Special Tests of the Hip

Question 1

What does a positive Trendelenburg test indicate?

Answer 1

Paralysis or weakness of gluteal muscles

Inhibition of gluteal muscles due to pain from hip joint

Question 2

What is a positive Trendelenburg test?

Answer 2

Standing on one leg - supported by plinth - therapist stood behind

Pelvis drops downwards on unsupported side

Question 3

Which muscles could be effected in Trendelenburg’s sign?

Answer 3

TFL, glut med and min (adduct the hip and turn it in)

Question 4

What does Thomas’ test look for?

Answer 4

loss of extension of the hip (FFD)

Question 5

What is a positive Thomas’ test?

Answer 5

Stand on the side of the affected hip. - Place one hand under the pt lumbar spine to assess its position.
Ask the pt to flex one hip fully towards their chest (note that your hand under the model’s lumbar spine should be compressed due to flattening of the lumbar curve).

Positive test - opposite hip and thigh rise from plinth

Question 6

What is the modified Thomas Test?

Answer 6

Complete Thomas test - if FFD then try modified test

Passively extend hip to make contact with the plinth

If no contact with plinth then assess:

• Anterior rotation of pelvis and Lx extension
• Add knee extension
• Add abduction with flexed knee
• Add knee extension and hip abduction

Question 7

Why would there be anterior rotation of the pelvis and Lx extension during Thomas Test?

Answer 7

Inability to stabilise lumbopelvic region

Question 8

Why would adding knee extension cause contact with the plinth in Modified Thomas Test?

Answer 8

Shortened rectus femoris

Question 9

Why would adding hip abduction cause contact with the plinth in Modified Thomas Test?

Answer 9

Tightness/Shortening of TFL or ITB

Question 10

Why would adding knee extension and hip abduction still cause a positive Modified Thomas Test?

Answer 10

Shortened iliopsoas

Tightened Anterior JC

Question 11

How to complete FABER test?

Answer 11

Flexion, abduction and external rotation (passively)

• place lateral malleolus above knee on opposite side
• stabilise pelvis on opposite side
• apply pressure into lateral rotation and abudction

Question 12

What is a positive FABER test?

Answer 12

Pain provocation or reduced ROM

Question 13

What does pain during FABER suggest?

Answer 13

Pain in groin = Hip joint pathology (OA)
If pain is on lateral hip with no movement restriction = gluteal tendinopathy
If pain is in the SI/buttock region = SI pathology

Question 14

Why does FABER indicate gluteal tendinopathy?

Answer 14

Places anterior portions of Glut Min and Med under tensile loads

Question 15

How to complete FADIR?

Answer 15

Flexion, adduction and internal rotation

1. full hip flexion
2. hip adduction
3. Add internal rotation by turning foot out

Question 16

What is a positive FADIR test?

Answer 16

Pain in the hip and restriction of movement

OR Pain over lateral hip

Question 17

What is pain in the hip joint and decreased ROM indicating in FADIR?

Answer 17

Femoral-acetabular impingement

Pathology within the hip joint inself

Question 18

What is the cause of pain over lateral hip during FADIR?

Answer 18

Gluteal tendinopathy - because tendons are compressed by overlying ITB

Question 19

What is FADIR-R?

Answer 19

At the end of FADIR, as the patient to internally rotate hip against resistance (isometrically)

Question 20

What is a positive FADIR-R and why?

Answer 20

Increased pain over lateral hip

Causing the already stretched and compressed gluteal tendons to contract

Question 21

How to complete leg length testing?

Answer 21

Supine ly

Place end of the tape measure over the ASIS and press it backwards until it hooks under its inferior edge.
Measure to the inferior border of the medial malleolus

Complete 3 times and take mean score

Question 22

What is true shortening in leg length testing?

Answer 22

Pathology proximal to the trochanter - e.g. loss of femoral head length, loss of articular cartilige

Question 23

What is apparent shortening in leg length testing?

Answer 23

Visible appears shorter, however on measurement in supine ly there is no difference

Due to contactures around the pelvis causing tilting