Knee deep in Mike Reinold’s Knee Seminar, we came across a newer test, the Lever Test, for testing for anterior cruciate ligament (ACL) laxity. One study proposed that it surpassed the standard Lachman’s and Anterior Drawer tests.
We have to say: We get the bio-mechanics of the test and can see its clinical usefulness in a less acute stage of ACL tears (less swelling, tissue irritability, pain and guarding). However, the Lever Test is basically a one shot deal for us. Because the test is a bit aggressive on the knee, it can often increase pain, which may increase client apprehension and hamstring guarding. That is to say, once we administer the Test, the client’s knee may get “pissed off,” guard and give us a false negative grade to the test.
Overall, we prefer the less aggressive Lachman’s and Anterior Drawer tests for assessing ACL lesions for most new, acute ACL injuries and post-surgical procedures. We would, however, recommend adding the Lever Test for later re-evaluations, when pain and muscle guarding have calmed down.
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