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Thomas Test Overview and Interpretation

Aug 16, 2025

Overview

This lecture explains how to perform and interpret the Thomas Test for detecting hip flexor contractures, with focus on test procedures and key findings.

Performing the Thomas Test

  • Have the patient lie in a supine (face up) position.
  • Check for excessive lumbar lordosis (inward curve of the lower back) as it may indicate a tight iliopsoas muscle.
  • Instruct the patient to pull one knee up to their chest and hold it.
  • Ask the patient if they feel a stretch in the groin area.

Interpreting the Results

  • A positive test is indicated when the extended leg lifts off the table, suggesting a hip flexor contracture.
  • Measure the angle at the knee of the extended leg as a reference point.
  • If the extended leg does not lift off but abducts (moves outward), this is called the J-Sign and suggests a tight iliotibial band.

Key Terms & Definitions

  • Thomas Test — a physical exam used to identify hip flexor contractures.
  • Lumbar Lordosis — excessive inward curvature of the lower spine.
  • Iliopsoas — a major hip flexor muscle.
  • J-Sign — abduction of the extended leg during the test, indicating a tight iliotibial band.
  • Hip Flexor Contracture — shortening or stiffness of muscles that flex the hip.

Action Items / Next Steps

  • Practice performing the Thomas Test on a peer.
  • Review the Rectus Femoris Contracture Test and other related assessment videos.