Thomas test

Question 1

What does the thomas’ test diagnose?

Answer 1

tightness of either rectus femoris or iliopsoas

Question 2

What is the rationale behind thomas’s test.

Answer 2

If knee flexion causes hip flexion, rectus femoris is tight
If knee flexion does not cause flexion at the hip, iliopsoas is tight
The test thus differentiates between tightness of the hip flexors and
rectus femoris.

Question 3

What does a positive result suggest?

Answer 3

identifies tightness in either the independent hip flexors or rectus femoris

Question 4

Procedure of thomas’ test

Answer 4

1) Explain & IC
2) Patient stands at the end of the plinth hugging one knee to their chest
3) Physio asks them to lie back and supports this movement - the non-hugged leg should be kept relaxed
4) Physio passively flexes the patient’s knee and observes any movement
5) Compare to other side

Question 5

Positive result of thomas’ test

Answer 5

A lack of hip extension in either position of knee flexion or extension may suggest tightness in either rectus femoris or iliopsoas.
If the hip flexes during knee flexion: rectus femoris is the leading cause of the limitation of range
If hip fails to flex as the knee is flexed, this may suggest that iliopsoas is responsible for the limitation of range.
The test may also reproduce symptoms

Question 6

Negative result of thomas’ test

Answer 6

No change in the range or symptoms during testing.
It should be noted there is no ‘normal’ for this test and some subjects may demonstrate rectus femoris tightness and other may demonstrate iliopsoas tightness, however, what is to be noted is if there is a difference between the
affected and the non-affected side.

Question 7

Result: Hip flexes during knee flexion
What does this mean?

Answer 7

Rectus femoris tightness

Question 8

Result: hip doesn’t flex after knee flexion
What does this mean?

Answer 8

Iliopsoas is tight