HIP- SIJ- Lumbar Lab Flashcards
Hip quadrant
patient is supine
- the examiner places bilateral thumbs in popliteal crease and passively moves hip into
- flexion w o/p
- flex/add w o/p
- flex/add/ IR w o/p
4 tests to assess hip joint accessory mobility
1 hip joint AP mob through knee
2 hip joint AP mob
3. hip joint PA mob
4. Femoral Inferior glide mobility
Hip joint AP mob through the knee
Purpose: Improve mobility (posterior/lateral hip)
Patient os supine. involved leg os crossed over the univolved LE with flexion of the hip and knee
the examiner then places the patient’s knee against their sternum using the hands as spacers and pushes down into the posterior lateral hip
Hip joint AP mobility
Purpose: assess hip AP mobility
patient is positioned in supine position. involved hip placed into open pack position (flexion, abduction, and ER) over examiners shoulder. examiner’s hands interlocked around proximal femur at hip. a grade 1 traction force is applied and AP mobility assessed
Hip joint PA mobility
Purpose: assess hip PA mobility
Patient is positioned in prone. examiners passively extends involved extremity and pressure is applied through the gluteal fold. a grade 1 traction force is applied and PA mobility assessed
FEmoral inferior Glide mobility
Purpose: to assess hip inferior glide mobility
Patient is supine. involved hip placed into open pack. felx, abd, ER. examiners hands are interlocked around proximal feur at hip joint. a grade 1 traction force is applied and inferior mobility is assessed.
What are the special tests for Labrum and capsule Assessment?
Hip Scour FABER SLR with femoral anterior glide Anterior labral test Click test
Hip scour
to screen out labral tear or degeneration
patient is supine. flex hip and knee closest to clinician.
hug leg with forearms wrapped around lower leg and fingers interlocked over the knee. fore hip into max flexion and perform a sweeping compression and rotation action from external to internal rotation.look for reproduction of pain
FABER
Purpose: asses for antalgic hip capsule or SIJ
patient is supine. the non-painful leg is placed in figure four position and the examiner provides a gentle pressure downward on both the knee and the contra ASIS. then repeat with painful leg. the patients pain is assesses specifically by location and type. (groin= hip, PSIS= SIJ)
SLR with femoral anterior glide
Purpose: to screen out unstable labrum or capsule
patient is supine. the examiner passively raises the affected leg while palpating greater trochanter with opposite hand. patient is asked to hold position and examiner palpates for an anterior shift of greater trochanter
Anterior Labral Tear test
Purpose: to screen out labral dysfunction
patient is supine. passively wind up labrum into flexion abd and ER. the examiner then brings the involved LE in extension add and IR. assess for pain, popping or clicking
Click Test
Purpose: Scour labrum
Patient is side-lying, treatment side up. stabilizing hand stabilizes pelvis, ensuring neutral pelvis alignment. the examiner the moves the hip in a flexion, add, and IR and scour’s the joint while cradling the knee. Moving to extension, abd, and ER
Noble’s test
Purpose: Screen for TFL and ITB tightness
the patient is supine with affected extremity placed into 90 degrees of flexion
palpate the lateral condyle of the femur
fo approx. 1-2 in above and add pressure
. have the patient extend their leg, looking for reproduction of symptoms
Ober’s test
Purpose: Assess IT band length/mobility
Patient in side-lying, treatment side up. the uninvolved l leg is flexed as the hip and knee for stability. stabilizing hand stabilizes pelvis, ensuring neutral pelvis alignment. the examiner passively extends and abd the hip with the knee flexed at 90 deg. the examiner lowers the leg slowly. positive if the LE does not adduct past neutral
Sign of Buttock
Purpose: to screen out space occupying lesion
patient is supine. examiner passively raises the affected leg into SLR assessing for restriction to motion. the examiner then flexes the knee and assess for an incr in hip flexion range.
positive if no change in hip flexion ROM
Thomas Test
Purpose: assess iliopsoas, rectur femoris and IT band length
patient is supine with coccyx at the edge of the table with legs hanging off, head on pillow. palpate non treatment side ASIS. bring that same leg into hip flexion and stop before ASIS moves under fingers. have patient hold leg in that position and clinician places their foot on own torse to lock up.
place hand on treatment side leg on anterior distal thigh. place other hand on treatment side ASIS to feel for movement into anterior rotation.
