Test #2 Hip Flashcards
What do you look for during a visual inspection?
- swelling
- ecchymosis
- deformity
What is Trendelenberg?
- the patient stands on the injured leg
- flexes the contralateral hip to 90 degrees
- observe the movement of the pelvis
What is a positive Trendelenberg test?
If the pelvis on the NON-STANCE side falls, then the test is considered positive for weakness or instability of the gluteus medius on the STANCE SIDE
What are the prone ROM test?
Passive hip extension
Passive bilateral IR
Resisted hip extension
Resisted hip IR
Resisted knee extension
Resisted knee flexion
Passive hip extension
- patient = prone
- examiner = opposite side
- Stabilize the patient’s ipsilateral ischial tuberosity with one hand (proximal)
- Grasp the patient’s distal femur from lateral with your other hand and passively extend the hip
Passive hip bilateral IR
- patient = prone; knees 90 degrees
- examiner = stand at end of treatment table
- Passively internally rotate bilateral hips bringing the ankles/lower legs laterally
Resisted hip extension
Patient = prone
examiner = testing side
- Grasp the malleoli with your distal hand
- Place your proximal hand on the posterior side of the distal femur
- Apply resistance to the distal thigh while asking the patient to hold in extension
- Ask the patient to simultaneously kick into your other hand (knee extension)
Resisted knee extension
Patient = prone
Examiner = testing side
- Grasp the malleoli with your distal hand
- Place your proximal hand on the posterior side of the distal femur
- Bring the knee into 45-90 degrees of knee flexion
- Stabilize the posterior thigh
- Provide isometric resistance at the distal tibia for knee extension
Resisted knee flexion
Patient = prone
Examiner = testing side
distal hand
- Place your proximal hand on the posterior side of the distal femur
- Bring the knee into 45-90 degrees of knee flexion
- Stabilize the posterior thigh
- Provide isometric resistance at the distal tibia for knee flexion
Resisted hip IR
Patient = prone; knees flexed 90 degrees
Examiner = end of the treatment table
- Place your hands on the lateral aspect of the distal tibia bilaterally
- Apply isometric resistance to hip IR by having the patient press his/her lower legs into your hands
Resisted hip ER
Patient = prone; knees flexed 90 degrees
Examiner = end of the treatment table
- Place your hands on the medial aspect of the distal tibia bilaterally in such a way that your forearms are crossed
- Apply isometric resistance to hip ER by having the patient press his/her lower legs into your hands
Supine ROM tests
Passive hip flexion
Passive hip IR
Passive hip ER
Passive hip abduction
Knee extended & knee flexed
Passive hip adduction
Resisted hip flexion
Resisted hip adduction
0 vs 45 vs 90 degrees
Resisted hip abduction
Passive hip flexion
Patient = supine
Examiner = testing side
- bring hip into full available hip flexion
Passive hip ER
Patient = supine
Examiner = testing side
- Grasp the patient’s posterior thigh just above the knee with your distal hand
- flex the patient’s hip and knee to 90 degrees.
- Support the lower leg with your forearm and support the medial knee with your hand.
- Move the hip into full available external rotation
Passive hip IR
Patient = supine
Examiner = testing side
- Grasp the patient’s posterior thigh just above the knee with your distal hand
- flex the patient’s hip and knee to 90 degrees.
- Support the lower leg with your forearm and support the medial knee with your hand.
- Move the hip into full available external rotation
Passive hip adduction
Patient = supine
Examiner = opposite side
- The clinician bends the knee of the nonaffected leg and cross the leg over the affected leg
- Place your proximal hand on the ipsilateral ASIS to stabilize the pelvis (opposite side being tested)
- Cradle the lower leg and knee with your distal hand and bring the hip into adduction.
- Ensure the hip remains in neutral rotation
Passive hip abduction
Patient = supine
Examiner = testing side
- Grasp the patient’s leg at the mid-calf with your distal hand
- Place your proximal hand over the ASIS
- Abduct the hip keeping the knee straight until you feel movement of the ASIS
Passive hip abduction pain
- Maintain this position and passively flex the knee.
- If the groin pain disappears, the lesion is likely in the gracilis muscle.
- If the pain persists, it is likely in the adductor longus, adductor brevis, or pectineus
Resisted hip flexion
Patient = supine; knee flexed to 45 and 90 degrees
Examiner = testing side
- Stabilize the ipsilateral shoulder with your proximal hand
- Place your distal hand on the patient’s anterior thigh directly above the knee
- Keeping your elbow straight provide isometric resistance to hip flexion
- Pain provoked is likely due to a lesion in the iliopsoas or the rectus femoris
Resisted hip abduction
Patient = supine with the hips and knees extended
Examiner: either side
- Place your hands on the outside distal femur bilaterally
- Apply isometric resistance to abduction
Resisted hip adduction
Patient = supine; hips and knees @ 0 degrees flexion
Examiner = either side
- Place your hands on the inside of the distal femur in such a way that your forearms are crossed
- Apply isometric resistance to adduction
- Assess the quality of the contraction, the quantity of strength, and any provocation of symptoms
- Repeat test at 45 degrees and 90 degrees of hip flexion
Resisted hip adduction: muscles tested at each degree
Zero degrees: adductor longus/gracilis
45 degrees: pubic symphysis
90 degrees: pectineus