1. Hip and Pelvis
Muscle Tests

2. Gaenslen’s Sign Used to assess if pathology exists in sacroiliac joint
Patient lies supine on table with both knees bend and hug knees to chest
Patient located at end of table to one buttock is over edge

3. Gaenslen’s Sign
Both shoulders remain on table as long as full range of hip extension is permitted
Therapist stabilizes patient at torso so patient feels balanced
Keeping supporting leg flexed, allow unsupported leg to drop over edge of table
Ask if any pain
Pain in area of sacroiliac joint may indicate pathology
Test both sides

4. Thomas Test
Used to help detect flexion contractures of the hip or to evaluate range of hip extension
Muscle contracture: a muscle that fails to relax completely
Orthopedic contractures: shortening of the connective tissue (Houglam, 2005)

5. Thomas Test Patient lies supine on table
Ensure pelvis is level and square to trunk
Stabilize the pelvis by placing hand under lumbar spine
Bend patient’s knee to chest, flex hip
Therapist notes the point that the back flattens, at this point the movement is purely hip joint and no pelvic movement
Flex hip as far as possible

6. Thomas Test Thigh should rest against abdomen Flex other hip
Patient holds one leg and extend the other as far as possible
Leg should rest flat on table
If leg does not lie flat, may indicated a fixed flexion contracture
Rocking forwards or lifting of the thoracic spine and return of lumbar lordosis are indicators of contracture
Approximate angle between the extended leg and the table

7. Trendelenburg Test
Tests the stability of the hip and evaluate the strength of the gluteus medius because it is the main stabilizer (Adams, 1971)
Patient stands erect bearing weight evenly on both feet
Therapist stands behind the patient
Note where posterior superior iliac spines are, should be level

8. Trendelenburg Test Therapist asks patient to stand on one leg
Gluteus medius of support leg should contract and elevate hip of unsupported side (negative result)
If there is a weakness or gluteus medius is not functioning, the hip of the unsupported side will remain level or may drop below level of supported side (positive result)

9. Test for Leg Length Discrepancy
To determine the general leg length discrepancy
Patient lies supine and therapist ensures that patient is lying straight with no curves in spine or pelvic tilt
Therapist measures from the superior iliac spine to medial malleoli

10. Test for Leg Length Discrepancy
If measurements are even, no leg length discrepancy
If there is a difference, testing should be continued to determine where discrepancy exists

11. Tibial or Femoral Discrepancy
Flex knees to ninety degrees
Tibial discrepancy: standing in front of patients knees, therapist will notice one of the knees higher than the other
Femoral discrepancy: standing lateral to patient, therapist will notice one leg projecting past the other anteriorly

12. Ober Test Test of the iliotibial band
Testing for contracture of the band or the fascia lata
Patient lies on side with involved side up
Keeping hip neutral the therapist supports medial side of distal femur and medial side of tibia

13. Ober Test
Therapist abducts leg at hip as much as possible then flexes knee to 90º
Therapist slowly releases leg down
If leg drops to adducted position no contracture exists (negative Ober)
If leg remains abducted, contracture exists (positive ober)

14. References
Adams, J.C.(1971). Outline of orthopaedics (7th ed.). E.&S. Livingstone Limited: London.
Hoppenfield, S. (1972). Physical examination of spine and extremities. Applteton Croft.
Houghlum, P.A. (2005). Therapeutic exercises for musculoskeletal injuries. Human Kinetics.