McMurray’s Test

McMurray’s Test is a classic orthopedic examination to assess for meniscal tears in the knee. Specifically, the test assesses potential injury to the medial or lateral meniscus. The meniscus is a C-shaped cartilage that cushions and stabilizes the knee joint, commonly injured in twisting or traumatic movements.

How the Test is Performed

Client position: Supine (lying on their back) with the knee fully flexed.

The examiner holds the heel/foot with one hand and the knee/joint line with the other.

To test the medial meniscus:

The tibia is externally rotated (toes point outward), and a valgus stress is applied as the knee is slowly extended from a flexed position.

To test the lateral meniscus:

The tibia is internally rotated (toes point inward), and a varus stress is applied as the knee is extended.

• The examiner palpates for any audible or palpable click, thud, pop, snap, or pain at the joint line during movement especially at the transition from flexion to extension.

• A positive test: Reproduction of clicking, locking, catching, or pain (indicative of a potential meniscal tear).

Clinical Significance

• A positive McMurray’s Test indicates possible medial or lateral meniscus tear, frequently associated with joint line pain, swelling, mechanical symptoms (locking/giving way), or history of knee trauma.

• The test has higher specificity than sensitivity. A positive result is suggestive of a meniscal tear, but a negative test does not rule it out; MRI or further imaging may be required for confirmation.

• Other tests, like Thessaly or Apley’s Compression, may be used alongside for comprehensive knee assessment.

Assessment

• Use for clients with history of twisting knee injuries, mechanical symptoms, joint line pain, or persistent swelling/stiffness.

• Document the movements which provoke symptoms/clicks and be precise about pain location and intensity for referral and treatment planning.

Treatment

• If positive:

  • Avoid deep tissue work, direct joint mobilization, or high-force flexion/rotation at the knee, especially if mechanical symptoms or acute pain are present.

  • Focus on gentle soft tissue and pain-modifying techniques to the surrounding musculature (quads, hamstrings, calves).

  • Educate clients about avoiding deep squats, twisting, or pivoting activities until cleared by a healthcare provider.

  • Refer for further medical imaging (MRI) and evaluation by an orthopedic or physical therapist if a meniscal tear is suspected, as some tears may require surgical management.

Safety and Referral

• Monitor for “red flag” signs: locked knee, severe instability, significant effusion, or pronounced movement loss, which warrant urgent referral.

• Coordinate with the rehab team for structured progression in post-injury or post-operative cases.