Hip

Question 1

Functional Leg Length

Answer 1

Position: supine, in alignment

Test: measures from ASIS to umbilicus to check against lateral pelvis tilt or rotation. then measures each leg from the umbilicus to the medial malleolus

Positive Finding: if difference between legs exceeds 1 to 1.5 cm then it is a positive find

Question 2

True Leg Length

Answer 2

Position: supine, in alignment

Test: from ASIS to umbilicus. then ASIS to medial malleolus

Findings: if difference between legs exceeds 1 to 1.5 cm then it is positive

Question 3

Long Sitting-Lying

Answer 3

Position: supine

Test: Weber-barstow maneuver. three hip thrusts. legs back down. Pt. sits up and AT looks at difference between malleolus

Findings: difference between the two

Question 4

Long Sitting-Sitting

Answer 4

Position: sitting upright with legs extended on a table

Test: weber-barstow (supine) three hip thrusts. legs back down on table then they sit up. AT looks at difference between the malleolus

Findings: if the leg of the symptomatic side is shorter it indicates anterior rotation of the pelvis. if the leg of the symptomatic side gets longer it indicates a posterior rotation of the pelvis

Question 5

Scouring Test

Answer 5

Position: supine

Test: passively flex to 90 degrees and adducts the subjects hip and places the knee in full flexion. then apply a downward force along the shaft of the femur while passively abduction and externally rotating the hip.

Findings: any pain, crepitus, apprehension, or unusual movement is a positive sign for the following: arthritis, osteochondral defects, avascular necrosis, or acetabular labrum defects.

Interpretation: document ROM and where if there is a positive sign

Question 6

Anterior Labral Tear Test

Answer 6

Position: supine

Test: examiner takes hip into full flexion, lateral rotation and full abduction as starting position. the examiner then extends the hip combined with medial rotation and adduction

Findings: indicated by the production of pain, the reproduction of the pt. symptoms with or without a click, or apprehension

Interpretation: the test places the greatest strain on the anterolateral labrum

Question 7

Posterior Labral Tear Test

Answer 7

Position: supine

Test: examiner takes the hip into full flexion, adduction, and medial rotation as a starting position. The examiner then takes the hip into extension combined with abduction and lateral rotation.

Findings: positive test is indicated by the production of groin pain, patient apprehension, or the reproduction of the patient’s symptoms with or without a click

Question 8

Piriformis Test

Answer 8

Position: side-lying on non test side. With the test leg in 60 degrees of hip flexion and relaxed knee flexion. Examiner stands with the proximal hand on pelvis (laterally) and distal hand on subjects knee (laterally).

Test: apply an adduction (downward) force on the subjects knee

Findings: tightness or pain in the hip and buttock areas is indicative of piriformis tightness. pain in the buttock and posterior thigh is indicative of sciatic nerve impingement secondary to piriformis tightness.

Question 9

Fulcrum Test

Answer 9

Position: supine, crying about pain

Test: don’t do it
But if you have to create a fulcrum between their legs and have them press down into the table

Positive Test: pain. broken femur.

Question 10

Gluteus Maximus MMT

Answer 10

Position: Prone, test leg flexed at knee

Test: examiner lifts leg 3 in. and asks pt. to hold it there. examiner places hand on low back/pelvis and on hamstring next to knee and places resistive force

Positive Test: weakness, strength test 3+

Question 11

Gluteus Medius MMT

Answer 11

Position: Side lying with the bottom leg flexed at hip and knee. Pelvis should be rotated slightly forward

Fixation: the muscles of the trunk and the clinician stabilizes the pelvis

Test: Abduction of the hip with slight extension, slight rotation with knee maintaining extension

Pressure: against the leg near the ankle in the direction of adduction and slight flexion

Question 12

Gluteus Minimus MMT

Answer 12

Position: Side lying

Fixation: stabilizes the pelvis

Test: Abduction of the hip in a position neutral between flexion and extension. also neutral in regard to rotation

Pressure: Against the leg in the direction of adduction and slight extension.

Question 13

Ely’s Test (Rectus Femoris Test)

Answer 13

Position: prone with both knees extended

Test: examiner passively flexes one knee

Positive findings: the hip on the same side of knee flexion pops off the table 70-90 degrees
Tight Rectus Femoris

Question 14

Ober’s Test

Answer 14

Position: side-lying on the uninvolved side with the knee flexed at 90 degrees. bottom knee should be flexed.

Fixation: examiner places one hand on the hip joint and the other hand around the ankle on the affected side.

