4 flexion internal rotation test
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7 months ago
Published on May 18, 2024
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Table of Contents
Title: Flexion Internal Rotation Test Tutorial for Hip Pathology Assessment
Step 1: Understand the Purpose of the Test
- The flexion internal rotation test is used to assess hip intra-articular pathology, labral tears, and hip impingement.
- Patients typically present with deep-seated groin pain as a complaint.
Step 2: Positioning the Patient
- Have the patient lie down and bring their knee to a 90° angle.
- Apply overpressure gently while maintaining the position.
Step 3: Performing the Test
- With one hand near the head (cranial hand) and the other near the hip (caudal hand), passively internally rotate the patient's hip to end range.
- The test aims to reproduce deep-seated groin pain.
Step 4: Interpretation of Results
- A positive response is indicated by the reproduction of deep-seated groin pain during the test.
- This pain suggests potential issues such as a labral tear or impingement.
Step 5: Mechanism of the Test
- As the hip is rotated internally to end range, the femoral head may mechanically abut against a labral tear or an extended acetabular rim.
- Positive responses may include pain, clicking, or catching sensations.
Step 6: Flexion Internal Rotation Test with Biomechanical Considerations
- In this variation, there is no adduction involved.
- Passively internally rotate the hip to end range with overpressure at 90° of flexion.
Step 7: Impingement Considerations
- The test may impinge against the acetabular rim, especially in cases of cam or pincer morphology.
- Cam morphology or an enlarged femoral head can lead to mechanical abutment against the acetabular rim.
Step 8: Location of Pathology
- Clients with labral tears or mechanical abutments may experience pain in the same location as noted during the test.
By following these steps, you can effectively perform and interpret the flexion internal rotation test for assessing hip pathology.