Manual Muscle Testing: Hip External Rotation

Muscles Involved:

Gluteus Maximus

Piriformis

Quadratus Femoris

Obturator Externus

Obturator Internus

Gemellus Superior

Gemellus Inferior

Patient Positioning

  • Grades 3 to 5 - Patient is in short sitting on plinth with test-side knee flexed to 90 degrees, Ideally the foot should be suspended off the floor i.e. sitting on edge of high plinth
  • Grades 0-2 - Patient is in prone with knee flexed to 90 degrees ('gravity minimal' position)

Therapist Position

  • Therapist to kneel beside the patient and stabilise at the distal thigh laterally.
  • Therapist to stand on test-side if in prone

To Test

  • Patient actively externally rotates the hip
  • For grades 4 to 5 apply resistance through the medial ankle through range in a direction opposite to external rotation[1]
  • To satisfy grade 5 'normal muscle' performance criteria, the patient must have the ability to move through complete range of motion (active resistance testing) OR maintain an end point range (break testing) against maximum resistance.

References

  1. Hislop H, Avers D, Brown M. Daniels and Worthingham's muscle Testing-E-Book: Techniques of manual examination and performance testing. Elsevier Health Sciences; 2013 Sep 27.