Hip Flexors

Iliopsoas Strength Test

Testing for: iliopsoas weakness

Procedure:

• Patient is supine, with their knees in extension
• Stabilize the unaffected pelvis
• Patient flexes their affected hip at 30° and slightly externally rotates it
• Patient holds this position (Grade 3 strength)

Positive Sign: Patient cannot hold the affected leg off the table (in flexion and slight external rotation). To test Grade 5 Strength, therapist may try to put a downward pressure as the patient tries to keep the leg off the table in resistance.

Thomas Test

Testing for: Hip flexor muscle contracture or shortness

Procedure:

• Patient is supine , with lower gluteal folds at the end of the table and their hips and knees flexed. Patient may hold the legs in flexion with their hands.
• Therapist makes sure that the patient’s lower back is not so high off the table.
• Patient keeps the unaffected leg flexed, and slowly lowers the affected leg and lets it extend as far as it can

Positive Sign:

• Short QUADS: the affected knee stays extended
• Short Psoas muscles: the hips remains flexed
• Short TFL/ ITB: Abducted hip