Hip & Pelvis

Question 1

Joint play - hip

Answer 1

circumduction, traction, compression

Question 2

FADDIR test

Answer 2

• Patient reports groin/anterior hip pain
• Passive flexion to 90º, end range adduction & internal rotation of hip, with overpressure
• Positive: reproduction of pain caused by femur abutting acetabular rim/tear
• High sensitivity (94%), Low specificity (8%)

Question 3

Labral Tear/Femoroacetabular Impingement (FAI)

Answer 3

• Patient reports groin/anterior hip pain
• Passive flexion to 90º, end range internal rotation of hip with overpressure
• Positive: reproduction of pain caused by femur abutting acetabular rim/tear
• high sensitivity (96%), low specificity (17%)

Question 4

Trendelenburg test

Answer 4

Pathology: Hip Joint Pathology (Labral Tear/OA) or Lateral Hip Pain (gluteal tendinopathy/GTPS)
Positive finding: Ipsilateral pain in lateral hip, or excessive hip adduction on stance

Sensitivity - medium (61%)
Specificity - high (92%)

Question 5

Resisted hip abduction

Answer 5

Pathology: Hip Joint Pathology (Labral Tear/OA) or Lateral Hip Pain (gluteal tendinopathy/GTPS)
Positive Finding: Weakness and/or pain on muscle contraction
- Sensitivity (71%), Specificity (84%)

Question 6

FABER test

Answer 6

Pathology: Hip Joint Pathology (Labral Tear/OA)
Positive finding: Pain or ROM loss in Hip Flexion or ER
- Sensitivity (57%), Specificity (34%)

Question 7

Adductor Squeeze test

Answer 7

Tests for pubic and/or adductor related groin pain (FKA osteitis pubis)
Sensitivity 43%, Specificity 91% (Delahunt et al, 2011)
Extension of resisted isometric testing

Patient supine, hips at 45 degrees
Patient squeeze knees together against you closed fist (slowly
building up force)
Look for pain in groin and/or pubic area
Also look for weakness and resistance
+ve test can indicate presence or risk of pubic related groin pain
(osteitis pubis)

Question 8

Key Articulation techniques for the hip (supine)

Answer 8

Supine Hip Articulation:
- Flexion
- Internal and external rotation (hip at 90)
- Abduction
- Adduction
- Traction (short and long lever)
- Circumduction

Question 9

Key Articulation techniques for the hip (prone)

Answer 9

Prone Hip Articulation:
- Extension

Question 10

Techniques variations for hip articulations (sidelying)

Answer 10

Sidelying:
- Flexion
- Extension
- Abduction
- Internal rotation
- External rotation

Question 11

Techniques variations for hip articulations (prone)

Answer 11

Prone:
- Internal rotation
- External rotation

Question 12

Soft tissue techniques for the hip

Answer 12

stretches (hamsting, rectus femoris, Thomas test stretches, Gluteal, piriformis)
inhibition (Hamstrings, Quadriceps, Gluteus maximus, Gluteus medius, Piriformis, Tensor fascia lata, Psoas)
cross fibre kneading (hamstrings, quadriceps, Gluteus maximus)
longitudinal soft tissue (hamstrings, quadriceps, Gluteus maximus)

Question 13

MET for the hip (joint)

Answer 13

Flexion (supine, sidelying)
Extension (prone, sidelying)
Internal rotation (supine, sidelying, prone)
External rotation (supine, sidelying, prone)
Abduction (supine, sidelying)
Adduction (supine)

Question 14

MET for the hip (muscles)

Answer 14

Iliopsoas (supine, sidelying)
Rectus femoris (supine, sidelying, prone)
Hamstrings (supine, sidelying)
Adductors (supine)
Gluteus maximus (supine)
Gluteus medius (sidelying, supine)

Question 15

Bony landmarks ant hip - palpation

Answer 15

Iliac crest
Iliac tubercles
ASIS
GT
Pubic tubercles

Question 16

Bony landmarks post hip - palp

Answer 16

PSIS
Sacrum
Inferior lateral angle of the sacrum
Coccyx
Ischial Tuberosity

Question 17

Exercise Rehab hip - mobility

Answer 17

Seated Gluteal mobilisation
Kneeling hip flexor stretch
Standing adductor stretch

Question 18

Exercise rehab hip - strength

Answer 18

clamshell
banded hip abduction
glute bridge