Prone Knee Bend Test

Understanding radicular pain

When medical professionals speak of radicular pain, they talk about a type of pain that spreads. This pain originates from the neck, hip, or back. It travels along the spinal nerve root and spreads to the legs. This pain can be felt in areas like the anterior thigh, groin, calf, and even the foot, to mention a few.

Radicular pain occurs because of a pinched nerve, specifically nerve roots in the spine, due to compression or irritation of the pinched nerve’s root. This can happen in the cervical, thoracic, or lumbar regions. They will likely occur as a result of physical trauma due to falls or other accidents, the emergence of bone spurs, because of a herniated disc, or because of aging.

A person experiencing radicular pain will feel the pain in the area where the pinched nerve is located. They might feel tingling sensations in these areas, and their muscles might feel weak. In some cases, there’s numbness.

The pain will be felt in the neck, arms, and hands if it is cervical. If it’s thoracic, it’ll be felt in and around the chest area. If it’s lumbar, it’ll be felt in the lower back and legs.

What is the Prone Knee Bend Test?

For this guide, we will focus on a test for assessing radicular pain in the lumbar region. It’s called the Prone Knee Bend Test. This neurodynamic test was created to determine whether the pinched nerve causing radicular pain is the femoral nerve in the lumbar region.

Before conducting this physical examination, the examiner must prepare an examination bed. The patient lies in a prone position for this test. Once the patient is in position, the examiner must place one hand on the posterior thigh and the other on the leg.

Next, the examiner passively forces the patient's knee into knee flexion and must gently push the knee to the end. Once the knee reaches the end of the flex, the examiner must maintain the position for 45 to 60 seconds. Throughout this time, the examiner should watch for the reproduction of the patient’s symptoms of radicular pain.

If, for some reason, the knee can’t be flexed completely, an alternate way of performing this neurodynamic test is to flex the knee as far as they can and then perform passive hip extension by raising the knee a bit. They also need to maintain this position for 45 to 60 seconds. There should be no hip rotation (anterior rotation or otherwise).

How are the results of this test interpreted?

A positive test result can indicate the following possibilities:

• If the patient feels unilateral pain in the lumbar spine area, their buttocks, or their posterior thigh(s), the pain may be located in the L2-L4 nerve roots of their lumbar spine. This can mean that there is an L2-L4 nerve root lesion.
• If the patient feels pain in the anterior thigh area, there may be neural tension in the femoral nerve. It can also mean their quadriceps muscle is strained or tight.

Please note that the diagnostic accuracy of this test isn’t confirmed, so it shouldn’t be the one test to rely on. It merely detects the possible location of the radicular pain, specifically in the lumbar area.

It would be prudent to conduct other tests that involve hip flexors and the knee, like the Thomas Test, Straight Leg Raise Test, and the Slump Test, to cover more ground and to narrow the possibilities. The problem (potentially musculoskeletal disorders) should be confirmed through MRIs, CT scans, etc.

How does our Prone Knee Bend Test template work?

Usually, examinations such as the Prone Knee Bend Test don’t have specific recording sheets to accompany them. We at Carepatron took the liberty to create a results recording template for this test to make it easier for neurologists, physical therapists, etc., to record their results.

The template asks these professionals to indicate their patient’s name, medical history, feelings of radicular pain, and the date they underwent this test.

It also contains instructions on performing the test and four checkboxes to indicate whether the test is positive or negative. There are two positive checkboxes. The professional must select the one based on the location of the pain.

There are two negative checkboxes, too—one for indicating no pain and one for indicating pain but not in the lumbar region.

Prone Knee Bend Test example

Now that you know how the Prone Knee Bend Test is conducted and what our template entails, it’s time to show you what it looks like.

Download our free Prone Knee Bent Test template example here

Another feature of this template is the additional comments box. This is where you can discuss your findings in depth and detail any next steps you have in mind for your patient.

You can print physical copies or engage with it through a computer or capable mobile device. If you use the PDF file, there are fillable fields, and the checkboxes can be ticked with a mouse click.

If you like what you see and believe this is a great way to record results, feel free to download our template!

What are the benefits of this test?

Here are some of the benefits of using our Prone Knee Bend Test template:

It’s easy and quick to conduct.

One of the great things about neurodynamic tests, such as the Prone Knee Bend Test, is that they don’t require much to be conducted. All this test needs is an examination bed and the examiner's two hands to conduct. The instructions are nowhere near complicated, and the test can be completed in two minutes.

It can help narrow down the source of a person’s radicular pain

Before anything, it’s best to remember that this test is not diagnostic, mainly because it doesn’t confirm the problem. It confirms the location of the radicular pain, and knowing its location can help narrow down the potential issues causing it. It’s also a good fit for comprehensive physical examinations because it can work well with other neurodynamic examinations to determine the potential sources of radicular pain.

It can be used as a monitoring test

Let’s stipulate that an official diagnosis is made. The patient is confirmed to have a femoral nerve lesion. A professional can schedule a routine physical examination to check if the pain is still there and if it’s improving. One way of doing so is to reconduct the Prone Knee Bend Test. If the pain is still there and still hurts to the same degree as before, perhaps tweaking a patient’s treatment plan is best. If the pain is still there but is considerably less painful, then it’s safe to assume the plan is working.

Radicular pain treatments

Radicular pain treatments vary depending on the severity of the condition and its underlying cause. Some treatments are more conservative:

Using ice or heat compress

This is the most conservative way to treat radicular pain. Ice or heat compresses will help soothe the muscles in the back, which can relax and untighten them. Using compresses may even reduce swelling. How often and long such compresses should be used depends on a patient’s discussions with their healthcare provider.

Using pain relievers

If ice or heat compress isn’t doing it, then it’s likely that healthcare professionals will prescribe over-the-counter NSAIDs to relieve the pain. It would be best to follow the recommended dosage and for how many days they should be taken. Another option is to take corticosteroids, which come in the form of pills or injections. Like NSAIDs, these should relieve the pain as well.

Taking physical therapy

Physical therapy can help relieve radicular pain over time by having the patient participate in simple exercises to relieve spinal pain. Not only will such exercises ease pain, but they can also help with fixing posture. Whatever exercises a patient will take will depend on what their therapist believes is right for them.

Why use Carepatron as your physical therapy software?

Thanks for reading this guide! We hope this was a good introduction or refresher to the Neoplasmic Reticulum (Neoplasm) Test and that our Neoplasmic Reticulum Test template helps you record patient results easily.

While we still have you, we’d like your time to check more of the Carepatron platform. We have various features that we believe are cool and helpful enough that you’ll consider us your number one clinical documentation and physical therapy practice management software. We won’t detail those features here, but we’d like to highlight our resource library at least.

Our resource library is one of the features we’re most proud of. It houses a massive collection of clinical and non-clinical resources, and it covers a wide range of healthcare fields, practices, and topics, including physical therapy!

We have guides about other neurodynamic tests, some of which we mentioned earlier, like the Straight Leg Raise Test and Slump Test. We recommend checking these out and adding them to a comprehensive physical examination along with the Prone Knee Bend Test! They also come with templates for recording patient results.

What’s great about these templates and guides is that they’re all free, so read as many as you want and download as many templates as you need for your work!