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In the year 1957 Childress et al described that isolated lesions of the posterior third of the medial meniscus are frequently overlooked and misdiagnosed. Upon reviewing he discovered that most of the patients had done work involving a squatting position or crouching down which led him to the invention of the duck walk test. The duck walk test has now been validated by a study of van der Post et al in the year 2017 who found a sensitivity of 71% and a specificity of 39%. Although designed for the posterior meniscus the test scored equal for anterior posterior medial and lateral tears in this study. However due to its limited accuracy its clinical value is rather weak. To perform the duck walk test have your patient assume a full squat position. The patient is then asked to waddle back and forth and from side to side while in the squatting position without extending the knee very much. This position applies both a flexion and axial load and the patient actively rotates the tibia internally and externally during the waddle. This test is positive if the patient is not able to attain complete knee flexion due to pain at the posterior joint or by clicking at the posterior medial portion of the joint, usually followed by discomfort. Obviously it cannot be performed by some patients. It would not be appropriate in patients in whom the McMurray test was already positive or where the patient was lacking full flexion due to its considerable compressive force.⁠
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