Apley Test

What is the Apley test?

The Apley test is a series of knee and lower leg movements healthcare providers use to diagnose a torn meniscus. You might see it referred to as an Apley grind test or an Apley compression test. Providers use these names interchangeably to refer to the same test.

The Apley test is an in-office physical exam, which means your provider can perform it without any special equipment or a separate appointment. You’ll lie on your stomach and your provider will twist your lower leg to identify any pain or other symptoms you feel during the movements.

The Apley test is usually part of a preliminary exam when you visit a provider with knee pain or after an injury. You’ll probably also need at least one of a few imaging tests to confirm a torn meniscus or any other injuries in your knee.

Apley test for shoulders

There’s also a type of Apley test used to diagnose issues in your shoulder. You might see it referred to as the Apley scratch test. Even though the names are similar, these are two different tests and sets of motions used to diagnose different issues and conditions. You won’t need an Apley scratch test if you have a knee injury.

Apley test vs McMurray test and Thessaly test

The Apley test is similar to other tests used to diagnose damage inside your knee. The Apley test, McMurray test and Thessaly test are all different forms of physical motions that can help your provider diagnose a torn meniscus or damage inside your knee. The difference between them is which specific movements they use.

During an Apley test, you’ll lie on your stomach while your provider moves your knee.

If you need a McMurray test, you’ll lie on your back while your provider bends and moves your knee.

If you need a Thessaly test, you’ll stand on one leg and twist your knee.

During all three tests, your provider will feel or listen for symptoms of injuries in your knee. Make sure you tell them if you feel any pain or discomfort.

When would I need an Apley test?

A provider might perform an Apley test if they think you have a torn meniscus. It’s one of the most common knee injuries — especially among athletes.

Your meniscus is a rubbery wedge of cartilage in your knee between your femur (thigh bone) and tibia (shin bone). It’s like a shock absorber that cushions your bones and knee joint. Any sudden and intense jerking motion on your knee can tear your meniscus. Sports injuries are the most common cause, but traumas like falls and car accidents can also tear your meniscus.

The most common symptoms of a torn meniscus include:

• Feeling or hearing a pop in your knee.
• Instability in your knee or feeling like it might give out.
• Pain.
• Stiffness.
• Swelling.
• Being unable to fully bend or straighten your knee like you usually can.

You might need an Apley test when you visit a provider after injuring your knee. They’ll perform the test as part of your physical exam, especially if you’re having symptoms of a torn meniscus. The Apley test can help your provider know if you damaged your knee ligaments or other connective tissue during your injury.

People who have torn their meniscus have an increased risk of developing osteoarthritis of the knee.

Who performs the Apley test?

Your provider will perform the Apley test in their office. They don’t need any special equipment or facilities to conduct the test.

How does the Apley test work?

The Apley test is a series of movements to check your symptoms and range of motion (how far you can move your knee joint). The test is simple and includes the following steps:

• You’ll lie on your stomach (prone).
• Your provider will lean their knee on the back of your thigh to hold your leg in place.
• Your provider will bend your knee to 90 degrees (perpendicular to the rest of your leg).
• They’ll lightly pull up on your knee.
• They’ll rotate your lower leg away from the center of your body then back toward the center of your body.
• After this, your provider might reset and do the same motions, but instead of pulling up on your lower leg, they’ll press down lightly. They might refer to this as applying compression or Apley’s compression test.

Your provider will probably perform an Apley test on both legs, starting with your uninjured leg. This will help them understand your usual range of motion before doing the test on your injured leg.

The Apley test’s movements apply mild stress to your meniscus. They’re similar to the kind of tension that’s applied to your knee while you use it normally.

While they’re moving your leg and knee, your provider will ask you if you’re feeling any pain or if your knee feels like it’s sticking or locking. They’ll also listen for a popping in your knee, or feel for your knee rotating too far one way or the other. This lets them check for where your meniscus might be torn.

How do I prepare for an Apley test?

You don’t need to do anything to prepare for an Apley test. Just visit your provider as soon as possible if you’ve injured your knee or you notice any new symptoms.

What should I expect during an Apley test?

Try to relax during the Apley test — if you tense up it might affect your provider’s ability to perform the test.

Because the Apley test is a series of physical motions, tell your provider everything you’re feeling — especially if any of the movements hurt or make you uncomfortable.

Any pain, discomfort or other symptoms you feel during an Apley test will help your provider know where your meniscus is torn, or what other kind of injury you might have.

What should I expect after an Apley test?

Your provider will probably recommend some imaging tests to diagnose an injury in your knee, even after they perform an Apley test.

These tests will take pictures of the inside of your knee and confirm any damage inside your joint. The most common imaging tests to diagnose a torn meniscus include:

• Magnetic resonance imaging (MRI).
• Ultrasound.
• X-rays.

Your provider will tell you which imaging tests you’ll need and which injuries they’re looking for.

You might also need a knee arthroscopy to diagnose or repair damage inside your knee. Knee arthroscopy is a minimally invasive surgical procedure that lets your surgeon see inside your knee joint with a tiny camera. Most knee arthroscopies are outpatient procedures, meaning you can go home the same day.

Does the Apley test have any risks?

There are no risks to your knee while having an Apley test performed on it.

You might feel a little pain or discomfort during the test, but even if your meniscus is torn, you shouldn’t feel intense pain.

Studies have found that the Apley test isn’t perfectly accurate at diagnosing a torn meniscus. However, it’s usually only the first step your provider will take to diagnose your injury. Imaging tests will give a more conclusive answer. They’re more accurate ways to evaluate your meniscus if your provider thinks it might be torn.

What type of results will I get and what do they mean?

The Apley test’s results aren’t as direct as some other tests you might have had before. Instead of giving an exact range or a specific number, an Apley test gives your provider a better understanding of what might be injured in your knee.

It’s more like true or false questions and less like a math problem that gives an exact answer. Your provider will classify your test as positive if they find anything that indicates that your meniscus is torn. A negative result means you didn’t experience pain, discomfort or other symptoms during the test.

A negative result doesn’t necessarily mean you won’t need other tests. Your meniscus might still be torn, or there might be other damage inside your knee.

When should I call my doctor?

Visit your provider if you’re experiencing symptoms like pain or swelling that get worse after a few days.

Go to the emergency room right away if you notice any of the following:

• Extreme pain.
• Swelling that’s getting worse.
• Discoloration.
• You can’t move your knee at all or can’t move it like you usually can.

A note from Cleveland Clinic

The Apley test is a quick, easy test your provider can use to begin diagnosing a torn meniscus in your knee. Even though you’ll probably still need at least one imaging test like an MRI, the Apley test is a good way for your provider to understand where exactly you’re feeling pain or other symptoms and where in your knee the damage might be.

Let your provider know if any of the motions hurt or make you uncomfortable. The Apley test puts mild tension on your meniscus, but you shouldn’t feel any intense pain.