MSK - Hip

Question 1

What are the active movements of the hip, normal ranges and end feels?

Answer 1

Flexion 110-120° - tissue stretch or STA
Extension 10-15° - tissue stretch
Abduction 30-50° - tissue stretch
Adduction 30° - tissue stretch or STA
IR 30-40° - tissue stretch
ER 40-60° - tissue stretch

Question 2

MMT - Hip Flexors

Answer 2

Sitting edge of plinth - resistance applied downward proximal to knee joint

Question 3

MMT - Hip Extensors

Answer 3

Prone with testing leg in hip extension, stabilize pelvis

Resistance applied proximal to knee downward into flexion

Question 4

MMT - Hip Abductors

Answer 4

Side lying with test leg elevated into abduction, resistance applied proximal to knee into adduction

Question 5

MMT - Hip Adductors

Answer 5

Side lying on test side with leg in adduction, resistance applied into abduction

Question 6

MMT - Medial Rotators

Answer 6

Sitting (support medial aspect of knee), resistance applied to medial distal lower leg into ER

Question 7

MMT - External Rotators

Answer 7

Sitting (support lateral aspect of knee), resistance applied to lateral lower leg into IR

Question 8

MMT - TFL

Answer 8

Supine - leg in abd, flex, IR

Resistance applied in extension and adduction direction

Question 9

MMT - Iliopsoas

Answer 9

Lumbar plexus and femoral nerve
Supine with hip in slight flexion, abd and ER
Resistance applied against anterior aspect of leg in ext and slight add direction

Question 10

MMT - Glut Min

Answer 10

Superior gluteal nerve L4-S1
Side lying with leg elevated in abduction
Resistance applied in adduction and slight extension direction

Question 11

MMT - Glut Med

Answer 11

Superior gluteal nerve L4-S1
Side lying with leg in abduction, slight ext and ER
Resistance applied in adduction and slight flex direction

Question 12

MMT - Glut Max

Answer 12

Inferior gluteal nerve L5-S2
Prone with knee flexed to 90
Resistance applied against distal posterior thigh into hip flexion

Question 13

MMT - Sartorius

Answer 13

Femoral Nerve L2-4
Supine with leg in flexion, abd, ER and knee flexion
Resistance applied at anterolateral distal thigh into hip ext, add, IR and against lower leg into knee ext

Question 14

Patrick’s Test (Faber or Figure 4)

Answer 14

Supine, test leg placed so foot is on top of opposite knee, lower knee toward table
+ve = knee remains above opposite straight knee (should be parallel or to table)
Indicates: hip or SI involvement, tight adductors or iliopsoas spasm

Question 15

Flexion-Adduction (Hip Quadrant) Test

Answer 15

Pt supine and PT flexes and adducts pt’s hip so hip faces pt’s opposite shoulder and mild resistance is felt. Hip taken into abduction while maintaining flexion in an arc of movement.
+ve = limitation in movement, bumps, pain
Indicates: hip pathology, possibly pinching inflamed muscles

Question 16

Anterior Labral Tear (FADDIR) Test

Answer 16

Hip into full flexion, ER and abd to start. Move into flexion with IR and adduction
+ve = pain or reproduction of symptoms with or without click
Indicates: anterior superior impingement, anterior labral tear, iliopsoas tendinitis

Question 17

Modified Thomas Test

Answer 17

Pt rolls back on plinth and holds knee and hip in flexion (L spine and pelvis stay in neutral). Lower test leg slowly to plinth and measure hip flexion.
+ve = Back of thigh to bed = normal. If unable to reach bed, extend knee – if goes lower then RF tight, if abducts = TFL tight. If no movements alter range of hip extension = iliopsoas tight. Sartorius tight = the hip still abducts and ER.
Indicates: muscle tightness around the hip

Question 18

Ely’s Test

Answer 18

Prone, passively flex knee
+ve = hip flexes on same side
Indicates: RF tightness

Question 19

Ober’s Test

Answer 19

In SL with bottom leg held in hip and knee flexion by pt to stabilize trunk. Test leg brought into hip flexion/abduction and then extension/adduction with knee flexed to 90°. Iliac crest firmly stabilized. As leg lowered straighten knee (Modified Ober’s keeps knee flexed) ** Watch for trunk side flexion
+ve = Unable to reach neutral add = max tightness; to neutral add = mod tightness; beyond neutral but not to plinth = min tightness; leg to plinth = normal
Indicates: TFL/ITB tightness

Question 20

Piriformis Test

Answer 20

Side lying with test leg on top, flex hip to 60 with knee flexed. Stabilize hip with one hand and apply downward pressure to knee
+ve = pain in buttock
Indicates: piriformis tight or pinching on sciatic nerve

Question 21

90-90 Straight Leg Raise Test

Answer 21

Supine, hips to 90 with knees bent. Actively or passively extend knee.
+ve = knee ext not within 20° of full ext
Indicates: hamstring tightness

Question 22

Hamstring Contracture Test

Answer 22

Sitting, knee flexed against chest to stabilize pelvis, other knee extended. Pt attempts to flex trunk to touch toes of extended leg. Should be able to touch toes
+ve = inability to touch toes
Indicates: tight hamstrings/contracture