The Lever test is performed with the patient supine and knee extended. The examiner places a fist below the proximal third of the patient's calf, thereby elevating the knee, and presses down on the distal third of the patient's quadriceps. If the ACL is intact, downward pressure on the quadriceps causes the ipsilateral heel to rise (panel A above). If the ACL is torn, downward pressure will not cause the heel to rise (panel B above).
