Athletic Training & Sports Medicine Center

LOW BACK STRESS EXAMINATION TESTS

TESTS	POSITION OF BACK	STRUCTURES INVOLVED	DESCRIPTION OF TEST BEING PERFORMED
Straight Leg Test	Patient is supine. Leg is extended and relaxed. Knee is straight.	Hamstring Muscle Sciatic Nerve	Examiner lifts patient’s leg upward by supporting the foot around the calcaneus. At the point where the patient experiences pain, lower the leg slightly and then dorsiflex the foot to stretch the sciatic nerve and reproduce sciatic pain. If patient does not experience pain when you dorsiflex his foot, then the pain is probably due to tight hamstrings
Hip Flexor Strength	Knees flexed 90 and hamstrings off edge of table	Sartorius Muscle	Patient flexes, abducts, and laterally rotates hip and flexes knee. Resistance to hip flexion and abduction is given with one hand above knee joint. This tests for strength and need to compare with the opposite leg.
Psoas Strength Test	Patient is supine with lower legs hanging over edge of table.	Psoas Muscle	Patient pulls one knee to chest, if opposite leg raises off table, the Psoas muscle is tight on that side. Repeat test with opposite leg.
Rectus Femoris Test	Patient is seated with legs over edge of table.	Rectus Femoris Muscle	Patient is allowed to grasp sides of table to stabilize trunk. Examiner stabilizes thigh without pressure over quadriceps. Patient extends knee through range of motion without terminal locking. Resistance is given above ankle joint. Compare with opposite leg.
Sciatic Nerve Palpation	Patient lies on side with back to examiner	Sciatic Nerve	Sciatic nerve is located midway between the greater trochanter and the ischial tuberosity. Knee is flexed and hip is extended to move gluteus maximus muscle out of the way of the sciatic nerve. If you press firmly into the soft tissue depression between greater trochanter and the ischial tuberosity you may be able to feel the nerve.
Bowstring Test or Cramm Maneuver	Knee flexed 90 and patient’s leg is placed on examiner’s shoulder.	Sciatic Nerve Root Impingement.	Patient is supine with knee flexed 90 and his leg placed on examiners shoulder. Place fingers in the popliteal space behind the knee and apply pressure. If test is positive there should be a tingling, burning sensation in the hip and buttocks.