Valgus and Varus Stress Tests

What are valgus and varus stress tests?

Valgus and varus stress tests are a series of movements your healthcare provider will use to diagnose ligament injuries to the collateral ligaments in your knee or elbow.

Your provider will physically press on your knee or elbow to identify any pain or other symptoms you feel during the movements. It’s less common, but your provider might perform valgus or varus stress tests on other joints like your wrists and ankles, too.

The tests check for damage to your collateral ligaments. There are collateral ligaments in your knees and elbows. You have an MCL (medial collateral ligament) on your knee’s inside edge, as well as on the side of your elbow that’s closer to your body. You have LCLs (lateral collateral ligaments) on the outside edge of your knees and elbows.

Valgus and varus stress tests are in-office physical exams, which means your provider can perform them without any special equipment or a separate appointment. They’re usually part of a preliminary exam when you visit your provider with knee pain, pain in your elbow or after an injury. You’ll probably also need at least one of a few imaging tests to confirm any ligament damage or other injuries in your knee or elbow.

If the damage inside your joint needs surgically repaired, you might need an arthroscopy.

When would I need a valgus or varus stress test?

Your provider might perform a valgus or varus stress test if you have pain in your knee or elbow — or if you injured your leg or arm. These tests help them check for damage to the collateral ligaments that support your joints.

Damaged ligaments are some of the most common sports injuries. An injury to a ligament is called a sprain or a tear. Many sprains are mild, but torn ligaments can be serious injuries.

Valgus stress tests are used to diagnose injuries to your MCLs. Varus stress tests check for damage to your LCLs.

If you injure a ligament, symptoms may include:

• Bruising or discoloration.
• A loose feeling in your joint.
• Pain.
• A popping or snapping sound.
• Swelling.
• Trouble putting weight on your leg or moving your elbow.
• Weakness in that joint.

Who performs valgus and varus stress tests?

A healthcare provider will perform valgus and varus stress tests in their office. They don’t need any special equipment or facilities to conduct the tests.

How do valgus and varus stress tests work?

Valgus and varus stress tests are a series of movements to check your symptoms and range of motion (how far you can move your joint). The tests are simple and include the following steps:

• You’ll lie on your back.
• Your provider will lift your arm or leg slightly above the rest of your body.
• Your provider will apply light pressure on just above your knee or elbow joint. They’ll press in, toward your body during a valgus stress test and out, away from your body during a varus stress test.

If you’re having a valgus or varus test on your knee, your provider might perform the test twice — once with your knee slightly bent, and once with it straight.

The different positions and pressure apply mild stress on your ligaments. The movements are close to the kind of tension that’s applied to your knee or elbow while you use them throughout a typical day.

While your provider is moving your knee or elbow, they’ll ask you if you’re feeling any pain. They’ll also listen and feel for a popping. This lets them check for where (or how severely) your ligaments might be torn.

Valgus vs. varus stress test

Valgus and varus stress tests are very similar. The only difference is which way your provider will press on your knee or elbow to check for ligament damage.

“Valgus” is the medical term for a force that pushes in toward the center of your body. Your provider will press your knee or elbow in, toward your body during a valgus stress test.

“Varus” is the medical term for pushing out, away from the center of your body. It’s the opposite of valgus. During a varus stress test, your provider will apply pressure on your knee or elbow out, away from your body.

How do I prepare for a valgus or varus stress test?

You don’t need to do anything to prepare for valgus or varus stress tests. Just visit a healthcare provider as soon as possible if you’ve injured your knee or elbow — or if you notice any new symptoms in your joints.

What should I expect during a valgus and varus stress test?

Try to relax while your provider is moving your knee or elbow.

Because valgus and varus stress tests are a series of physical motions, make sure you 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 the tests will help your provider know where your ligaments are damaged, or what other kind of injury you might have.

What should I expect after a valgus or varus stress test?

Valgus and varus stress tests are usually the first step in treating a ligament injury. If your provider feels or hears anything during the tests, they’ll recommend either further imaging tests or a treatment to relieve your symptoms.

After the valgus or varus stress tests, you might need at least one imaging test. These tests will take pictures of the inside of your joint and confirm any damage to your ligaments or other tissue. The most common imaging tests include:

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

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

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

Do valgus and varus stress tests have any risks?

There aren’t any risks to your knee or elbow during a valgus or varus stress test.

You might feel a little pain or discomfort during the test. But even if you do have a ligament injury, you shouldn’t feel intense pain while your provider performs the tests.

Valgus and varus stress tests aren’t the only tests you’ll need. They’re not perfect at diagnosing injuries or damage. But they’re a helpful first step your provider will take to diagnose your injury. Imaging tests will give a more conclusive answer, which is why you’ll probably need at least one even after a valgus or varus stress test.

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

Valgus and varus stress test results aren’t as direct as some other tests you might have had before. Instead of giving an exact range or a specific number, they give your provider a better understanding of what might be injured in your joint (and how severe the injury is).

They’re more like a true or false question and less like a math problem that has an exact answer. Your provider will classify your test as positive if they find anything that indicates that you have a damaged collateral ligament. A negative result means your provider didn’t feel or hear anything during the test.

A negative result doesn’t necessarily mean don’t have an injury. It just means your provider didn’t notice anything during the valgus or varus test. You might still have a torn ligament, or you could have another injury.

When should I call my healthcare provider?

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 or elbow.

A note from Cleveland Clinic

Valgus and varus stress tests are quick, simple first steps that will help your provider figure out if the ligaments in your knee or elbow are injured. They won’t give an exact result, but they’ll help guide what comes next as your provider diagnoses and treats your injury.

Visit your provider or go to the emergency room right away if you injure your knee or elbow — especially if you can’t use or move them.