♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together we are the most famous
physical therapists on the internet.
- In our opinion, of course, Bob.
- Today, we're talking about the easiest ACL
test you could do at home.
Is for an ACL tear. Really, is the question.
Do you have an ACL tear?
And we're gonna help you answer that.
- Exactly.
Yeah Bob, this specific test
statistically is the easiest
and more accurate manual test,
according to one particular study.
And after looking at this and working with it, it's great.
- I like it because it's visual.
- Yeah.
- It doesn't rely on your sense of touch.
- Right. Where you need to maybe do three or 400 tests
on a knee to get a good feel for it.
Do we have to do some introductions?
- Well, we'll mention that we are doing a giveaway.
We do one every week.
Just go to www.bobandbrad.com
go to the giveaway section,
find out what it is,
I don't even know what it is this week,
but you can also find it on Facebook
it will be pinned at the top of the page.
It could be the big motherload, the cornucopia.
- That's right. Oh, check out our podcast too.
- That's right. Okay.
Bob, so let's talk about this deal.
Back in the day, the very standard manual tests
that therapists, doctors would do,
there's three of them that come to my mind
that I used to do.
The McMurray's, which I didn't really like that one.
The Anterior Drawer and the Lachman.
I like both of those, but again,
it took a number, you know?
- Yeah, I had to do them for a while...
- Yeah to get a good feel for it.
So this one, again,
- That was back when the dinosaurs roamed the earth.
(Brad chuckles)
No, its still a good test.
- Yeah, they are, they're still used.
The idea is even if you do this test and it's positive,
that you do have a torn ACL,
you really cannot confirm that,
you need to see a doctor, an orthopedic doctor,
they'll do the test and they'll do an MRI
and then you'll confirm.
But with this, you have an idea of what's going on.
If they do this tests with you, so it's not new.
So if your knee is still swollen and painful,
you're not going to test it.
You know, it has to be where you can move it,
you may be walking out of it, but feels unstable
and you're wondering,
Do I have an ACL tear? Is what we're looking at.
So it's quite simple.
Typically you would do this on the floor,
probably a carpeted floor would be best.
We're going to do it on the plinth here.
But this is soft and you cannot do it on a bed,
so I just put this board here.
We're doing it up at this level,
it's easier viewing for the camera.
That's the only reason we're doing it.
- So we're gonna pretend that this knee is fine.
- Yep.
- My right knee.
My left knee has a tear.
- Or questionable.
- So I'll first put the right one up there.
- Right. Yeah, we can do it this way.
So you're going to take,
you know, I was going to use this six inch roll
that we use, you know,
- Sure.
- But actually it's kind of big and awkward.
So I'm going to use this.
This is a little over three inch
piece of PVC pipe, actually.
- You can actually just take a, I suppose a rolled towel.
- Hm, Its gotta be firm.
Something firm, you know.
It just has to be something about, you know,
three and a half to six inches in diameter and firm.
Yeah, bring up, you show a little leg.
(Bob and Brad chattering)
- You wanna see exactly where this is at.
- You're right.
Yeah, you don't want it in the crux of the knee.
The popliteal fossa, to be anatomically correct.
I wanna go right about there.
You could do it with the shoe on or the shoe off.
And what I'm going to do is go above the joint,
the joint lines from above the knee cap,
take my hand and press right here.
And then we're going to look...
Bob is going to relax.
He's going to be completely relaxed.
- [Bob] That's really key here.
That's why it's partly,
we wait for the swelling to go down
because a lot of times it's too painful before that.
- [Brad] Yeah, if it's painful the person is apprehensive-
- [Bob] They're tightening up-
- Yeah, and you won't get an accurate test.
So I'm going to go here,
and I'm not going to jerk kind of,
just a, you know, pleasant little push down.
And then we're going to look here.
Now, if I press down,
see how the heel inherently comes off the floor?
The reason as to doing that,
the transfer of the force
is going right through the ACL ligament, lifting that.
If you have a weak ligament,
or a torn ligament-
- Right, if it's no longer intact.
- You're going to push down...
- And the heel won't come up.
- Right. So that's why you do the good leg first,
just to get a good feel.
Because some people have really lax ligaments
and it'll vary this test a little bit.
So get an idea what the good one looks like.
So I know that. Now we're going to do the other one.
And do this, and do the same thing.
And if I push down...
- I'll pretend is not going up.
- Yeah. I'm doing the same force down,
and we get no motion at all.
You may even see some translation,
here at the skin where the joint is.
- Yeah, you might see that as pushing down, but it's not.
- Yeah, you get more emotion there,
the person is going to have a different sensation
or maybe a little painful.
So that is the test, and it's that simple.
- A very simple, very easy to do, and very easy to see.
- Did we mention who started this?
- No you didn't.
- Oh.
- Give the credits.
- Yeah, the doctor, his name is from Italy.
His name is doctor -I hope I can pronounce it properly-
Dr. Alessandro Lelli.
It's the Lelli sign, or the lever sign, or the Lelli's test.
- Is spelled L-E-L-L-I.
- Right, right.
So you can look that up and see what-
- But you said he had a lot experience.
- Oh, he did thousands of ACL surgeries.
He's been a surgeon for over 30 years.
He's just an expert in the field, and you know,
you just got to depend on.
And the test, like I said,
really test extremely high in the positivity rates.
So it's a wonderful test.
- One study you saw was 100%?
- Yeah. Yeah.
And you know, so we're not just making this up,
like some of our videos.
I'm just kidding, just kidding,
We don't make anything up.
Except for Bob.
- Being smart.
We make that up. All right.
- All right, be careful in everything you do.