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The psoas sign, also known as Cope's sign (or Cope's psoas test [1]) or Obraztsova's sign, [2] is a medical sign that indicates irritation to the iliopsoas group of hip flexors in the abdomen, and consequently indicates that the inflamed appendix is retrocaecal in orientation (as the iliopsoas muscle is retroperitoneal).
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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: opposite/ contralateral hip flexes without knee extension- tight iliopsoas
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Therapists may use myotherapy (deep pressure as in Bonnie Prudden's approach, massage or tapotement as in Dr. Griner's approach), mechanical vibration, pulsed ultrasound, electrostimulation, [15] ischemic compression, trigger-point-injection (see below), dry-needling, "spray-and-stretch" using a cooling spray (vapocoolant), low-level laser ...
Stretching the hip into extension and limiting excessive knee flexion avoids placing the rectus femoris in a position of passive insufficiency, thereby maximizing the stretch to the iliopsoas tendon. Strengthening exercises for the hip flexors may also be an appropriate component of the program.
The psoas major unites with the iliacus at the level of the inguinal ligament. It crosses the hip joint to insert on the lesser trochanter of the femur. [1] The iliopsoas is classified as an "anterior hip muscle" or "inner hip muscle". [2] The psoas minor does contribute to the iliopsoas muscle.