Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Passive extension

Positioning.

The subject lies prone with the hip extended. The examiner stands level with the hip. One hand is placed on the thigh, just below the gluteal fold. The other hand grasps the thigh just proximal to the patella.

Procedure.

Lift the knee off the couch until the movement comes to a stop. Meanwhile press the pelvis firmly to the couch.

Common mistakes:

• Lack of stabilization allows the pelvis to move upwards, causing a false interpretation of the range of hip extension and putting stress on the lower lumbar spine and the sacroiliac joint.
• If the stabilizing hand is placed too high up on the sacrum, stress will be induced at the ipsilateral sacroiliac joint.

Normal functional anatomy:

• Range: 10-30°
• End-Jee/: hard ligamentous
• limitiNg strllcillres:

– anterior part of the capsule with the iliofemoral, pubofemoral and ischiofemoral
ligaments
– iliopsoas muscle.

Common pathological situations:

• Extension is one of the first movements to become restricted in arthritis and arthrosis.
• Some children have an isolated limitation of extension.

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