Hip Tests
Ober's test
The Ober's test evaluates a tight, contracted or inflamed tensor fasciae latae and iliotibial band.
Patient position:
Lying In lateral position on the uninvolved side, with his knee flexed in a 90º angle.
Therapist position:
Standing in the back of the patient, holding the leg to test.
Action of the test:
The examiner places the knee in a 5º flexion angle, fully abducts the lower extremity that needs to be tested, then allows the force of gravity to adduct the extremity until the hip cannot adduct any further.
Positive result:
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If the IT band is normal, the leg will adduct and the patient won't experience any pain.
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If the IT band is tight, the leg would remain in the abducted position and the patient would experience lateral knee pain, in this case the test is calles positive.
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If the IT band is not tight, the leg would adduct and the patient won't experience lateral knee pain, in this case the test is called negative.
Thomas' test
The Thomas Test or Iliacus Test or Iliopsoas Test is used to measure the flexibility of the iliopsoas muscle group, the M. Rectus Femoris, as well as the M. Tensor Fascia Latae and the M. Sartorius.
Patient position:
The patient should be supine, using the whole length of the table.
Therapist position:
Next to the pacient, near the contralateral leg to test.
Action of the test:
The patient must flex their knee and pull it back to their chest as close as they can, using both arms while doing so. The other leg can be relaxed. The lumbar spine must remain flat and in contact with the table during the test. The physical therapist controls the opposite leg to ensure that it maintains full contact with the table.
Positive result:
When the patient is not able to maintain their lower back and sacrum against the table. Otherwise if the hip has a large posterior tilt or hip extension greater than 15°, or if the knee is not able to meet flexion of 80° or more.
Special considerations:
It must be done in both legs.
Rectus Femoris shortened test
Position of the patient:
The patient lies down on their back, at the very edge of the table, with both legs hanging freely.
Action of the test:
The patient must then flex their knee and pull it back to their chest as close as they can, using both arms while doing so. The other leg can hang down. The lumbar spine must remain flat and in contact with the table during the test.
Positive result:
If the hip to test flexes, is because of the shortening of the rectus femoris.
Ely's test
Ely’s test or Duncan-Ely test is used to assess rectus femoris spasticity.
Patient position:
The patient lies prone in a relaxed state.
Therapist position:
The therapist is standing next to the patient, at the side of the leg that will be tested. One hand should be on the lower back, the other holding the leg at the heel.
Action of the test:
Therapist must passively flex the knee in a rapid fashion. The heel should touch the buttocks. Test both sides for comparison.
Positive result:
The test is positive when the heel cannot touch the buttocks, the hip of the tested side rises up from the table, the patient feels pain or tingling in the back or legs.
Piriformis test
The piriformis test is used to screen the piriformis muscle and to detect tightness or other discomforts of the sciatic nerve as it passes trought or under the Piriformis muscle. Because this is a muscle and neurological test.
Patient position:
The position of the patient by the Piriformis test is in side-lying with the asymptomatic leg against the table en the symptomatic leg in a postition of 60 to 90 degrees of flexion in the hip and 90 degrees flexion in the knee joint. The patient should lay with the face directed to the examiner
Therapist position:
The therapist is standing next to the patient, one hand is placed on the pelvis to stabilize this point, the other hand is placed on the lateral side of the knee.
Action of the test:
The examiner is going to give resistance on the laterale side of the knee and tries to get as far as possible in this movement, until there is pain or numbness starting. The examinator performs a horizontal adduction while putting pressure on the knee in the direction of the table until the point when the client feels pain or discomfort.
Positive result:
When the patient has complains of pain in the piriformis muscle region or in other words the buttocks. This may be related to the sciatic nerve that passes through this muscle or that it has become pinched by the piriformis muscle. The Freiburg sing is a pain signal that occurs when the sciatic nerve is irritated. This pain will occur when the examinated leg will move in a passive horizontal adduction. If these symptoms occur; we can speak of a piriformis syndrome. In this syndrome, we speak of pain or numbness in the buttock and posterior thigh with occasional radiation into the foot. Another possible causes are trigger points in the piriformis muscle.