Apley’s Test assesses knee pain and symptom response during tibial compression and rotation. It may help identify meniscal irritation but does not confirm meniscal injury on its own.
Twisting knee pain, locking sensations and joint-line discomfort are common in sport and training settings.
Apley’s Test combines tibial compression and rotation to load the meniscus and observe symptom reproduction.
The test is commonly used alongside:
joint-line palpation
McMurray’s Test
Thessaly Test
knee history and swelling assessment
A positive result may increase suspicion of meniscal involvement but should always be interpreted within the broader clinical picture.
Test name: Apley’s Test
Also known as: Apley Compression Test
Body region: Knee
Purpose: Assess meniscal irritation and symptom provocation
Positive finding: Pain, clicking or locking during compression and rotation
Negative finding: No symptom reproduction during testing
Best used with: McMurray’s Test, Thessaly Test and joint-line palpation
Key limitation: Symptoms may overlap with ligament or joint irritation
Apley’s Test is performed with the knee flexed to approximately 90 degrees while compression and rotational force are applied through the tibia.
The test attempts to load the meniscus and reproduce symptoms linked to meniscal irritation or injury.
The test may help:
assess suspected meniscal irritation
reproduce twisting-related knee symptoms
guide further knee assessment
support clinical reasoning in mechanical knee pain presentations
It is commonly used after:
twisting injuries
change-of-direction sport injuries
rotational knee loading incidents
reports of clicking or locking sensations
Apley’s Test assesses:
symptom response during tibiofemoral compression
rotational tolerance of the knee joint
possible meniscal irritation
pain provocation under compressive load
It does not identify tear size, tear location or confirm structural damage.
This test may be useful for:
exercise professionals
rehabilitation practitioners
strength and conditioning coaches
sports medicine settings
movement assessment professionals
Use when there is:
twisting knee pain
joint-line tenderness
clicking or locking symptoms
pain during rotation or squatting
suspected meniscal involvement
Use caution with:
acute swelling
highly irritable knees
suspected fracture
recent surgery
inability to tolerate prone positioning
Stop testing if:
pain becomes severe
guarding prevents assessment
symptoms escalate rapidly
Treatment table
Pain scale
Measurz recording workflow
Position the client prone on a treatment table.
Knee flexed to approximately 90 degrees
Hip relaxed
Lower leg free to rotate
Stand beside the tested leg.
One hand stabilises the posterior thigh
Other hand grips the lower leg or heel
Apply downward pressure through the tibia to compress the knee joint.
While maintaining compression:
internally rotate the tibia
externally rotate the tibia
Observe:
pain
clicking
locking
symptom location
Ask the client to:
remain relaxed
report familiar symptoms
describe pain location and intensity
A positive Apley’s Test may include:
joint-line pain
clicking
catching
locking sensation during rotation
A negative finding involves:
no symptom reproduction
tolerance to compression and rotation
no mechanical symptoms
Stop if:
pain becomes severe
locking occurs
guarding limits movement
Use controlled force and avoid aggressive rotation in highly irritable knees.
A positive Apley’s Test may suggest:
meniscal irritation
meniscal injury involvement
rotational sensitivity of the knee joint
It becomes more meaningful when combined with:
joint-line tenderness
swelling history
mechanical symptoms
other meniscus tests
A negative test may reduce suspicion of meniscal involvement, but it does not exclude smaller tears or less irritable presentations.
The test does not confirm meniscal injury on its own.
Research shows variable diagnostic accuracy for Apley’s Test across populations and study designs.
Condition or presentation: suspected meniscal injury
Population: adults with knee pain or mechanical symptoms
Test variation: Apley Compression/Rotation Test
Reference standard: arthroscopy or imaging depending on study
Sensitivity: generally reported as low to moderate
Specificity: generally reported as moderate
Positive likelihood ratio: variable across studies
Negative likelihood ratio: variable across studies
Key limitations: examiner technique, symptom irritability and overlap with other knee pathology
Evidence suggests Apley’s Test has greater value when combined with other meniscal assessments rather than used alone.
Reliability improves with:
consistent knee positioning
controlled compression force
clear symptom clarification
Validity is stronger when symptoms match:
twisting injury history
locking or clicking
joint-line tenderness
Common errors include:
excessive compression force
rotating too quickly
poor stabilisation
not clarifying symptom location
over-interpreting general knee discomfort
Limitations include:
overlap with ligament or joint irritation
limited standalone diagnostic strength
symptom variability between individuals
Apley’s Test may help:
assess mechanical knee symptoms
guide exercise modification
support referral decisions
monitor symptom irritability over time
contribute to meniscus assessment clusters
Record:
test name
side tested
result (positive / negative / unclear)
pain location
pain score (0–10)
clicking or locking symptoms
internal/external rotation response
compression tolerance
comparison side
irritability level
swelling presence
related findings
interpretation notes
McMurray’s Test
Thessaly Test
Joint-Line Palpation
Ege’s Test
Sweep Test
Lachman Test
What does Apley’s Test assess?
It assesses knee pain and symptoms during compression and rotation.
What is a positive Apley’s Test?
Pain, clicking or locking during rotational compression.
Does it diagnose a meniscus tear?
No. It may suggest meniscal involvement but does not confirm injury.
Should it be used alone?
No. It works best with other meniscus tests and clinical findings.
Can ligament irritation affect the test?
Yes. Other knee structures can also reproduce pain during testing.
What does Apley’s Test assess?
Meniscal pain and symptom response during knee compression and rotation.
Does it confirm a meniscus tear?
No. It only helps support assessment reasoning.
What does a positive result mean?
It may suggest meniscal irritation or mechanical knee sensitivity.
What does a negative result mean?
It may reduce suspicion of meniscal involvement.
Should it be used alone?
No. It works best as part of a meniscus assessment cluster.
What is the main value of the test?
Helping identify whether rotational knee loading reproduces familiar symptoms.
Hegedus, E. J., et al. (2018–2022). Diagnostic accuracy of knee special tests. British Journal of Sports Medicine.
Smith, B. E., et al. (2020–2023). Meniscal assessment and knee pain clinical reasoning updates. Journal of Orthopaedic & Sports Physical Therapy.
Logerstedt, D. S., et al. (2021). Knee pain and meniscal lesion clinical practice guideline updates. Journal of Orthopaedic & Sports Physical Therapy.
