Outflare
- Dysfunction of Ipsilateral SIJ

METHOD
- Pt; Standing
- Contain Inferior aspect
of PSIS
- Instruct Pt. to bend

POSITIVE
- One PSIS moves further
- Dysfunctional side

forwards with knees

straight as far as
possible

SEATED FLEXION TEST

STORK TEST

Sacroiliac Lesions
Torsions, Unilateral Flexion /
Extension
Dysfunction of Ipsilateral SIJ

Ipsilateral SIJ Dysfunction

NAME
ILIAC ROCKING TEST

INDICATION
- Dysfunction of Ipsilateral SIJ

Pt; Seated
Contain Inferior aspect
of PSIS
Instruct Pt. to put
hands between legs
and bend forwards as
far as possible

One PSIS moves further

Dysfunctional Side

Pt; Standing
Contact PSIS with both
hands
Ask Pt. to lift one leg
off the ground

PSIS should move inferiorly on

Ipsilateral side
+ve if PSIS doesnt move or
moves superiorly

METHOD
- Pt; Supine
- Contact ASIS with
Hypothenar and

POSITIVE
- Resistance to Motion
- Unbalanced spring in comparison

GAPPING TEST

SIJ Dysfunction

APPROXIMATION TEST

SIJ Dysfunction

HIP QUADRANT TEST

SIJ Dysfunction
Iliosacral Dysfunction
Hip Pathology

Thenar eminence
Apply pressure to one
Innominate at a time,
monitoring the spring
Compare Bilaterally
Pt; Supine
Internal Rotation of
both Ilia
simultaneously
This opens up posterior
SIJ
Pushing in against
lateral border of Ilium
bringing them medial

Pain

Pt; Supine
External Rotation of
both Ilia
simultaneously
This jams up articular
components of
posterior SIJ
Pushing outside on
medial border of Ilium

Pain

Pt; Supine
Flex the Knee & Hip
Compress downwards
towards table
Test in each quadrant

SIJ Pain

NAME
ERICHSENS TEST

PRONE SPRINGING TEST

INDICATION
- SIJ Dysfunction

SIJ Dysfunction

METHOD
- Pt; Prone
- Palpate SIJs
- Contact both lateral
aspects of sacrum
(PSIS) by cupping your
hands and interlocking
fingers
- Approximate hands
medially together
-

Pt; Prone
Apply P A
compression over
sacral base & then
Sacral ILAs at all 4
points
Assess whether
restriction occurs in
Nutation or Counter
Nutation
Note which side is
restricted
Important in Diagnosis

POSITIVE
- Pain at SIJ

Pain

DOPS EXAM; Revision Orthopaedic Testing; Thoracic Spine, Thorax

& Ribs
NAME
ROOS TEST

WRIGHTS TEST

ALLENS TEST

INDICATION
- Thoracic Outlet Syndrome

METHOD
- Pt; Seated
- Pt; Abducts arm to 90*
- Pt. flexed elbow to 90*
- Pt. opens & closes
hand repetitively for up
to 3mins

Thoracic Outlet Syndrome

Specifically compression in
Costoclavicular space & Pec
minor

Thoracic Outlet Syndrome

Modification of Wrights

POSITIVE
- Pain
- Paraesthesia
- Tingling
- Heaviness
- Weakness
- Unable to hold position

Diminished Pulse

Pt; Seated
Locate & Palpate radial
pulse
Hyperabduct Pt. arm
passively over their
head

Pt; Seated
Palpate for Radial Pulse
Flex Pt. elbow to 90*

Diminished Pulse

NAME
ADSONS TEST

MILITARY BRACE

INDICATION
- Thoracic Outlet Syndrome
- Specifically Interscalene
compromise

Thoracic Outlet Syndrome

Costoclavicular Involvement

with shoulder
horizontally extended
& externally rotated
Instruct Pt. to turn
head away from test
arm

METHOD
- Pt; Seated
- Palpate Radial Pulse
- Instruct Pt. to turn
head towards test
shoulder
- Instruct Pt. to extend
head
- Passively extend & ER
shoulder
- Instruct Pt. to take a
deep breath and hold it
- Pt; Seated
- Palpate Radial Pulse
- Draw Pt. shoulder
down and backwards

POSITIVE
- Diminished Pulse

Diminished Pulse

DOPS EXAM; Revision Orthopaedic Testing; Cervical Spine

NAME
MAIGNES TEST

SPURLINGS TEST

INDICATION
- VBI symptoms
- Pre Manipulative Test

Vertebral Artery Insufficiency

Provocation Test for Cervical
Radiculopathy

METHOD
- Pt; Supine
- Place Pt. head in
position to be used for
manipulation
- Hold position for 10
seconds
- Observe for any
symptoms of VBI
-

