greater trochanter may indicate hypotonic muscles depending upon where ROM is limited. Pain deep in the joint or crepitus (crackling) at any point through the ROM may indicate a dysfunction between the acetabulum and the head of the femur. The head of the femur can be pressed into the acetabulum Ober’s test Tests for hypertonicity of the iliotibial band aka IT band and the tensor fasciae latae aka TFL muscle. The client should be placed in the side-lying position. Their bottom leg, the leg not being tested, is flexed to 90 degrees at the hip and knee. The leg being tested is kept straight. The client abducts their Pace abduction test Tests for a dysfunction of piriformis. The client should be in the supine position with both legs flexed to 90 degrees at the hip and knee. With the massage therapist’s hands on the lateral aspect of the client’s knees, the client is asked to abduct their knees away from each other. Weakness of the piriformis muscle is indicated if the client is unable to abduct their legs against the therapist’s light resistance. Pain in the area of the piriformis may indicate a dysfunction or injury of the piriformis muscle or other Piriformis length test Tests for hypertonicity of piriformis. The client should be in the prone position on the table. Their legs should be straight with knees together before the massage therapist passively flexes the knees to 90 degrees. Together, the legs are rotated laterally to Hip quadrant test Tests for hypertonic muscles or a dysfunction of the hip joint. The client is placed in the supine position on the table. The massage therapist passively flexes the client’s hip to 90 degrees and moves the leg into adduction until there is resistance. Maintaining resistance, the therapist moves the thigh superiorly Posterior sacroiliac joint test Tests for a posterior SI joint dysfunction. The client should be in the side-lying position. Both their hips and legs should be together and flexed to 90 degrees. The massage therapist places their fingers on the ASIS and their other palm on the Anterior sacroiliac joint test Tests for an anterior SI joint dysfunction. The client is in the supine position on the table. The massage therapist places criss- crossed hands, fingers facing away from the body, across client’s SI joint squish test Tests for the posterior ligament integrity of the SI joint. The client should be should in the supine position on the table with their legs laid out straight. The massage therapist places criss-crossed hands, fingers facing the midline of the body, across client’s ASIS SI joint motion test/ stork-gillet test Testing for ROM at the SI joint. The client should be standing with the massage therapist’s thumbs on both the client’s PSIS. The client flexes the hip of the side being tested while standing on the unaffected side. Then the other hip will be tested. This should be repeated several times so the therapist has a good Gaenslen’s test Tests for an SI joint dysfunction. The client is in the side-lying position on the table and flexes their hip and the knee of the unaffected side toward their chest. The massage therapist stands behind the client and stabilizes the superior pelvis with one hand, while extending the affected side’s thigh as far as possible. A positive result is indicated by pain at the SI joint when the Straight leg test Tests for the cause of lower back pain. The client should be supine on the table with their legs fully extended. Beginning with the client’s leg adducted and medially rotated, the massage therapist grasps the client’s heel and, keeping the knee in extension, slowly raises the leg until the client feels
to elicit pain to confirm the result. Stretches may lengthen hypertensive muscles that may be limiting ROM but the therapist should avoid performing ROM movements and stretches if crepitus is present.
entire leg while attempting extension to 45 degrees. Then the client is asked to slowly lower their leg to the starting position. If the client is unable to lower their leg smoothly, this indicates hypertonicity of the IT band or TFL. Myofascial release along the IT band from knee to hip may by beneficial. lateral rotators in the inferior gluteal region. Pain, numbness, tingling or burning that radiates to the lateral thigh or knee may indicate sciatica/piriformis syndrome. The therapist should apply cold therapy to reduce pain and inflammation. The therapist may then use PNF stretches to lengthen the piriformis muscle once pain has subsided. If using deep tissue techniques to treat the piriformis muscle, the therapist should take care not to innervate the sciatic nerve that is deep to piriformis itself. test the length of piriformis. A hypertonic piriformis is indicated if there is less than 45 degrees lateral rotation to the affected side. As in the previous case, similar precautions should be taken when working on piriformis. and inferiorly in an arc along the body’s midline. Hypertonic muscles are indicated by a low ROM while a dysfunction of the joint itself is indicated by crepitus or pain deep in the hip joint during movement of the thigh.
ischial tuberosity of the side being tested. The therapist attempts to rotate the hip posteriorly. Pain at the posterior SI joint indicates an SI joint dysfunction.
ASIS and pushes them laterally and inferiorly away from each other on the side that is being tested. Deep pain in the inferior abdomen, at the anterior SI joint, indicates a dysfunction.
and presses both ASIS medially. A sprain of the posterior SI joint ligaments is indicated by pain in the posterior SI joint region during the test.
sense of the client’s hip movement. An anterior tilt to the pelvis, commonly attributed to hypertonic iliopsoas, may be indicated by a lack of movement of the PSIS on the side of the raised knee or if the PSIS moves superiorly instead of inferiorly.
affected side’s thigh is moved beyond 20 degrees of extension. Note that the pain may be due to either injured ligaments or a hypertonic gluteus maximus origin along the superior aspect of the border of the sacrum. Cross-fiber friction between the sacrum and ilium may be massaged by the therapist within the client’s pain tolerance. pain or discomfort. The leg is slowly lowered until no pain is felt. Hypertonicity of the hamstrings is indicated by pain at the ischial tuberosity, in the posterior thigh and/or the posterior knee. A lumbar or sacral dysfunction is indicated if the client is in pain after 70 degrees of flexion at the hip. A herniated disc
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Book Code: MTX1324B
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