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The straight leg raise is a test that can be performed during a physical examination, with the leg being lifted actively by the patient or passively by the clinician. If the straight leg raise is done actively by the patient, it is a test of functional leg strength, particularly the rectus femoris element of the quadriceps (checking both hip flexion and knee extension strength simultaneously).
Lift your left leg straight back while you contract the glute, raising it to about a 45-degree angle from the standing leg. Slowly lower the leg back down and perform 10 reps on this side.
The leg raise is a strength training exercise which targets the iliopsoas (the anterior hip flexors). Because the abdominal muscles are used isometrically to stabilize the body during the motion, leg raises are also often used to strengthen the rectus abdominis muscle and the internal and external oblique muscles.
This constitutes a positive Thomas test. [2] Sometimes, with a very flexible patient, the Thomas test will be normal despite a psoas dysfunction being present. However, in the patient with a normal hip joint, a positive test is a good indicator of psoas hypertonicity. [2] Other signs from the Thomas test:
While this test is positive in about 90% of people with sciatica, approximately 75% of people with a positive test do not have sciatica. [4] Straight leg raising of the leg unaffected by sciatica may produce sciatica in the leg on the affected side; this is known as the Fajersztajn sign. [15]
Involuntary extension of the "normal" leg occurs when flexing the contralateral leg against resistance. To perform the test, the examiner should hold one hand under the heel of the "normal" limb and ask the patient to flex the contralateral hip against resistance (while the patient is supine), asking the patient to keep the weak leg straight while raising it.
The straight leg raise test is almost always positive in those with disc herniation, [5] and lumbar provocative discography may be useful to identify a specific disc causing pain in those with chronic high levels of low back pain. [47] Therapeutic procedures such as nerve blocks can also be used to determine a specific source of pain. [5]
A positive Trendelenburg's sign is caused by weakness or ineffective action of the abductor muscles of the lower limb, the gluteus medius muscle and the gluteus minimus muscle. [ 2 ] Damage to the motor nerve supply of the lateral gluteal muscles (gluteus medius muscle and gluteus minimus muscle)
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