McMurray Test

What is the McMurray Test?

Before we discuss what the is, let’s discuss what meniscus tears are for a bit. A meniscus is a type of cartilage found between the shinbone and the thighbone, and it serves as the knee’s shock absorber. But this absorber has its limits, though! If you aren’t careful, you can accidentally tear your meniscus.

Meniscus tears are actually the most common type of knee injury. More often than not, athletes or people who normally engage in physically taxing activities get checked for meniscus tears, though they aren’t exclusive to them. Sometimes, a meniscus tear happens because the meniscus degenerates over time as a person gets older.

If you need to know if you have a meniscus tear or not, here are the symptoms to look out for:

• There is a pain in the knee. The pain can be inside (medial), outside (lateral) or in the back of the knee
• The knee is swelling
• The knee joint locks from time to time
• The person is limping
• There is an inability to fully extend the knee
• There is an inability to bend the knee

Of course, just because you have these symptoms doesn’t necessarily mean you have a meniscus tear. To find out, it’s best to see a physical therapist or adjacent healthcare professional for a test.

One of the tests that they will administer is the McMurray Test. This test is a type of physical therapy assessment where the person administering it actually tends to the patient instead of simply observing them. The therapist will manipulate a patient’s legs while applying pressure to the knee joint to gauge the patient for any meniscus tears.

How to administer the McMurray Test

The McMurray Test is one of the simplest ways to check patients for meniscus tears. Earlier, we mentioned that the physical therapist conducting this test will be tending to the patient by manipulating the patient’s legs in such a way that they can apply pressure on the knee joints. This is how it is exactly done:

• The physical therapist must let the patient lie down on a flat surface in a supine position. The patient must also flex the knee that will be examined.
• The physical therapist must position themselves on the side that will be examined.
• The physical therapist must use their proximal hand to hold the patient’s knee as well as to palpate the joint line. Their thumb must be on one side while their fingers should be on the other.
• The physical therapist will hold the sole of the patient’s foot with their distal hand. They will use this to support the limb and move it as instructed.
• “Move it as instructed”, you ask? Here’s what needs to be done once you have followed the directives that were just mentioned:
• From a position of maximal flexion, extend the knee with internal rotation (IR) of the tibia and a VARUS stress. This is for checking the patient for lateral meniscus tears.
• Return to maximal flexion and extend the knee with external rotation (ER) of the tibia and a VALGUS stress test. This is for checking the patient for medial meniscus tears.

How to interpret the results of the McMurray Test

Most physical therapy-related assessments have scores, however, for the McMurray Test, there is none. Given that, how exactly do we interpret the findings of this test?

The results of this test will be based on what the physical therapist notices while following the instructions above.

To determine if the patient is positive for having a meniscus tear, whether lateral or medial, the physical therapist must take note of the following:

• Is there pain? Does the patient react audibly or through their facial expressions in a way that tells you they are in pain whenever you manipulate their leg and apply pressure on their knee?
• Did you hear any snapping or clicking while applying pressure on their knee?
• While flexing their knees, did it lock at any instance?

If you noticed that these symptoms are present, then these are indicators of a torn (or at least compromised) lateral and/or medial meniscus.

We did mention earlier that this is one of the tests a physical therapist can conduct to check for meniscus tears. It’s highly recommended that you conduct other tests, such as the Thessaly Test, Apley’s Test, and the Joint Line Tenderness (JLT) Test in order to to be more comprehensive and sure about the patient being positive for meniscus tears. If all tests are consistent, then you should recommend them for an X-ray or MRI to confirm the tear. Depending on the severity of the tear, they might have to undergo surgery.

When is it best to conduct the McMurray Test?

The best time to conduct the McMurray Test will always be when a patient sets up an appointment with you to have their knees checked for any possible meniscus tears they might have. It is usually included as part of a comprehensive examination.

As mentioned earlier, the McMurray Test may not be enough to confirm any suspicions, so it’s best to administer tests like the Joint Line Tenderness (JLT) and have them checked using imaging tests like X-rays or MRIs. As much as possible, the McMurray Test should not be the sole assessment used to determine if a patient has meniscus tears.

The test doesn’t have to be a one-time, big-time test to be administered either. You can definitely re-administer this test as a way to monitor your patient. Let’s say that the X-ray results didn’t show any signs of meniscus tears, but the patient is still in pain. You can schedule them for routine examinations to check on the progress of this pain. Who knows, a meniscus tear might appear down the line! Of course, hopefully, that doesn’t happen.

It can also be used to determine if whatever treatment was applied is working or not. But if you will use this on someone who had to get surgery for their meniscus tears, it’s better to hold off administering this for a while and only do so after they have healed up a bit.

Who can conduct the McMurray Test?

Given that the McMurray Test is a type of physical therapy assessment, the following healthcare professionals can definitely use this to evaluate their patients and check for any possible meniscus tears they might have:

• Physical Therapists
• Occupational Therapists
• Primary Care Physicians
• Orthopedists

So long as the healthcare professional using this is highly trained and experienced when it comes to conducting examinations where they actually manually check the patient instead of simply observing them from a short distance, then they can definitely add this to their roster of physical therapy assessments.

It’s a test that is only allowed to be conducted by such professionals because they will be able to make educated decisions based on what they notice while manipulating the limbs of the patient and applying pressure on their knees.

We mentioned earlier that meniscus tears are common when it comes to athletes. This particular test can be conducted by Sports Physicians as well since they will be on the bench (pun intended) just in case an athlete suddenly gets into an accident while competing, which causes a meniscus tear. They can even implement it as part of an athletic training evaluation in order to check for potential risks of meniscus tears, and adjust their training accordingly to avoid the risk of tears.

What are the benefits of the McMurray Test?

It can help identify meniscus tears in real-time.

Since the McMurray Test is a manual type of physical therapy assessment that requires the professional to manipulate a patient’s legs and apply pressure to their knees, the professional can identify potential meniscus tears in real-time. The results are immediate and based on what the professionals notice as they apply pressure to the knees.

It makes comprehensive examinations more effective.

The McMurray Test is one of several types of physical therapy assessments that evaluate patients for Meniscus Tears. Normally, you want to conduct as enough tests as possible, and this is definitely one that you can include in your roster of tests. It’s inexpensive to conduct as well because you don’t need any special equipment. All you need is a flat surface and your hands.

It can monitor the progression of injury or recovery in patients.

You can re-administer this test as part of a routine examination. If a patient is showing signs of having a possible meniscus tear but test results show that they don’t, you can re-administer this every now and then to check if a patient’s knee pain is gradually getting worse. Who knows, at first, they were simply at risk of getting tears, but after a series of examinations, the pain eventually got worse and resulted in a lateral or medial meniscus tear.

If a patient was already treated, you can use this to see if they are recovering well. Of course, if they are already recovering, it’s best to be gentle when conducting the McMurray Test on them.