Dutton's Orthopedic Survival Guide: Managing Common Conditions: Managing Common Conditions by Dutton Mark

Author:Dutton, Mark [Dutton, Mark]
Language: eng
Format: mobi
Publisher: McGraw-Hill Education
Published: 2011-02-28T05:00:00+00:00

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The straight leg raise test may also be used as a screen for adverse neural tension, particularly of the sciatic nerve.

90–90 straight leg raise

The hamstring length can also be assessed with the patient positioned in supine and the tested leg flexed at the hip and knee to 90 degrees. From this position, the patient is asked to extend the knee of the involved side without extending the hip (Figure 8-15). The measurement is taken at the first resistance barrier.

Piriformis

The patient is positioned in sidelying. The clinician flexes the involved hip to 60 degrees. After stabilizing the patient’s pelvis, the clinician applies a downward pressure through the femur, and maximally adducts the involved hip. From this position, the hip is moved into internal rotation and then external rotation. Internal rotation stresses the superior fibers, while external rotation stresses the inferior fibers. Normal range of motion should be 45 degrees into either rotation. Pain is elicited in the muscle if the piriformis is adaptively shortened. There are no studies in the literature that discuss the sensitivity, specificity, positive predictive value, or negative predictive value of this maneuver.

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