Have you ever had knee pain or discomfort? Or maybe you've injured your knee while playing sports and can't bend or straighten it properly? When we go to a doctor, he or she uses various methods to examine our knee. One such special test that we're going to talk about today is the Apley test . This helps determine if there's something wrong with your knee.
So what is this Apley test?
Simply put, the Apley test is a method doctors use to determine if the meniscus, a piece of cartilage in your knee, is torn or damaged . You may have also heard it called the 'Apley grind test' or the 'Apley compression test.' Both names refer to the same test, with slight differences.
Imagine, this is an in-office physical exam that can be done right where the doctor is, right in his room, without any special equipment. All you have to do is lie on a table with your stomach on the floor, that is, face down (prone position) . Then the doctor will hold your lower leg and rotate it from side to side near the knee, checking to see if you have any pain or any other discomfort. He will also ask if you feel anything stuck inside your knee, like it's stuck or won't move.
Often, when you see a doctor with knee pain or after an injury, one of the first tests done is the Apley test. However, this alone cannot immediately confirm that there is a tear or other injury in the meniscus. This can give the doctor some idea. Then, in addition to confirming it , one or two more imaging tests, that is, tests that look inside, will have to be done .
Is there an Apley test for the shoulder?
Yes, that's good to know. Just like the Apley test for the knee, there is a different test called the 'Apley' that is also used to diagnose shoulder problems. It's called the 'Apley scratch test.' Although the names are similar, these are two completely different tests, and the movements used are different. The conditions they are trying to diagnose are also different. So if you have a knee problem, you don't need an Apley scratch test for the shoulder.
What is the difference between the Apley, McMurray, and Thessaly tests?
In addition to the Apley test, there are other tests used to detect damage inside the knee, especially meniscus tears. The McMurray test and the Thessaly test are two of the main tests. All three involve moving the knee in different ways and looking for symptoms. However, the way the leg is moved and the position you are in are different for each test.
- During the Apley test: The doctor moves your knee while you are lying prone.
- In the McMurray test: While you are lying on your back, the doctor bends, stretches, and rotates your knee.
- In the Thessaly test: You have to stand on one leg, lift the other leg slightly, bend the knee slightly, and rotate that leg.
During all three tests, the doctor will listen for sounds coming from your knee (crackling, popping) and will also pay attention to what he feels with his hands. You should tell your doctor immediately about any pain or discomfort you feel. This is very important for diagnosis.
When do I need an Apley test?
A doctor may perform an Apley test on you if they suspect you have a torn meniscus . A meniscus tear is a very common knee injury , especially among athletes.
What is this meniscus?
Imagine, inside your knee, between your thigh bone (femur) and your shin bone (tibia), there is a rubbery, slightly firm cushion called the meniscus. It is like a shock absorber in a car. The main function of the meniscus is to absorb the shock and pressure that comes to the knee when we walk, run, and jump, and to protect the bones and joint.
A sudden, sharp blow to the knee can tear the meniscus. Sports injuries are the most common cause. However, it can also occur from things like falls and car accidents.
Common symptoms of a meniscus tear:
- Feeling or hearing a 'pop' sound coming from the knee.
- The knee loses stability , and it feels like the leg is losing control.
- Severe pain .
- Knee stiffness .
- Swelling .
- Inability to fully bend or extend the knee normally.
When you go to the doctor with a knee injury, especially if you have the symptoms mentioned above, he or she will likely perform an Apley test. This will also give the doctor some idea of whether there is any damage to the ligaments or other connective tissue in your knee.
Also, someone who has a meniscus tear is at increased risk of developing osteoarthritis of the knee or joint inflammation later in life.
Who performs the Apley test?
Your doctor can perform this Apley test in his or her office. It doesn't require any special equipment or facilities.
How is the Apley test performed?
The Apley test is a series of tests that assess your symptoms and your knee's range of motion , which is how far you can bend, extend, and rotate your knee. It's very simple. Here are the steps:
- You will need to lie on the examination table , prone , meaning face down.
- The doctor will hold your leg still, pressing his knee against the back of your thigh.
- Next, the doctor will bend your knee 90 degrees , which means it is perpendicular to the rest of your leg.
