One of the first assessments we do in the evaluation of a patient is to assess their amount of hyperextension. It is important to have the patient relaxed while performing this assessment. In general, we lift the ankle or the great toe while providing a stabilizing force to the distal thigh to determine the amount of hyperextension, or genu recurvatum, present. The amount of hyperextension is measured in negative “-” degrees, while a lack of full extension is measure in positive “+” degrees. Limitations of knee extension in younger patients may be due to osteochondritis dissecans, a mild amount of arthritis, or a locked meniscus tear.