Hip Flashcards
(26 cards)
Functional Leg Length
Position: supine, in alignment
Test: measures from ASIS to umbilicus to check against lateral pelvis tilt or rotation. then measures each leg from the umbilicus to the medial malleolus
Positive Finding: if difference between legs exceeds 1 to 1.5 cm then it is a positive find
True Leg Length
Position: supine, in alignment
Test: from ASIS to umbilicus. then ASIS to medial malleolus
Findings: if difference between legs exceeds 1 to 1.5 cm then it is positive
Long Sitting-Lying
Position: supine
Test: Weber-barstow maneuver. three hip thrusts. legs back down. Pt. sits up and AT looks at difference between malleolus
Findings: difference between the two
Long Sitting-Sitting
Position: sitting upright with legs extended on a table
Test: weber-barstow (supine) three hip thrusts. legs back down on table then they sit up. AT looks at difference between the malleolus
Findings: if the leg of the symptomatic side is shorter it indicates anterior rotation of the pelvis. if the leg of the symptomatic side gets longer it indicates a posterior rotation of the pelvis
Scouring Test
Position: supine
Test: passively flex to 90 degrees and adducts the subjects hip and places the knee in full flexion. then apply a downward force along the shaft of the femur while passively abduction and externally rotating the hip.
Findings: any pain, crepitus, apprehension, or unusual movement is a positive sign for the following: arthritis, osteochondral defects, avascular necrosis, or acetabular labrum defects.
Interpretation: document ROM and where if there is a positive sign
Anterior Labral Tear Test
Position: supine
Test: examiner takes hip into full flexion, lateral rotation and full abduction as starting position. the examiner then extends the hip combined with medial rotation and adduction
Findings: indicated by the production of pain, the reproduction of the pt. symptoms with or without a click, or apprehension
Interpretation: the test places the greatest strain on the anterolateral labrum
Posterior Labral Tear Test
Position: supine
Test: examiner takes the hip into full flexion, adduction, and medial rotation as a starting position. The examiner then takes the hip into extension combined with abduction and lateral rotation.
Findings: positive test is indicated by the production of groin pain, patient apprehension, or the reproduction of the patient’s symptoms with or without a click
Piriformis Test
Position: side-lying on non test side. With the test leg in 60 degrees of hip flexion and relaxed knee flexion. Examiner stands with the proximal hand on pelvis (laterally) and distal hand on subjects knee (laterally).
Test: apply an adduction (downward) force on the subjects knee
Findings: tightness or pain in the hip and buttock areas is indicative of piriformis tightness. pain in the buttock and posterior thigh is indicative of sciatic nerve impingement secondary to piriformis tightness.
Fulcrum Test
Position: supine, crying about pain
Test: don’t do it
But if you have to create a fulcrum between their legs and have them press down into the table
Positive Test: pain. broken femur.
Gluteus Maximus MMT
Position: Prone, test leg flexed at knee
Test: examiner lifts leg 3 in. and asks pt. to hold it there. examiner places hand on low back/pelvis and on hamstring next to knee and places resistive force
Positive Test: weakness, strength test 3+
Gluteus Medius MMT
Position: Side lying with the bottom leg flexed at hip and knee. Pelvis should be rotated slightly forward
Fixation: the muscles of the trunk and the clinician stabilizes the pelvis
Test: Abduction of the hip with slight extension, slight rotation with knee maintaining extension
Pressure: against the leg near the ankle in the direction of adduction and slight flexion
Gluteus Minimus MMT
Position: Side lying
Fixation: stabilizes the pelvis
Test: Abduction of the hip in a position neutral between flexion and extension. also neutral in regard to rotation
Pressure: Against the leg in the direction of adduction and slight extension.
Ely’s Test (Rectus Femoris Test)
Position: prone with both knees extended
Test: examiner passively flexes one knee
Positive findings: the hip on the same side of knee flexion pops off the table 70-90 degrees
Tight Rectus Femoris
Ober’s Test
Position: side-lying on the uninvolved side with the knee flexed at 90 degrees. bottom knee should be flexed.
Fixation: examiner places one hand on the hip joint and the other hand around the ankle on the affected side.
Test: examiner extends and abducts the hip joint. slowly lower the leg toward the table (adduct the hip) until motion is restricted. Ensure that the hip does not internally rotate during the test and the pelvis must be stabilized to maintain position.
Positive Findings: If normal IT band is normal, the leg will adduct and the pt. won’t experience any pain. If IT band is tight, the leg would remain in the abducted position and the pt. would experience lateral knee pain.
90/90 straight leg raise test
Position: Pt. lies supine with the hips and knee flexed to 90 degrees
Test: the pt. grasps behind both thighs to stabilize the hip joints. next the pt. actively extends each knee in turn.
Positive findings: the pt. is unable to extend the knee to within 20 degrees of full knee extension. Indicative of hamstring muscle tightness.
Trendelenburg’s sign
Position: standing with feet shoulder width apart
Test: slowly lift one foot off the ground, balancing with your other foot
Positive Findings: when the hip of your non weight bearing leg drops or is lower than the other side
Indicative of: week hip abductors Gluteus minimus/medius. can’t stabilize the pelvis
Craigs Test
Position: Prone
Test: examiner passively internally and externally rotates the femur until the greater trochanter is parallel with the examining table. At this point the subject is asked to hold the hip in this position while the examiner measures the angle between the long axis of the lower leg and the perpendicular axis to the table with a goni
Positive Findings: if the measured angle is greater than 15 degrees, femoral ante version is indicated. if the measured angle is less than 8 degrees, femoral retroversion is indicated
Iliopsoas MMT
Position: supine
Test: examiner stabilizes opposite ASIS and the pt. flexes the hip with the leg extended. slight abduction and lateral rotation
Pressure: against the anteromedial aspect of the leg in the direction of extension and slight abduction
Sartorius MMT
Position: supine
Test: lateral rotation, abduction, and flexion of the thigh, knee flexion
Pressure: against the anterolateral surface of the lower thigh in the direction of hip extension adduction and medial rotation. also against the leg in the direction of knee extension
Tensor Fascia latae MMT
position: supine
Test: abduction, flexion and medial rotation of the hip with the knee extended
Pressure: against the leg in the direction of extension and adduction
Hip Adductors MMT
Position: side lying
Test: examiner holds upper leg in abduction. pt. lifts the bottom leg up and the examiner resists adduction of the bottom leg
Positive findings: hip adduction deformity
**forward rotation of the pelvis with extension of the hip shows and attempt to hold the lower fibers of the Glute maximus.
Sacral Rotation Test
Position: standing or side-lying
Test: examiner palpates on each side of the sacrum at the level of S1. as the patient flexes, the innominate bones bend to the same side and the sacrum rotates slightly in the opposite direction
Findings: if torsion movement does not occur, the pt. finds that more effort is required to side flex and it is harder to maintain balance
Thomas Test MMT
Position: supine on the end of the table
Test: pt. pulls both knees to chest in a hug and then lets one leg drop.
Findings: inability to drop leg all the way to table indicates tight hip flexors. lateral rotation of foot with abduction indicates tight IT band
Ely’s Test
Position: prone with both knees extended
Test: the clinician passively flexes one of the patient’s knees
Positive Findings: the hip on the same side of knee flexion flexes as well. Rectus Femurs tightness
