Thigh Hip and Pelvis Examination

WeberBarstow Maneuver Test

Steps

Patient begins in a supine position with his/her heels off the end of the table
Examiner holds the feet of the patient & places the thumbs over the medial
malleoli while providing slight traction on the legs
Examiner instructs the patient to flex both knees & hips to place the feet on
the table aligned next to each other (line up the medial malleoli)
Examiner instructs the patient to bridge his/her hips upward and then return
to his/her starting position

Supine to LongSit Test

Steps

Patient is in a supine position with the heels off of the end of the table
Examiner "clears the hips" using the WeberBarstow Maneuver
Examiner passively extends the patient's legs & compares the position of the
medial malleoli
Examiner pulls the patient up to a longsit position from a supine position
Examiner observes the position of the medial malleoli for any change from
the starting position

Positive Test

Observable change in the position of the medial malleoli

Positive Test Implications

Posterior pelvic rotation (equal/short to long); anterior pelvic rotation

(equal/long to short)

Supine ("True") Leg Length Discrepancy Measurement Test

Steps

Patient is placed in a supine

Examiner "clears the hips" using the WeberBarstow Maneuver and then
extends both legs
Examiner measures the distance from the ASIS to the crest (i.e., highest
point) of the medial malleolus on each leg OR Examiner measures the

distance from the ASIS to the crest (i.e., highest point) of the lateral malleolus
on each leg
Positive Test

Difference of greater than inch between the two legs

Positive Test Implication

Possible structural leglength difference

Supine "Apparent" Leg Length Discrepancy Test

Clinical discrimination between Femoral & Tibial Leg Length Discrepancy Test
Steps

Athlete is lying supine with his/her hip flexed to 45 & knee flexed to 90 and
both feet lined up next to each other (line up medial malleoli and 1st MTP
joints)
Examiner holds the athlete's feet to the table and instructs the athlete to
raise the pelvis up off the table and then lower the pelvis back to the table
Examiner observes the patient from the side (viewing both tibial tubercles)
for anterior positioning of one knee compared to the other
Examiner observes the patient from the front (viewing the top of both
patellae) for height differences of one knee compared to the other

Positive Test

Anterior positioning and/or height differences of one knee compared to the

other

Positive Test Implication

Femoral length difference (lateral viewincreased anterior position); tibial

length difference (front viewincreased height difference)

Gaenslen's Test
Steps

Athlete is supine, lying close to the side of the table

Examiner allows the near leg to hang over the side edge of the table
Examiner instructs the athlete to actively flex the other leg to his/her chest &
hold

Examiner stabilizes the athlete & applies pressure to the near leg, forcing it
into hyperextension

Positive Test

Pain in the SI region

Positive Test Implications

SI joint dysfunction

Hip Scouring Test

Steps

Athlete is supine
Examiner fully flexes the athlete's hip & knee
Examiner applies downward pressure along the femoral shaft while
repeatedly externally & internally rotating the hip with multiple angles of
flexion

Positive Test

Pain or reproduction of symptoms at the hip

Positive Test Implications

Defect in the articular cartilage of the femur or acetabulum

SI Compression Test
Steps

Athlete is supine
Examiner applies pressure to spread the ASIS

Positive Test

Pain arising from the SI joint

Positive Test Implications

SI pathology

SI Distraction Test
Steps

Athlete is in the sidelying position

Examiner is positioned behind the athlete with both hands over the lateral
aspect of the pelvis
Examiner applies downward pressure through the anterior portion of the
ilium, spreading the SI joints

Positive Test

Pain through the SI joint

Positive Test Implications

SI pathology

Piriformis Tightness Test

Steps

Athlete is sidelying with the test leg being the uppermost leg
Athlete's test leg is flexed at the hip to about 60 & the knee flexed
Examiner stabilizes the hip with one hand & applies a downward pressure to
the knee

Positive Test

Piriformis muscle pain; buttock pain; sciatica pain

Positive Test Implications

Piriformis tightness (piriformis muscle pain); piriformis muscle pinching the

sciatic nerve (buttock pain and sciatica pain)

Thomas Test
Steps

Athlete is supine with his/her knees bent at the end of the table
Examiner places one hand between the lumbar lordotic curve & the tabletop
Examiner passively flexes one of the athlete's legs to his/her chest, allowing
the knee to flex during the movement
Examiner observes the involved leg for movement

Positive Test

The knee of the leg on the table cannot flex past 90 (i.e. the knee of the leg
on the table will extend as the examiner flexes the contralateral hip); the
involved leg (i.e. the leg on the table) rises up off the table (i.e. the
contralateral hip to the one being moved will flex)

Positive Test Implications

Rectus femoris tightness (the knee extends as the examiner flexes the hip);
iliopsoas tightness (the leg on the table will rise off of the table)

Patrick's Test (Faber Test or FigureFour Test)

Steps

Athlete is supine with the foot of the involved side crossed over the opposite
thigh (figure4 position) & the leg resting in the full external rotation
Examiner has one hand on the opposite ASIS & the other hand on the medial
apsect of the flexed knee
Examiner applies overpressure at the knee & ASIS

Positive Test

Inability to lower the flexed thigh down to the level of the leg on the table; hip
joint pain; Sacroiliac pain

Positive Test Implications

Ilipsoas tightness; hip pathology (groin or inguinal area pain); sacroiliac joint
pathology (pain during application of overpressure in the SI area)

Trendelenburg's Test
Steps

Athlete stands with the feet evenly distributed (i.e. approximately shoulder
width apart from each other)
Examiner sits or kneels behind the athlete
Examiner slightly lowers the athlete's shorts so that the examiner may
palpate the right & left PSIS and/or iliac crests
Examiner instructs the athlete to flex the hip thereby lifting the right (and
then the left knee) while observing the pelvis

Positive Test

The PSIS or iliac crest on the same side as the leg lifted will drop in relation to
the contralateral side

Positive Test Implications

Contralateral (i.e., stance leg) gluteus medius (hip abductor) weakness or

decreased innervation of the same muscles

Hoover Test
Steps

Subject is supine while examiner cups both heels of the patient with their
hands
Subject is asked to perform a unilateral straight leg raise

Positive Test

Inability to raise leg (or)

A positive finding is also noted when the examiner does not feel pressure in
the palm of the hand underlying the resting leg

Positive Test Implications

neuromuscular weakness (or)

lack of effort by subject