patellar-pubic Percussion test
Purpose: testing for fracture of hip or femur
patient is supine. place stethoscope on pubic symphysis
tap patella or hit tuning fork to create vibration and place the tuning fork on patella
Craig’s test
Purpose: assess hip anteversion/retroversion
>25 deg IR= clinical anteversion <5 deg IR= retroversion 8-12 normal
patient is prone. examiner palpates greater trochanter when most lateral and passively IR’s hip with knee flexed. measurements taken with greater trochanter is most lateral
FAIR test
Purpose: Rule in/out piriformis syndrome
Patient is side-lying, treatment side up. stabilizing hand stabilizes pelvis, ensuring neutral pelvis alignement. the examiner then places the LE in a flexion/add position and over presses into IR through the ankle. asses for reproduction of symptoms
Femoral Lateral distraction
Purpose: assessment and/or treatment to increase joint mobility
Patient is supine. the examiner places patient’s hip in the open packed position. the examiner the squats down and rests patient’s calf on clinician’s shoulder closest to table. both hands are placed near the hip joint line. a distractive force is applied toward clinician’s sternum, in line of femur
Hip longitudinal distraction
Purpose: increase joint mobility
Patient is supine. the examiner places patients hip in the open pack position. the examiner satnds at foot of table and grabs the ankle/lower part of the leg. using a distraction force slightly pull the involved limb
PA FABER Mobilization
Purpose: Improve mobility of the anterior hip capsule
patient is prone. involved extremity Is placed in figure four position. examiner administeres a PA force through the involved extremity’s gluteal fold
IR Mobilization
Purpose: Improve mobility of the anterior hip capsule
Patient is prone. involved extremity’s knee is held in 90 deg flexion. Examiner IR involved extremity to end range while placing pressure through contralateral innominate
Quadruped Rock Back
Purpose: Improve mobility of the posterior hip capsule
Patient is positioned on hands and knees. examiner cues patient into neutral spinal alignment. examiner tehn cues patient to brin bottom towards heels by increasing hip flexion and shoulder extension while maintaining normal spinal curvatures
Isometric mobilization for Hip Abduction with inferior glide
Purpose: improve mobility of the inferior hip capsule
Patient is side-lying. the involved hip is abducted and placed on the examiner’s knee which is on the table or places on a little padded stool. the patient is asked to adduct the hip while the examiner applies an inferior glide to the involved hip
MWM Hip flexion
Purpose: improve hip flexion ROM
Patient is positions in supine position. wrap a towel around upper thigh of patient. flex hip closest to you to 90 deg and allow knee to fall into flexion. wrap mob belt arounf towel and upper thigh of patient. belt just above gluteal fold. hug flexed leg and keep LE close to body. add traction force by sitting into mob belt. have patient actively flex hip to active end range.. add overpressure. repeat technique 10x
MWM Hip IR/ER
Purpose: to improve mobility
patient in supine. wrap a towel around upper thigh of patient. flex hip closest to you to 90 and allow knee to fall into flexion. wrap mob belt just below gluteal fold. hug flexed leg with arm closest to patient’s foot with elbow against lower leg and hand wrapping around upper leg just superior to knee joint. use other hand to stabilize pelvis. have patient actively IR /ER . keep glide maintained while also adding overpressure. repeat 10 x
MWM Hip abduction
Purpose: improve hip abduction ROM
Patient is standing with involved hip in slight Ab. therapist stands behind patient and stabilizes patient’s pelvis with hands. therapist applies a mobilization belt as close to hip joint as possible on the involved leg and provides a posterior glide. patient is asked to actively abduct the involved hip. mob direction is modified to reduce symptoms. multipole repetitions are done with mild overpressure at the end range
STM for Psoas
Purpose: increase psoas length/tonicity
patient is supine . the involved hip and knee are slightly flexed to put tissue on slack. the examiner provides soft tissue mobilization correlating with patients deep breathing
STM for gluteus max
Purpose: improve mobility of glute max
patient is prone
therapist use the flat portion of the elbow/forearm to apply pressure in direction of fibers.
Fortin Finger test
Purpose: to identify SIJ pathology
the patient completes a pain diagram. patient points to the area of pain with one finger. the examiner reviews the are of pain and diagram for consistency.
positive test: patient could localize the pain with one finger at SIJ. the patient consistently pointed to the spot over 2 trials
Provocation cluster for Ruling in/out SIJ pathology
Posterior thigh thrust
Compression
Distrcation
Gaenslen
Sacral spring
