Understanding the Thomas Test (Rectus Femoris and Iliopsoas Tightness) Assessment
To assess for a **hip flexion contracture**, differentiating between tightness of the **Iliopsoas** and the **Rectus Femoris**.
Watch How It's Done
How do I start?
Patient is supine at the end of the table. Both hips and knees are fully flexed.
What happens?
The patient holds the unaffected leg in maximal hip flexion (to flatten the lumbar spine). The examiner passively **lowers the affected leg** toward the table.
In Plain English
What Does a Positive Result Mean?
The thigh of the lowered leg **fails to drop to the table** (indicating **Iliopsoas** tightness). If the thigh is flat but the **knee extends** (loses 80°-90° of flexion), it indicates **Rectus Femoris** tightness.
Helpful Tip:
The amount the thigh lifts off the table quantifies the tightness.
Safety First
This guide is to help you understand what happens in a clinic. Do not try to diagnose yourself. If you have severe pain, swelling, or cannot put weight on your leg, please visit an urgent care center or your doctor immediately.
Other Hip Tests
Craig's Test (or Ryder's Test)
To determine the approximate amount of **femoral anteversion** (or retroversion) and assess for abnormal hip rotation alignment.
Ely's Test (Prone Rectus Femoris Contracture Test)
To assess for **tightness or contracture of the Rectus Femoris** muscle (a hip flexor and knee extensor).
FADIR (Flexion, Adduction, Internal Rotation) Test
To provoke symptoms associated with **Femoroacetabular Impingement (FAI)**, particularly **Anterior/Pincer Impingement** or **Acetabular Labral Tears**.
Fulcrum Test
To screen for a **Stress Fracture of the Femoral Shaft**.