Practical 2 - Hip Flashcards
(38 cards)
Inferior Glide
Patient in Supine
painful leg - knee is flexed. use your shoulder to stabilize the knee, don’t want to abduct hip. approximate adductor/quads before oscillations. you are pulling down (away from pt like towards their feet if that makes sense - inferior).
for abduction
Anterior Glide
Patient in prone, leg off the table
painful leg is slight flexion, slight abduction, PT hand is on distal buttock – not on ischial tube. support hand on or just below knee and can slightly externally rotate. push in straight anterior direction
for external rotation + extension
**if patient has limited or decreased extension, you can bring pt into extension (hold the leg or add a towel or something under the thigh) and apply anterior pressure.
Posterior Glide
patient in supine
painful leg is abducted, you (PT) sitting on the table inside the leg, hand on the inside of the thigh. flexed to 30°, abducted 30°, external rotation. hand support under the knee. pushing down posterolaterally.
for limited flexion and internal rotation.
Long Axis Distraction
Patient in Supine
Painful leg flexed to 30°, abducted 30°, external rotation. Hold around both malleoli and pull.
Helpful for generalized loss of motion, arthritis.
Lateral (Short Axis) Traction
Patient in Supine
painful leg - knee is flexed. use your shoulder to stabilize the knee, don’t want to abduct hip. approximate adductor/quads before oscillations. you are pulling into you.
for generalized loss of motion.
what grade mobs for pain vs increasing motion
1 & 2 to decrease pain
3 & 4 to increase motion
what tests are assessing Joint Integrity (9)
- Flexion-Adduction
- Flexion-Adduction-Axial Compression Test
- Internal Rotation-Flexion-Axial Compression Test
- Internal Rotation Load/Grind Test
- Fitzgerald Test
- Scour (Quadrant) Test
- Flexion-Abduction-External Rotation (FABER) Test (Patrick Test)
- Craig Test
- Log Roll Test
for joint integrity, what is the Flexion-Adduction Test looking for?
hip dysplasia, FAI, piriformis syndrome (posterior symptoms)
how do you perform the Flexion-Adduction
patient position: supine
steps: knee flexed to 90°, adduct the thigh toward opposite hip.
positive test: inability to adduct the flexed hip past midline to opposite hip
what is the Flexion-Adduction-Axial Compression Test looking for?
labral degeneration, fraying, or tearing
Adolescents
- Hip dysplasia
Adult population
- Piriformis irritation
- FAI
- Iliopsoas
how do you perform the Flexion-Adduction-Axial Compression Test
patient position: supine
steps: passively combine hip flexion, internal rotation, and adduction
positive test: reproduction of pain/discomfort in the groin
what is the Internal Rotation-Flexion-Axial Compression Test looking for?
labral degeneration, fraying, or tearing
how do you perform the Internal Rotation-Flexion-Axial Compression Test
patient position: supine
steps: passively combine hip flexion, internal rotation, and axial compression (longitudinally thru femur)
positive test: reproduction of pain/discomfort in the groin
what is the Internal Rotation Load/Grind Test looking for?
Labral pathology
how do you perform the Internal Rotation Load/Grind Test
patient position: supine
steps: hip flexed to 100°, passive IR/ER while pushing
along long axis of femur
positive test: reproduction of pain/discomfort in the groin
what is the Fitzgerald Test (Anterior/Posterior Labrum) looking for?
labral pathology (tears)
how do you perform the Fitzgerald Test (Anterior Labrum)
patient position: supine
steps: passively moves hip into combined motions of full flexion, external rotation, abduction. THEN extends hip with combined motion of internal rotation and adduction.
positive test: reproduction of pain with/without a click
how do you perform the Fitzgerald Test (Posterior Labrum)
patient position: supine
steps: passively moves hip into combined motions of full extension, external rotation, abduction as starting point. THEN flexes hip combined with adduction and internal rotation.
positive test: reproduction of pain with/without a click
what is the Scour (Quadrant) Test looking for?
Articular surfaces (OA)
Labrum (Tear/FAI)
Joint capsule
Iliopsoas (Acute/Chronic Strain)
Femoral neck
how do you perform the Scour (Quadrant) Test
patient position: supine
steps: flexes knee and provides axial load through femur. then performs sweeping compression and rotation movement from external-internal rotation
positive test: pain or apprehension at any given point during test
what is the Flexion Abduction External Rotation (FABER) Test (Patrick Test) looking for
Hip pathology
Labrum OA
Iliopsoas
Capsule
Sacroiliac joint dysfunction
what is the Craig Test looking for
anteversion / retroversion
8-15° normal
<8° = anteversion
>15° = retroversion
how do you perform the Craig Test?
patient position: prone
steps: involved knee flexed to 90° and palpates greater troch until its most lateral, then uses goni to get measurement of ER/IR.
positive test:
<8° = anteversion
>15° = retroversion
what is the log roll test for
a click reproduced during this test is suggestive of labral tear
or
increased external rotation range-of-motion may indicate iliofemoral ligament laxity.
