Special Tests of the Lower Extremity

If you have hip pain, knee pain, or ankle pain, your physical therapist can perform a thorough examination to help determine the cause of your lower extremity problem and to devise an appropriate treatment strategy. Lower extremity special tests may be one component of that examination to determine the cause of your pain.

Male patient lying on massage table with leg held by massage therapist
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Special tests are often performed to assist in diagnosing musculoskeletal disorders. There are various special tests, each specific for a certain diagnosis. Disorders of muscles, joints, tendons, and ligaments can all be confirmed with a positive finding if the correct special test is performed. Scroll through the step-by-step program to review common special tests of the lower extremities.

If you are having a problem with your hip, knee, or ankle, check in with your healthcare provider and visit your physical therapist to learn more about your condition and to get started on the correct treatment for you.

Patrick's (or FABER) Test

The Patrick or FABER test is a screening test for pathology of the hip joint or sacrum.
The test is performed as follows:

  1. Place the patient in the supine position.
  2. Flex the leg and put the foot of the tested leg on the opposite knee. (the motion is that of Flexion, Abduction, External Rotation at the hip).
  3. Slowly press down on the superior aspect of the tested knee joint lowering the leg into further abduction.
  4. The test is positive if there is pain at the hip or sacroiliac joint, or if the leg cannot get to the same position that the opposite leg was able to get to.

A positive FABER test may indicate hip joint pathology like osteoarthritis or a labrum tear. Tightness in your piriformis muscle may also elicit a positive FABERs test.

Ober's Test

The Ober's test is done to assess tightness of the iliotibial band and the tensor fascia lata.
The test is performed as follows:

  1. Place the patient in the side-lying position on a table with the side to be tested up.
  2. Extend and abduct the hip joint.
  3. Attempt to lower (adduct) the leg down toward the table and release it.
  4. A positive test is found if the leg remains in the abducted position.
  5. This test may be done two ways: one with the test knee bent and one with the test knee fully straightened.

Tightness in your iliotibial band may lead to iliotibial band friction syndrome (ITBS) or patellofemoral stress syndrome (PFSS). You may benefit from physical therapy to help you decrease your knee pain from these conditions. Rehab for ITBS or PFSS focuses on restoring normal hip flexor and quadriceps strength and stretching muscles that may be tight.

Thomas Test

The Thomas test is used to evaluate a ​flexion contracture of the iliopsoas muscle.

The test is performed as follows:

  1. Have the patient supine on the exam table.
  2. Flex the hip and knee on the side NOT being tested, and have the patient hold their knee against their chest. The non-flexed leg is examined.
  3. A positive test result occurs if this leg raises off the table, indicating a flexion contracture of the iliopsoas muscle.
  4. The test can be performed with the patient lying near the edge of the table with the test leg hanging over the table. That way, tightness in the quadriceps muscle can also be assessed.
  5. If the test knee does not bend while the patient is lying down with their leg over the edge of the table, the test is positive for quadriceps tightness.

By Laura Inverarity, DO
 Laura Inverarity, PT, DO, is a current board-certified anesthesiologist and former physical therapist.