Bony Palpations; Patella Tibial Plateau Joint Line Tibial Tuberosity Head of Fibula Soft Tissue Palpations Patellar Tendon 355 Exceptions IT Band Pes Anserinus

Patella -The kneecap. Feel around the entire circumference.

Patellar Tendon - Find the patella. Move directly inferiorly and find the tendon. Should be able to “pinch” the tendon.

Tibial Tuberosity - The superficial knob located distal to the patella on the shaft of the tibia. Partner seated with knee flexed, locate the patella. Slide fingers three to four inches inferior from the patella. Using thumb pad, explore the tuberosity.

Joint Line (Medial/Lateral) - Partner seated with knee flexed. Place thumbs on either side of the patella. Slide inferiorly, compressing into the tissue. You will feel a softening in the knee as your thumbs sink into the joint space between femur and tibia.

Tibial Plateau ( Medial/Lateral) - Continue inferiorly until you feel a bony rising, this is the plateau edges. Palpate both the lateral and medial side.

Medial Collateral Ligament (MCL) – Best found through the joint line. Dig thumb into the joint line and move medially roughly 1-2”. Joint density will go from a ‘squishy’ feel to tense. When you reach the point of tenseness, move your thumb up and down roughly two inches.

This is the length of the MCL.

Head of Fibula - Partner seated with knee flexed. Locate the tibial tuberosity. Slide your fingers laterally three to four inches toward the outside of the leg. Palpate the head of the fibula and feel the entire diameter.

Lateral Collateral Ligament (LCL) - Place the knee in 90 degrees of flexion and externally rotate and abduct the hip (i.e., cross the ankle of the involved leg over the opposite leg) to make the LCL more identifiable. Most easily identified if one finds the head of the fibula first and then goes directly above it.

The length of the LCL will go roughly 2-3” straight above the head of the fibula.

Active & Passive Range of Motion (ROM) & Manual Muscle Testing (MMT):

• Flexion
• Extension

If athlete is sitting on exam table, ensure that the exam table does not interfere with full ROM