This browser is too old to run Achievable.

Update it, or open this page in a current version of Chrome, Safari, Firefox or Edge. On an iPhone or iPad, update iOS: every browser there runs on the version of Safari that comes with it.

Achievable logoAchievable logo
NPTE-PTA
Sign in
Sign up
Purchase
Textbook
Practice exams
Support
How it works
Resources
Exam catalog
Mountain with a flag at the peak
Textbook
Introduction
1. Cardiovascular system
2. Pulmonary system
3. Neuromuscular system
4. Pediatrics
5. Musculoskeletal system
5.1 Anatomy of musculoskeletal system
5.2 Anatomical terminology and exercise training principles
5.3 Joint mechanics and phases of healing
5.4 Upper extremity anatomy
5.5 Special tests of upper extremity
5.6 Comparing clinical presentation and interventions for upper extremity
5.7 Lower extremity anatomy
5.8 Special tests of lower extremity
5.8.1 Hip special tests
5.8.2 Knee special tests
5.8.3 Ankle and foot special tests
5.9 Comparing clinical presentation and interventions for lower extremity
5.10 Spine and pelvis anatomy
5.11 Special tests of the spine, pelvis, and temporomandibular joint
5.12 Comparing clinical presentation and interventions for the spine, pelvis, and temporomandibular joint
5.13 Other musculoskeletal conditions
5.14 Gait
5.15 Prosthetics
5.16 Orthotics
5.17 Medications, imaging, and fractures
5.18 Surgical protocols
6. Other systems
7. Non-systems
Wrapping up
Achievable logoAchievable logo
5.8.1 Hip special tests
Achievable NPTE-PTA
5. Musculoskeletal system
5.8. Special tests of lower extremity

Hip special tests

8 min read
Font
Discuss
Share
Feedback

PTA role: these special tests are data-collection tools you perform within an established plan of care - you’re not making a diagnosis or independently changing the plan. When a test is positive (or a red flag appears), recognize the finding and report it to the supervising PT, who determines the next step, including any referral or imaging.

A positive finding can still guide same-day care within that plan - for example, confirmed hip flexor tightness on Thomas’s test supports stretching already included in the plan of care, while pain reproduced on the scour test should be reported before continuing to load the joint.

  • Hip scour test
    • Patient supine; the examiner flexes and adducts the hip, applies axial compression down the femoral shaft, and sweeps the hip through an arc from flexion/adduction to abduction (adding rotation)
      • Tests for general hip pathology and degenerative joint disease
    • Positive: reproduction of pain symptoms or apprehension to perform
Hip scour test with the hip flexed and adducted while applying axial compression to assess for hip joint pathology.
Hip scour test
Achievable
  • Patrick (FABER) test
    • Patient supine, passively flex, abduct, and externally rotate the test leg so the foot is resting above the knee on the opposite leg; then slowly lower the leg toward the table
      • Identifiers: dysfunction of the hip, specifically mobility dysfunction
      • Also screens for iliopsoas tightness and SI joint dysfunction: anterior/groin pain points to the hip, while posterior pain near the SI joint points to the SI joint
    • Positive: involved knee is unable to assume a relaxed position and/or reproduce painful symptoms
Clinician performing the Patrick FABER test on a patient's hip and leg.
Patrick (FABER) test
Achievable
  • Thomas test
    • Patient supine; one hip and knee maximally flexed to the chest with hold; opposite limb is kept straight on the table
      • Tests for the tightness of hip flexors
    • Positive: straight limb flexes, and the patient is unable to keep this leg straight on the table
      • If the thigh rises off the table, this implicates the iliopsoas (a one-joint hip flexor); if the thigh stays down but the knee extends instead, this implicates the rectus femoris
Thomas test assessing hip flexor tightness.
Thomas test
Achievable
  • Ober’s test
    • Patient side-lying on the untested side with the bottom leg flexed at the hip and knee for stability; the examiner stabilizes the pelvis, passively abducts and extends the top (tested) leg with its knee flexed to 90 degrees, then slowly lowers it toward the table
      • Tests for the tightness of the tensor fascia lata or the iliotibial band
    • Positive: uppermost leg remains above horizontal
Ober's test with the patient side-lying and the top leg passively abducted, extended, and lowered to assess iliotibial band tightness.
Ober's test
Achievable
  • Ely’s test
    • Patient is prone; flex the knee of the tested limb
      • Tests for the tightness of the rectus femoris
    • Positive: hip of the tested limb flexes
Ely's test with the patient prone and the knee passively flexed; the hip on the same side rising indicates rectus femoris tightness.
Ely's test
Achievable
  • 90-90 hamstring test
    • Patient position in supine; hip and knee supported in 90 degrees flexion; passively extend the knee until end feel is encountered
      • Test for the tightness of the hamstrings
    • Positive: knee lacks more than about 20 degrees of knee extension
90-90 hamstring test with the patient supine, hip flexed to 90 degrees, and knee passively extended to assess hamstring flexibility.
90-90 hamstring test
Achievable

