hip and thigh - ligamentous/capsular and special tests Flashcards
fulcrum test
▪ Positions patient sitting
▪ Places one hand under the posterior thigh, and the other hand over the distal portion of the anterior thigh
▪ Apply pressure to the anterior distal thigh as the other hand is moved in a proximal direction along the posterior thigh
▪ Assesses the movement of the sacroiliac joint
▪ A positive test is indicated by pain and apprehension
▪ Tests for a femoral shaft stress fracture
hip scouring (quadrant) test
▪ Positions patient in a supine position
▪ Passively flexes and adducts the athlete’s hip and places the knee in full flexion
▪ Applies downward pressure along the shaft of the femur while simultaneously adducting and externally rotating the hip
▪ Then adducts and internally rotates the hip while maintaining a downward pressure
▪ Repeats this movement two to three times
▪ Notes any unusual movement or athlete apprehension
▪ A positive test is indicated by pain or apprehension
▪ Tests for hip joint pathology such as arthritis, osteochondral defects, avascular necrosis, or acetabular labrum defects
anterior impingement test
▪ Positions patient in a supine position
▪ Passively flexes, internally rotates, and adducts the hip
▪ A positive test is indicated if pain or symptoms within the hip are reproduced
▪ Tests for femoral acetabular impingement (FAI) and/or acetabular labral tear
90-90 straight leg raise test
▪ Positions patient in a supine position
▪ Instructs patient to stabilize both hips at 90 degrees of flexion with both hands so as the knees are bent in a relaxed
position
▪ Instructs patient to actively extend one knee as much as possible
▪ A positive test is indicated by the knees being flexed greater than 20 degrees
▪ Tests for hamstring tightness
trendelenburg test
▪ Positions patient in a standing position on one leg
▪ Instruct athlete to remain in the position for 10 seconds and then switch to other leg
▪ A positive test is indicated by the pelvis on the unsupported side dropping noticeably lower than the pelvis on the
supported side
▪ Tests for weakness of the gluteus medius muscle on the supported side
thomas test
▪ Positions patient in a supine position with both knees against chest and the buttocks near the table edge
▪ Places one hand under the curve of the lumbar spine
▪ Instructs the patient to slowly lower the test leg until the leg is fully is fully relaxed or until either anterior pelvic tilting or an increase in lumbar lordosis occurs
▪ Positive test is indicated by a lack of hip extension with knee flexion greater than 45 degrees is indicative of iliopsoas muscle tightness
▪ Positive test is indicated by full hip extension with knee flexion less than 45 degrees is indicative of rectus femoris tightness
▪ A positive test is indicated by a lack of hip extension with knee flexion greater than 45 degrees is indicative of iliopsoas muscle and rectus femoris tightness
▪ Positive test is indicated by hip external rotation during any of the previous is indicative of ITB (particularly the tensor fascia latae) tightness
ely’s test
▪ Positions patient in a prone position
▪ Passively flexes the athlete’s knee and notes the reaction at the hip joint
▪ A positive test is indicated when the knee is flexed, the hip flexes also
▪ Tests for a tight rectus femoris muscle
gaenslen’s test
▪ Positions the patient on the side with the upper leg hyperextended at the hip
▪ Instructs the athlete to hold the lower leg fixed against the chest
▪ Stabilizes the pelvis while extending the hip of the uppermost leg
▪ A positive test is indicated by pain
▪ Tests for an ipsilateral sacroiliac joint lesion, hip pathology, or an L4 nerve root lesion
patrick’s (faber) test
▪ Positions patient in a supine position
▪ Passively flexes, abducts, and externally rotates the involved leg until the foot rests on the top of the knee of the uninvolved lower extremity
▪ Slowly abducts the involved lower extremity toward the table
▪ A positive test is indicated by the involved lower extremity not abducting below the level of the non-involved lower extremity
▪ Tests for iliopsoas, sacroiliac, or hip joint abnormalities
ober’s test
▪ Positions patient in a side-lying position with the hips and knees extended such that the test leg is superior to the non-test leg
▪ Places proximal hand stabilizing the pelvis and the distal hand supporting the lower leg
▪ Abducts and extends the test hip in order to position the iliotibial band (ITB) behind the greater trochanter
▪ Allows the leg to slowly lower
▪ Stabilizes the pelvis and allows the abducted leg to relax and then drop into adduction
▪ A positive test is indicated by the inability of the leg to adduct and touch the table
▪ Tests for ITB (particular the tensor fasciae latae) tightness
craig’s (ryder or angle or torsion) test
▪ Positions patient in a prone position with affected leg’s knee flexed to 90 degrees
▪ Palpates the greater trochanter of the involved side
▪ Passively internally and externally rotates the femur until the greater trochanter is parallel with the examining table
▪ Instructs subject to hold the hip in this position while measuring the angle between the long axis of the lower leg and the perpendicular axis to the table with a goniometer
▪ A positive test is indicated by the angle being greater than 15 degrees and is indicative of femoral anteversion (can lead to toeing-in and squinting patellae)
▪ Positive test is indicated by the angle being less than 8 degrees and is indicative of femoral retroversion (can lead to toeing-out position)
femoral nerve tension (traction) test
▪ Positions patient side lying on unaffected side with the knee, hip, and neck flexed
▪ Passively extend the involved hip 15 degrees with the knee extended
▪ Passively flex the knee
▪ Positive test is indicated by a neurological pain that radiates down anterior aspect of the thigh
▪ Tests for femoral nerve pathology
