Assessment of the Hip

Passive hip ROM tests will give you a lot of valuable information about hip restrictions that may be negatively affecting the function on the pelvis and low back.

Passive Hip ROM Tests

PASSIVE HIP ROM TESTS 

1. Passive Hip Flexion - Normal 125°

  • Pain may indicated a pinching of MTJ of iliopsoas
  • Pain may indicate hip capsulitis

2. Passive Medial Rotation - Normal 40-45°

  • Tests length of lateral rotators (piriformis)
  • Medial rotation is the most commonly limited passive movement of the hip. This could be due to short lateral rotators, or indicate arthritic changes in the hip joint.

3. Passive Lateral Rotation - Normal 60°

  • Tests length of medial rotators (glut med/min)
  • Internal + External rotation should add up to about 100°

4. Hamstring Length- Normal 90°

5. FABER Test - Normal 2” from table top

F =  Flexion

AB =  Abduction

ER =  External Rotation

  • Tests length of Adductors (pectineus, adductor brevis & longus)

6. Passive Adduction with 30° of Flexion - Normal 35°

  • Tests length of gluteus medius and minimus
  • May indicate trochanteric bursitis

7. Passive Adduction with Mild Extension - Normal 30°

  • Tests the length of TFL

8. Passive Hip Extension with Bent Leg - Normal 30°

  • Length of rectus femoris
  • Head turned toward therapist
  • Abduct to 20° and extend hip
  • Monitor PSIS movement

9. Passive Hip Extension with Straight Leg - Normal 20° - 30°

  • Length of all hip flexors (iliopsoas complex)
  • Head turned toward therapist
  • Abduct to 20° and extend hip
  • Monitor PSIS for movement

Goals of Range of Motion Testing

  1. Duplicate the symptoms (to determine the structures that require treatment).
  2. Test Anatomical Motion Barrier - taking the joint to it’s absolute anatomical limitation.
  3. Test Pathological Motion Barrier - taking the joint to it’s initial point of resistance. The point during a passive stretch where the tissues being stretched are approaching the limit of their flexibility with NO PAIN.
  4. Passive ROM testing also puts the muscles that are antagonistic to the movement pattern on stretch. Perform hold/relax stretches at this PAIN FREE motion barrier to improve ROM.
  5. Active ROM testing helps to locate painful lesions where soft tissue work can be performed to release adhesions. Ask your client to tell you where it hurts.
  6. Identify Normal End Feel. End feel refers to the quality of resistance during overpressure: Only apply overpressure** if there is NO PAIN at end range.

a) Firm End Feel (normal end feel)

  • Normal resistance felt in the slightly elastic tissues involved, will create a firm end feel, that is limited by stretching the soft tissues.
  • Sensation is described as ‘leathery’

b) Hard End Feel (absolute limitation of the joint)

  • Bone to bone (passive hyperextension of elbow or knee)

c) Soft End Feel (soft tissue approximation)

  • Joint could move further without damage or discomfort (elbow, knee flexion)

d) Empty End Feel

  • Abnormal, as in a ligament tear.

 

  • Overpressure Test: Controlled induced movement to test end range.  Only perform, if passive test is negative with NO PAIN present at normal end range.