- Then, while pulling slightly up on your knee, he rotates your lower leg outward and inward from the midline of your body .
- After doing this, the doctor may rotate the leg again in the same way as before. But this time, instead of pulling up, the lower leg is pressed down (compression) . This is also called the 'Apley's compression test'.
Most often, the doctor will perform the Apley test on both legs . He or she will first do the uninjured, healthy leg. This will give him or her an idea of your normal range of motion before examining the injured leg.
The Apley test involves these movements, which place a mild amount of stress on your meniscus. This is similar to the stress you experience when you normally use your knee.
As the doctor moves your leg and knee, he or she will ask you if you feel any pain, if your knee feels like it's getting stuck or locked . He or she will also listen for things like a 'pop' sound coming from your knee, and will check to see if your knee is turning too much to one side or the other. All of this will give him or her an idea of where your meniscus may be torn.
How to prepare for an Apley test?
There is really no special preparation you need to do for an Apley test. All you need to do is see a doctor as soon as possible, whether you have injured your knee or if you have any new symptoms.
What to expect during an Apley test?
Try to stay as relaxed as possible during the test. If you tense up, it may make it difficult for the doctor to perform the test accurately.
Since the Apley test is a series of physical movements, it is important to tell your doctor immediately about everything you feel – especially if any movement causes pain or discomfort. This is very important.
Any pain, discomfort, or other symptoms you feel during the Apley test will help your doctor pinpoint where in your meniscus you have a tear or what other type of injury you may have.
What happens after an Apley test?
Even after performing the Apley test, your doctor will likely order several more imaging tests to confirm the exact nature of the knee injury.
These tests take pictures of the inside of your knee and can confirm any damage inside the joint. The most common imaging tests used to diagnose a meniscus tear are:
- Magnetic Resonance Imaging (MRI)
- Ultrasound
- X-rays
The doctor will explain to you what imaging tests you need and what types of disorders they are looking for.
Sometimes, you may need to have a knee arthroscopy to find or repair damage inside your knee. A knee arthroscopy is a minimally invasive surgical procedure that uses a small camera to look inside your knee joint. Most knee arthroscopy procedures are outpatient procedures. This means you can go home the same day.
Are there any risks with the Apley test?
In fact, there is no risk to your knee from doing an Apley test.
You may feel some pain or discomfort during the test, but even if your meniscus is torn, you should not feel any unbearable pain .
But there's one thing to keep in mind. Some studies have found that the Apley test is not perfectly accurate in detecting a meniscus tear. However, this is usually only the first step your doctor takes to diagnose your injury. Imaging tests are the most definitive. If your doctor suspects you have a torn meniscus, they are the most accurate way to evaluate it.
What will the results look like for me and what do they mean?
The results of the Apley test are not like some of the tests you may have had before. That is, it does not give a specific range or a specific number. Instead, the Apley test gives your doctor a better idea of what kind of injury may be in your knee.
This is not a 'true or false' question , but a math problem with a definite answer. Your doctor will classify your test as positive if they find something that suggests you have a torn meniscus. A negative result means you did not experience any pain, discomfort, or other symptoms during the test.
However, a negative result does not mean that you do not need further testing. Your meniscus may still be torn, or there may be other damage inside your knee.
When should I see a doctor?
If you have symptoms like knee pain and swelling that get worse after a few days, see a doctor immediately.
Also, if you have any of the following symptoms, go to a hospital emergency department immediately:
- Very severe pain.
- If the swelling is getting worse.
- If you notice skin discoloration.
- If you can't move your knee at all or can't move it normally.
Finally, things to remember
The Apley test is a quick and easy test that your doctor can do to check for a torn meniscus in your knee. You will likely also need to have an imaging test, such as an MRI. However, the Apley test is a good way for your doctor to understand exactly where you are feeling pain, what other symptoms you may have, and where in your knee there may be damage.
The most important thing is to tell your doctor about any pain or discomfort you feel during the test. Although the Apley test may cause a little stress on your meniscus, you should not feel unbearable pain.
So, if you have a knee problem, don't be afraid to see a doctor. He or she will do the necessary tests and provide you with the best treatment.
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