  • Piriformis test

    • Patient supine with the tested hip and knee flexed so the foot rests lateral to the opposite knee; the tested hip is then passively adducted (moved across midline)
      • Tests for piriformis tightness and syndrome
    • Positive: tested knee is unable to pass over the resting knee, or reproduction of pain in the buttock or along the sciatic nerve

  • FAIR (flexion, adduction, internal rotation) test

    • The side-lying version of the piriformis test: the patient lies on the untested side with the top hip flexed to about 60 degrees and the knee flexed; the examiner presses the knee down toward the table, adducting and internally rotating the hip
    • Positive: buttock pain or pain along the sciatic nerve
Piriformis test with the patient supine and the hip flexed and adducted so the foot rests lateral to the opposite knee, stretching and assessing the piriformis muscle.
Piriformis test
Achievable
  • Trendelenburg test
    • Patient standing and asked to stand on one leg; observe the pelvis on the swing (unsupported) side.
      • Tests for gluteus medius weakness
      • Watch the pelvis on the swing (unsupported) side: a drop there indicates weakness of the stance-leg gluteus medius (the hip abductor on the side the patient is standing on)
      • A leg length discrepancy commonly produces a compensatory pelvic tilt (pelvic obliquity), which is different from the contralateral pelvic drop during single-leg stance that defines a positive Trendelenburg sign
    • Positive: swing side pelvis drops when in single leg stance, or compensation by leaning the trunk over the stance leg
Three examples of Trendelenburg gait showing normal, positive, and compensated walking positions.
Trendelenburg test
Achievable

PTA scope of practice

  • Special tests are data-collection tools within an existing plan of care, not diagnostic tools
  • Positive findings/red flags must be reported to supervising PT, who decides referral/imaging
  • Some positive findings (e.g., confirmed hip flexor tightness) can still guide same-day treatment already in the plan; others (e.g., pain on scour test) warrant reporting before continued loading

General hip joint pathology tests

  • Scour test: supine, hip flexed/adducted with axial compression swept through arc; positive = pain reproduction or apprehension; screens for degenerative joint disease
  • Patrick (FABER) test: figure-4 position, leg lowered toward table; positive = knee can’t relax or pain reproduced
    • Anterior/groin pain = hip dysfunction; posterior/SI pain = SI joint dysfunction
    • Also screens iliopsoas tightness

Muscle tightness/flexibility tests

  • Thomas test: supine, opposite hip/knee flexed to chest, test leg stays straight; positive = test leg flexes/can’t stay straight
    • Thigh rises = iliopsoas tightness; knee extends instead = rectus femoris tightness
  • Ober’s test: side-lying, top leg abducted/extended then lowered; positive = leg stays above horizontal; tests IT band/TFL tightness
  • Ely’s test: prone, knee flexed; positive = hip flexes; tests rectus femoris tightness
  • 90-90 hamstring test: supine, hip/knee at 90°, knee extended; positive = lacks >~20° knee extension; tests hamstring tightness
  • Piriformis test: supine, hip/knee flexed and adducted across midline; positive = knee can’t cross opposite knee or pain in buttock/sciatic distribution; tests piriformis tightness/syndrome; FAIR test = side-lying flexion/adduction/internal rotation version

Muscle weakness/functional test

  • Trendelenburg test: standing on one leg, observe swing-side pelvis
  • Positive = swing-side pelvis drop or trunk lean over stance leg
  • Indicates weakness of stance-leg gluteus medius (hip abductor)

Sign up for free to take 9 quiz questions on this topic

Previous
Next  | 5.8.2 Knee special tests
All rights reserved ©2016 - 2026 Achievable, Inc.

Hip special tests

PTA role: these special tests are data-collection tools you perform within an established plan of care - you’re not making a diagnosis or independently changing the plan. When a test is positive (or a red flag appears), recognize the finding and report it to the supervising PT, who determines the next step, including any referral or imaging.

A positive finding can still guide same-day care within that plan - for example, confirmed hip flexor tightness on Thomas’s test supports stretching already included in the plan of care, while pain reproduced on the scour test should be reported before continuing to load the joint.