Test: examiner extends and abducts the hip joint. slowly lower the leg toward the table (adduct the hip) until motion is restricted. Ensure that the hip does not internally rotate during the test and the pelvis must be stabilized to maintain position.

Positive Findings: If normal IT band is normal, the leg will adduct and the pt. won’t experience any pain. If IT band is tight, the leg would remain in the abducted position and the pt. would experience lateral knee pain.

Question 15

90/90 straight leg raise test

Answer 15

Position: Pt. lies supine with the hips and knee flexed to 90 degrees

Test: the pt. grasps behind both thighs to stabilize the hip joints. next the pt. actively extends each knee in turn.

Positive findings: the pt. is unable to extend the knee to within 20 degrees of full knee extension. Indicative of hamstring muscle tightness.

Question 16

Trendelenburg’s sign

Answer 16

Position: standing with feet shoulder width apart

Test: slowly lift one foot off the ground, balancing with your other foot

Positive Findings: when the hip of your non weight bearing leg drops or is lower than the other side

Indicative of: week hip abductors Gluteus minimus/medius. can’t stabilize the pelvis

Question 17

Craigs Test

Answer 17

Position: Prone

Test: examiner passively internally and externally rotates the femur until the greater trochanter is parallel with the examining table. At this point the subject is asked to hold the hip in this position while the examiner measures the angle between the long axis of the lower leg and the perpendicular axis to the table with a goni

Positive Findings: if the measured angle is greater than 15 degrees, femoral ante version is indicated. if the measured angle is less than 8 degrees, femoral retroversion is indicated

Question 18

Iliopsoas MMT

Answer 18

Position: supine

Test: examiner stabilizes opposite ASIS and the pt. flexes the hip with the leg extended. slight abduction and lateral rotation

Pressure: against the anteromedial aspect of the leg in the direction of extension and slight abduction

Question 19

Sartorius MMT

Answer 19

Position: supine

Test: lateral rotation, abduction, and flexion of the thigh, knee flexion

Pressure: against the anterolateral surface of the lower thigh in the direction of hip extension adduction and medial rotation. also against the leg in the direction of knee extension

Question 20

Tensor Fascia latae MMT

Answer 20

position: supine

Test: abduction, flexion and medial rotation of the hip with the knee extended

Pressure: against the leg in the direction of extension and adduction

Question 21

Hip Adductors MMT

Answer 21

Position: side lying

Test: examiner holds upper leg in abduction. pt. lifts the bottom leg up and the examiner resists adduction of the bottom leg

Positive findings: hip adduction deformity

**forward rotation of the pelvis with extension of the hip shows and attempt to hold the lower fibers of the Glute maximus.

Question 22

Sacral Rotation Test

Answer 22

Position: standing or side-lying

Test: examiner palpates on each side of the sacrum at the level of S1. as the patient flexes, the innominate bones bend to the same side and the sacrum rotates slightly in the opposite direction

Findings: if torsion movement does not occur, the pt. finds that more effort is required to side flex and it is harder to maintain balance

Question 23

Thomas Test MMT

Answer 23

Position: supine on the end of the table

Test: pt. pulls both knees to chest in a hug and then lets one leg drop.

Findings: inability to drop leg all the way to table indicates tight hip flexors. lateral rotation of foot with abduction indicates tight IT band

Question 24

Ely’s Test

Answer 24

Position: prone with both knees extended

Test: the clinician passively flexes one of the patient’s knees

Positive Findings: the hip on the same side of knee flexion flexes as well. Rectus Femurs tightness

Question 25

Ober’s Test

Answer 25

Position: side-lying on uninvolved side

Fixation: examiner places one hand on the hip joint and the other hand around the ankle on the affected side

Test: examiner extends and abducts the hip joint. slowly lower the leg toward the table until motion is restricted. no internal rotation.

Positive Findings: if the IT band is normal, the leg will adduct. and the pt. won’t experience any pain. if the IT band is tight, the leg would remain in the abducted position and the pt. would experience lateral knee pain

Question 26

Femoral Nerve Traction Test

Answer 26

Position: side-lying on uninvolved side with hip and knee slightly flexed. examiner places one hand on lateral aspect of the subjects involved pelvis while the other hand grasps the involved lower leg

Test: subject slightly flexes his head while the examiner completely extends the subjects knee and extends the hip approx. 15 degrees. examiner then flexes the subjects knee

Positive findings: motion of hip extension and knee flexion places the femoral nerve on stretch. subjective complaints of pain along the anterior thigh region may indicate decreased mobs of the femoral nerve

**keep spine in neutral position