Manual Muscle Testing: Hip Extension

Original Editor - Claire Knott

Top Contributors - Claire Knott, Lucinda hampton and Wanda van Niekerk  

Introduction

An assessment of muscle strength is typically performed as part of a patient's objective assessment and is an important component of the physical exam that can reveal information about strength and or neurologic deficits. It is used to evaluate weakness and can be effective in differentiating true weakness from imbalance or poor endurance. See Muscle Strength Testing

Muscles

The main hip extensors are:

• Gluteus Maximus
• Semitendinosus
• Semimembranosus
• Biceps Femoris

Patient Positioning

• Grades 3 to 5 - Patient is in prone
  • to test gluteus maximus and hamstrings - side-side knee in extension
  • to test gluteus maximus only - test-side knee flexed to 90°

• Grades 0-2 - Patient is in side lying ('gravity minimal' position)

Therapist Position

• Therapist to stand on test side, stabilize the pelvis over the sacrum and palpate muscular recruitment

To Test

• Patient actively extends the hip
• For grades 4 to 5 apply resistance through distal thigh in the direction opposite to hip extension.
• 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.