  • Hip scour test
    • Patient supine; the examiner flexes and adducts the hip, applies axial compression down the femoral shaft, and sweeps the hip through an arc from flexion/adduction to abduction (adding rotation)
      • Tests for general hip pathology and degenerative joint disease
    • Positive: reproduction of pain symptoms or apprehension to perform
  • Patrick (FABER) test
    • Patient supine, passively flex, abduct, and externally rotate the test leg so the foot is resting above the knee on the opposite leg; then slowly lower the leg toward the table
      • Identifiers: dysfunction of the hip, specifically mobility dysfunction
      • Also screens for iliopsoas tightness and SI joint dysfunction: anterior/groin pain points to the hip, while posterior pain near the SI joint points to the SI joint
    • Positive: involved knee is unable to assume a relaxed position and/or reproduce painful symptoms
  • Thomas test
    • Patient supine; one hip and knee maximally flexed to the chest with hold; opposite limb is kept straight on the table
      • Tests for the tightness of hip flexors
    • Positive: straight limb flexes, and the patient is unable to keep this leg straight on the table
      • If the thigh rises off the table, this implicates the iliopsoas (a one-joint hip flexor); if the thigh stays down but the knee extends instead, this implicates the rectus femoris
  • Ober’s test
    • Patient side-lying on the untested side with the bottom leg flexed at the hip and knee for stability; the examiner stabilizes the pelvis, passively abducts and extends the top (tested) leg with its knee flexed to 90 degrees, then slowly lowers it toward the table
      • Tests for the tightness of the tensor fascia lata or the iliotibial band
    • Positive: uppermost leg remains above horizontal
  • Ely’s test
    • Patient is prone; flex the knee of the tested limb
      • Tests for the tightness of the rectus femoris
    • Positive: hip of the tested limb flexes
  • 90-90 hamstring test
    • Patient position in supine; hip and knee supported in 90 degrees flexion; passively extend the knee until end feel is encountered
      • Test for the tightness of the hamstrings
    • Positive: knee lacks more than about 20 degrees of knee extension

  • Piriformis test

    • Patient supine with the tested hip and knee flexed so the foot rests lateral to the opposite knee; the tested hip is then passively adducted (moved across midline)
      • Tests for piriformis tightness and syndrome
    • Positive: tested knee is unable to pass over the resting knee, or reproduction of pain in the buttock or along the sciatic nerve

  • FAIR (flexion, adduction, internal rotation) test

    • The side-lying version of the piriformis test: the patient lies on the untested side with the top hip flexed to about 60 degrees and the knee flexed; the examiner presses the knee down toward the table, adducting and internally rotating the hip
    • Positive: buttock pain or pain along the sciatic nerve
  • Trendelenburg test
    • Patient standing and asked to stand on one leg; observe the pelvis on the swing (unsupported) side.
      • Tests for gluteus medius weakness
      • Watch the pelvis on the swing (unsupported) side: a drop there indicates weakness of the stance-leg gluteus medius (the hip abductor on the side the patient is standing on)
      • A leg length discrepancy commonly produces a compensatory pelvic tilt (pelvic obliquity), which is different from the contralateral pelvic drop during single-leg stance that defines a positive Trendelenburg sign
    • Positive: swing side pelvis drops when in single leg stance, or compensation by leaning the trunk over the stance leg
Key points

PTA scope of practice

  • Special tests are data-collection tools within an existing plan of care, not diagnostic tools
  • Positive findings/red flags must be reported to supervising PT, who decides referral/imaging
  • Some positive findings (e.g., confirmed hip flexor tightness) can still guide same-day treatment already in the plan; others (e.g., pain on scour test) warrant reporting before continued loading

General hip joint pathology tests

  • Scour test: supine, hip flexed/adducted with axial compression swept through arc; positive = pain reproduction or apprehension; screens for degenerative joint disease
  • Patrick (FABER) test: figure-4 position, leg lowered toward table; positive = knee can’t relax or pain reproduced
    • Anterior/groin pain = hip dysfunction; posterior/SI pain = SI joint dysfunction
    • Also screens iliopsoas tightness

Muscle tightness/flexibility tests

  • Thomas test: supine, opposite hip/knee flexed to chest, test leg stays straight; positive = test leg flexes/can’t stay straight
    • Thigh rises = iliopsoas tightness; knee extends instead = rectus femoris tightness
  • Ober’s test: side-lying, top leg abducted/extended then lowered; positive = leg stays above horizontal; tests IT band/TFL tightness
  • Ely’s test: prone, knee flexed; positive = hip flexes; tests rectus femoris tightness
  • 90-90 hamstring test: supine, hip/knee at 90°, knee extended; positive = lacks >~20° knee extension; tests hamstring tightness
  • Piriformis test: supine, hip/knee flexed and adducted across midline; positive = knee can’t cross opposite knee or pain in buttock/sciatic distribution; tests piriformis tightness/syndrome; FAIR test = side-lying flexion/adduction/internal rotation version

Muscle weakness/functional test

  • Trendelenburg test: standing on one leg, observe swing-side pelvis
  • Positive = swing-side pelvis drop or trunk lean over stance leg
  • Indicates weakness of stance-leg gluteus medius (hip abductor)

More from Special tests of lower extremity

  • Knee special tests
  • Ankle and foot special tests