A) Hip dysfunction, mobility restriction

B) Supine; flex, ABD, and ER hip so foot is resting above knee on opposite leg; allow lower testing leg down toward table surface

C) Unable to assume relaxed position and/or reproduction of painful symptoms

A) DJD of hip joint

B) Supine, hip in 90 flexion, max knee flexed --> compressive load into femur into hip joint

C) Pain within hip joint, may refer pain into knee

A) Identifies weakness of gluteus medius or unstable hip

B) Patient standing, ask to SLS --> observe stance leg

C) Ipsilateral pelvis drops when lower limb support is removed

A) Hip flexor tightness

B) SK2C --> observe whether hip flexion occurs on straight leg as opposite leg is flexed

A) Tightness of TFL and/or ITB

B) Side-lying, extend hip/abduct hip with knee flexed; Modified ober starts with knee extended --> slowly lower upper leg

C) Unable to come to rest on table

A) Tightness of rectus femoris

B) Prone, knee of testing limb flexed

C) Positive if hip of testing limb flexes

A) Tightness of hamstrings

B) Supine, hip & knee flexed to 90 --> extend knee

C) Unable to reach 10 from neutral position

A) Piriformis Syndrome

B) Supine, place testing leg lateral to oppositie knee --> adduct testing leg hip

C) Testing knee doesn't cross over oppositie knee, reproduction of symptoms, sciatica

A) Identify abnormal antetorsion angle

B) Prone, knee flexed to 90 --> IR/ER hip and palpate greater trochanter = most lateral position --> Measure line perpedicular to the table

C) Normal = 8 - 15 degrees IR; Retroversion = > 8;

> 15 = anterversion

A) ACL injury

B) Supine, knee extended, hip flexed, abducted 30, slight IR --> Valgus at knee flex

C) Ligament laxity = tibia relocating "clunks" @ 30-40 flexion (ITB reducing subluxation as knee flexes)

A) Help to differentiate between mensical tears and ligamentous lesions

B) Prone, knee flexed to 90 --> Distract and slowly rotate IR/ER & compression and ER/IR

C) Pain or decreased ROM during compression = meniscal

Pain or increased motion during distractino = ligamentous

A) Dysfunction of the plica

B) Supine, testing knee flexed with tibia IR -->

passively glide patella medial while palpating medial femoral condyle --> passively flex & extend knee

C) Pain or popping duing test

A) Past history of patella dislocation

B) Supine --> passively glide patella laterally

C) Patient does not alow and/or doesn't like patella to move in lateral direction

A) Patellofemoral Dysfunction

B) Supine, knee in extension --> Push posterior on superior pole of patella --> Ask patient to contract quadriceps

C) Pain reproduction

A) Determine if ITB friction syndrome is present

B) Supine, hip flexed 45, knee flexed to 90 --> apply pressure to lateral femoral epicondyle then extend knee

C) Pain reproduction overal lateral femoral condyle ~ 30 degrees

A) Measure angle between quadriceps muscle and patellar tendon

B) Normal = 13 (M), 18 (F)

C) Knee, biomechanic dysfunction outside of normal range

1. Distraction (supine)

2. Compression (side-lying)

3. Gaenlen's (supine), (hyperflexion [non-tested] & hyperextesnion [tested])

4. Thigh thrust (supine, hip flexed to 90)

5. Sacral thrust (prone)

+ = painful

A) Differentiate between intermittent claudication and spinal stenosis

B) Seated, stationary bike --> begin pedaling sitting erect, time how long patient can pedal @ set pace/speed; repeat in slumped position. Compare differences b/w erect vs slumped

C) Pain related to stenosis = demonstrate ability to pedal longer in slumped

A) Identifies compression of neural structures at the intervertebral foramen and facet dysfunction

B) Foramen = SB ipsi, R ipsi, Ext with OP Facet = SB ipsi, R contra, Ext with OP

C) Pain and/or paresthesia in dermatomal pattern for the involved nerve root, or loclaized pain in facet dysfuction

A) Spondylolisthesis

B) SLS --> Extension; repeat other leg

C) Pain in low back with ipsilateral leg on ground

A) Differentiates between scoliotic curvature versus neurological dysfunction causing abnormal curvature (lateral shift) of trunk

B) Stand on shifted side (towards you), place shoulders into patient's upper trunk and wrap arms around pelvis

--> stabilize upper trunk and pull pelvis to bring into proper alignment 

C) Reproduction of neurological symptoms as alignment of trunk is corrected