Patrick's test

Patrick's test is also called the FABER test. FABER stands for hip Flexion, ABduction, and External Rotation. In other words, the hip is positioned in flexion, abduction, and external rotation.

The test is said to be named after the American neurologist Hugh Talbot Patrick. Because the position of the raised leg resembles the number 4, it is also sometimes called the “figure-four test” or “number-four position” in Korea.

This position is used to assess not only the hip joint but also the sacroiliac joint at the back of the pelvis, because this single movement places stress on both joints.

Moving the hip outward and rotating it externally stretches the structures at the front and inner side of the joint, as well as the muscles of the inner thigh. At the same time, a twisting force is transmitted through the pelvis, placing pressure on the sacroiliac joint as well.

For this reason, the first thing assessed during this test is where it hurts.

• Pain in the groin or front of the thigh — This is considered a response that may be related to structures within or around the hip joint.
• Pain in the back of the buttock or pelvis — This is considered a response that may be related to the sacroiliac joint or surrounding tissues.
• The knee remains well above the surface — This is taken as a clue that the range of hip abduction and rotation is limited. The two sides are compared.

1. Lie comfortably on your back, facing the ceiling. 2. Place the ankle of the leg being tested over the opposite knee, forming a figure-four position. 3. The examiner stabilizes the opposite side of the pelvis with one hand and slowly presses the raised knee toward the surface with the other. 4. During this movement, the examiner checks whether pain occurs, where you feel a pulling sensation, and how far the knee lowers. 5. The same procedure is performed on the other side, and the two sides are compared.

If you feel pain, relax and let the examiner know right away. There is no need to press hard; the test assesses movement within a comfortable range.

• People who feel an aching pull in the groin when standing up after sitting for a long time
• People who find sitting cross-legged or assuming a figure-four position particularly uncomfortable on one side
• People who have difficulty lying on one side because of pain in the lower buttock or back of the pelvis
• People who take part in sports involving substantial hip rotation, such as running, soccer, or golf
• People with discomfort around the pelvis during pregnancy or after childbirth

• Describe the location of your pain precisely. The area to be examined differs depending on whether the pain is at the front or back, or on the inner or outer side.
• A single test is not enough to draw a conclusion. The hip region contains structures inside the joint, muscles, and tendons, while the pelvis connects with the lumbar spine and sacroiliac joints. Professionals therefore use Patrick's test alongside other sacroiliac joint tests, such as the Gaenslen test, and hip joint tests. Studies also report different levels of accuracy depending on the population and reference standard, so several factors are considered when interpreting the results. For more detail, see Test accuracy and measurement terminology.
• Having the same examiner perform the test makes side-to-side comparisons easier. The amount of pressure applied varies slightly between examiners, so inter-rater reliability is also considered when making repeated comparisons.

• Lie on your back in a figure-four position, then gently draw the opposite knee toward your chest to stretch the outer buttock. Go only as far as feels like a comfortable stretch without pain.
• Sit in a butterfly position with the soles of your feet together, and slowly let your knees lower with gravity. Keep your back upright and breathe out as you do this.
• When sitting for long periods, getting up and walking once an hour helps reduce aching at the front of the hips.