Test INTERPRETATION/WHAT TISSUE STRUCTURE DOES THIS TEST LOAD?

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Squat test Patient squats down as far as possible. Tests for ankles, knees and hips. Test is
negative if patient can squat and bounce with no signs and symptoms.

Lumbar Kemps test Seated patient rotates, laterally flexes, and extends (circular motion). Test aims to
decrease IVF and create extension & rotation in lumbar spine. Positive neurogenic
claudication if patient experiences pain in leg. If pain is local, facets may be
responsible. Pain on contralateral side can suggest lumbar strain or sprain.

Djerine’s triad
(Valsalva, cough,
Patient told to take a breath and mimic bowel evacuation. Patient asked to cough.
sneeze)
Positive if pain in low back, leg or thigh increases on Valsalva.

Flip or Bechterew’s Examiner extends patient’s knee. Raised straight leg. Positive if both tests cause
test sciatic nerve pain. If one test is positive, possible lower lumbar spine problem.

Straight leg raising Passive test. Knee extended and hip flexed until patient complains of pain or
test (SLR) tightness. Pain after 70 degrees indicates joint pain from lumbar or SIJ. Test
positive if pain extends from the back down into the leg in the sciatic nerve.

Well straight leg Same as SLR. If the well leg is lifted and patient complains of pain on opposite leg,
raising test (WSLR) could indicate space-occupying lesion. Eg, herniated disc.

Braggard’s test From SLR position. Leg is slightly lowered until no pain is felt, foot is dorsiflexed.
Positive test if pain that increases with ankle dorsiflexion. Indicating stretching of
the dura mater of spinal cord.

Bowstring’s test Popliteal pressure test. SLR test, pain results. Knee is flexed to reduce pain. Thumbs
applied as pressure to the popliteal region to re-establish radicular pain. Positive
test for sciatic nerve pressure or tension.

Bonnet’s test Leg is lifted, 45 degrees, internally rotated to stretch piriformis. Leg pain results
from sciatic nerve irritation or compression from contracted piriformis.

Kernigs test Active test. Head is flexed onto chest, extended leg raised by flexing hip until pain
felt. At knee flexion, pain should disappear. Pain is positive, may indicate
meningeal, dural or nerve root irritation.
Sign of the buttock Passive SLR. If there is unilateral restriction, knee is flexed to see if hip flexion
increases. Hip flexion increase indicates lumbar spine problem, hence negative test
for buttocks. No increase in hip flexion with knee flexed is a positive test for
buttocks. Eg, bursitis, tumour, abscess.

Slump test Patient seated with hands behind back and slumped so lumbar and thoracic spine
is in full flexion. Examiner supports patient’s chin to prevent neck flexion. Pressure
is applied to over head while extending leg. Patient asked to straighten knee.
Positive for tension in neuromeningeal tract if knee extends further and pain
decreases with neck extension.

Milgrams test Patient supine, simultaneously raises both legs and holds for 30 secs. Test is
positive if the limbs cannot hold up for 30 secs. May indicate space-occupying
lesion.

Sacral thrust Patient prone, while practitioner applies heel/hypothenar of hand to the apex of
(Springing the the sacrum and springs firmly over it. While springing, other fingers palpate over
sacrum) SIJ. Test subjective to patient’s sensation of pain.

SIJ distraction Patient supine, practitioner crosses hands over and places them on each ASIS,
applying force posteriorly and laterally. Positive test is a reproduction of pain in
buttocks and/or sacroiliac region.

SIJ compression Patient supine, practitioner places hands over anterior aspect of SIJ, and compress
medially. A positive test would be a reproduction of the symptoms in the buttocks
and/or sacroiliac region.

Thigh thrust Patient supine, practitioner stands on asymptomatic side and flexes patient’s
symptomatic leg with slight adduction. Secondary hand is placed beneath patient’s
sacrum and apply pressure on the knee downwards. A positive test would be a
reproduction of the pain.

Gaenslen Patient supine with both legs drawn to their chest. Patient then shifted to edge of
couch so one side of buttock extends over table and leg drops off table.

Nachlas test (prone Patient is prone, passive knee flexion, so heel reaches buttocks, while stabilising
knee bending the opposite hip so it doesn’t rotate. Shooting pain in thigh and leg may indicate L2
or L3 nerve root lesion.

Ely’s test Passive knee flexion and foot pushed to opposite shoulder. On flexion of the knee a
positive test indicates femoral nerve tension (L2-4). Also rectus femoris tension.

Yeoman’s test Passive test. Hip extended in knee flexion while pelvis is stabilised. Positive test
indicated by pain in lumbar spine/SIJ.
Lumbar springing test Patient prone in slight extension position. Practitioner’s hands apply downward
force to each lumbar vertebra. Positive if pain felt on brisk release of contact.

Stoop test Patients stands in forward flexion. Assess neurogenic intermittent claudication
while patient walks for I min. Pain will present in buttocks and lower limb. Test is
negative if pain persists with flexion.

Hoover test Examiner places hands under each calcaneus. Patient asked to lift one leg off table,
straight leg raise. If lifted limb is weak, then pressure in the opposite calcaneus
increases, felt by the examiner. If patient expresses difficulty in raising leg with
absence of pressure in opposite calcaneus, then patient may be malingering.

Trendelenberg’s test Patient stands on one leg, with one knee flexed at 90 degrees. If pelvis on opposite
side drops, indicates positive test. Tests for weak gluteus medius or unstable hip
joint on the affected side.

Patrick Fabere test Patient supine with figure of 4 position. Examiner lowers test leg in abduction.
Positive test when tested leg cannot fall on the table. Positive test indicates
iliopsoas spasm or lesion in the SIJ.

Thomas test Patient supine, examiner checks for excessive lordosis, typical of tight hip flexors.
Examiner flexes one hip, knee to chest. Thomas test used to assess hip flexion
contracture. If contracture present, opposite straight leg will rise off the table.
Increase in lordosis is a positive test.

Test for true leg Patient’s both leg length is measured from umbilicus or greater trochanter to
length medial malleolus. Could be an issue with the hip joint rather than an actual shorter
leg.

Ober’s test Patient lying on side, passively abducts and extends leg knee straight or flexed.
Ober’s test used to assess the tensor fasciae latae (iliotibial band) for contracture.
Examiner stabilizes pelvis at the same time to stop the pelvis from falling
backwards indicating a positive test.

Pelvic Rock test Patient supine, examiner places palms on the iliac tubercles and applies pressure
on pelvis toward midline of body.

Homer pheasant test Patient is prone while examiner applies one hand on lumbar spine. Other hand is
flexing both legs until heel reaches buttocks for up to 5 mins. Size of IVF decreased.
Positive if pain produced, indicating unstable spinal segment and neurogenic
claudication.

Schober test Tests for amount of lumbar spine flexion. A point is measured between the PSIS
(level of S2) 5cm below & 10cm above. Distance is measured while patient is
flexed. A positive test is the separation of these contacts indicating SIJ movement
during flexion.
Bicycle test of Van Patient seated on a bicycle, and pedals against resistance, while accentuating
Felderen lumbar lordosis. Pain in buttock and posterior thigh indicates positive test. If pain
subsides on flexion, also positive test. Tests for neurogenic claudication.