Pt; Seated
Compression of Head
in Neutral
Compression of Head
in Extension

POSITIVE
- 5 Ds and 3 Ns

Pain radiating into UEX during

compression

COMPRESSION TEST

Disc Herniation
Vertebral Body Fracture
Z Joint Inflammation

NAME
DISTRACTION TEST

MAXIMAL CERVICAL
COMPRESSION TEST

INDICATION
- Ligament Strain

Nerve Root or Facet Joint

Involvement

Compression of Head
in Extension and
Rotation
If no symptoms,
progress to next step
Pt; Seated
Clasp hands together
and cup Vertex of Pt.
head
Slowly and Gently
apply direct
downwards pressure in
a controlled manner

METHOD
- Pt; Seated
- Place one hand under
Pt. chin and the other
hand around Occiput
- Slowly lift the Pt. head,
applying traction to the
Cx. Spine
-

Pt; Seated
Pt. SB and Rotates

Pain upon Compression

Reproduction of Radicular
symtpoms

POSITIVE
- Pain is relieved when the head is
lifted / distracted

Pain radiates to UEX

Ipsilateral Side
Pain on Opposite Side

DEKLEYNS TEST

Vertebral Artery Insufficiency

This test is STUPID

NAME
SHARP PURSER TEST

INDICATION
- Subluxation of Atlas on Axis
- Perform with great caution

head to same side

Examiner clasps hands
on top of Pt. head and
applies downward
pressure
Pt; Supine
Examiner passively
extends and rotates Pt.
head maximally
Hold position for 30
60 seconds or until
signs or symptoms of
VBI develop
10 seconds between
testing right & left

METHOD
- Pt; Seated
- Examiner places one
hand over Pt. forehead
- Thumb of other hand is
placed over SP of Axis
- Whilst Pt. actively

= Muscle strain
Be aware of Vertebral Aa.
Be aware of VBI symptoms

VBI symptoms

POSITIVE
- Examiner feels head slide
backward
- Hears a clunk during
movement

flexes head, examiner

presses backward with
palm of hand on Pt.
forehead
ANTERIOR SHEAR / SAGITTAL
STRESS TEST

ROTATIONAL ALAR
LIGAMENT STRESS TEST

Integrity of supporting
Ligamentous and Capsular
structures of Cx. Spine
Cx. Stability

Injury to Alar Ligament

Pt; Supine
Head in Neutral resting
on bed
Examiner applies an
anterior directed force
through posterior arch
of C1 or SP of C2 T1
or Bilaterally through
lamina of each
Vertebra

Pt; Seated
Examiner grips Lamina
of SP of C2 between
finger and thumb
While stabilising C2,
examiner passively
rotates Pt. head left or
right moving to the
non-symptomatic side
first

Normal End feel should be tissue

stretch with an abrupt stop
Nystagmus, Dizziness, Nausea
Lip Paraesthesia
Lump in throat sensation

If more than 20 30* of rotation

is possible without C2 moving, it
is indicative of injury to the
contralateral alar ligament

DOPS EXAM; Revision Orthopaedic Testing; Upper Limb Tension

Tests
NAME
Upper Limb Tension Test
#1

Upper Limb Tension Test

#2

INDICATION
- Median Nerve

Median Nerve
Musculocutaneous
Nerve
Axillary Nerve

METHOD
- Pt. Seated / Supine
1. Shoulder Depression &
Abduction (110*)
2. Elbow Extension
3. Forearm Supination
4. Wrist Extension
5. Finger & Thumb
Extension
6. Cx. Spine SB
(Contralateral)
- Pt; Seated / Supine
1. Shoulder Depression &
Abduction (10*)
2. Elbow Extension
3. Forearm Supination
4. Wrist Extension
5. Finger & Thumb
Extension
6. Shoulder External
Rotation
7. Cx. Spine SB
(Contralateral)

POSITIVE
- Reproduction of Pain
- Paraesthesia
- Dont progress to next
stage if pain is felt

Reproduction of Pain
Paraesthesia
Dont progress to next
stage if pain is felt

NAME
Upper Limb Tension Test
#3

Upper Limb Tension Test

#4

INDICATION
- Radial Nerve

Ulnar Nerve

METHOD
- Pt; Seated / Supine
1. Shoulder Depression &
Abduction (10*)
2. Elbow Extension
3. Forearm Pronation
4. Wrist Flexion & Ulnar
Deviation
5. Finger & Thumb
Flexion
6. Shoulder Internal
Rotation
7. Cx. Spine SB
(Contralateral)
- Pt; Seated / Supine
1. Shoulder Depression &
Abduction (Hand to
Ear)
2. Forearm Supination
3. Wrist Extension &
Radial Deviation
4. Fingers & Thumb
Extension
5. Shoulder External

POSITIVE
- Reproduction of Pain
- Paraesthesia
- Dont progress to next
stage if pain is felt

Reproduction of Pain
Paraesthesia
Dont progress to next
stage if pain is felt

Rotation
6. Elbow Flexion
7. Cx. Spine SB
(Contralateral)