Physical Therapy Haven

Thomas Test

In general it is used to check for hip flexion contractures; more specifically it tests for anterior or lateral capsular restrictions or hip flexor tightness. 

The patient is asked to lie supine. The examiner checks for lordosis which is a predictor of a tight hip flexor. The examiner then flexes one hip bringing the knee to the chest and asks the patient to hold the knee to help stabilize the pelvis and flatten out the lumbar region. If the leg that is being tested (the leg on the table) does not have a hip flexion contraction it will remain on the testing table. If a contracture is present the leg will raise off of the table. This is often measured if present. The test can also be performed with the starting position of both knees fully flexed to the chest and slowly lowering the leg being tested to see if the leg makes it to the table. Lack of Full hip extension with knee flexion less than 45° indicates iliopsoas tightness. If full extension is reached in this position it would indicates rectus femoris tightness. If any hip external rotation is observed it may indicate ITB tightness