How many types of Thomas tests are there? Some people are showing this test by the patient standing right on the edge of the table and lifting their knee and gradually falling back on the couch and then measuring by how much the other leg is extending straight, angular or perpendicular. So, which one is the correct Thomas Test, please? Thank you.
isnt it more usefull to test this with the the lower leg (under the knee) hanging off the table, that way you can differentiate betweet Rectus Femoris and Iliopsoas as well?
Hey Lieven, that's surely a way you could do that in practice, but: The reason why the Thomas Test is done with a straight leg is to take the rectus femoris out of the equation completely. This enables you to possible measure an angle of contracture as well. With the leg hanging off of the table, we can see following problem: If the patient has a tight rectus femoris, he could compensate by lifting the leg off the table or by extending the knee. Then you won't know if the test is positive because of a short (ilio)psoas or a short rectus femoris.
@@Physiotutors if the leg is lifting, you could passivly extend the knee and see if the leg is getting down. if so, the tightness is refered to the RF. if the leg stays up, the iliopsoas is tightned. isnt it?
@@Physiotutors When I lift my left leg, I don't feel any stretch in my right leg? What does that mean. Althought have pain and straining in my right knee.
@@luminouslink777 try it with the bottom leg hanging off the table. If you perform the movement and you're able to lower the leg to the table, it'd indicate tightness of two joint hip flexors, if there's no change, it'd indicate tightness of the one joint hip flexors
@@Physiotutors I feel a pull in my opposite leg groin!. By groin I mean the inner leg just below the private parts , It kinda hurts... But I am not using a pillow... Does this mean something?..
Hi. I always like yours videos. But here my question is that u didn't check the obliteration of the lumbar lordosis by putting ur palmar hand under the lumbar spine of patient which is I think very necessary to tell the point to which u would flex the hips initially & then straighten the one hip. What is your opinion? Regards.
If psoas shortness were the culprit in anterior tilt, one would expect to see a positive Thomas test concurrent with APT. I test many patients, athletes and clients in the Thomas position, and very very rarely find a positive outcome that correlates with an APT presentation. Mark Comerford (among other Physiotherapists and researchers) assert that Anterior Pelvic Tilt stems from weakness of the psoas, rather than from shortness - despite long-standing conventional wisdom to the opposite. I am curious. PhysioTutors, what are your thoughts on anterior pelvic tilt in asymptomatic and in LBP cohorts? Should it be assessed, with a view to correction? Is it a remarkable finding? Is it relevant?
Take a look at our "Muscle Tightness" video. I think we kind of explain our view on the whole topic of "tightness" vs. "shortness" and muscle weakness in general. So in general, we think that most of the muscles we perceive as "tight" are just overloaded and weak. I think with the psoas it's the same story like with the upper traps. I personally focus on other things in back pain patients to be honest. Do you strengthen or stretch it?
I don't know if you are going to read this but I need help. I am a soccer player and one day I didn't strech and also I didn't train for 2 months (it was summer), I shot the ball with full power and, heard a crack in my muscle and fell on the ground from pain. After 2 months of recovery I finnaly got back to soccer practice. Next time I had a big game against best team in our league. In the last minute of the game I wanted to pass long ball, my leg slipped and i heard a crack again. My leg was injured again... After a month of therapy I was back on the pitch and after 6 months of playing this april I went outside with friends to play football. Because of COVID-19 season was stopped for a month and I wasn't in form i shot the ball and my muscle cracked again, I didn't go on therapy and my muscle isn't ready for soccer yet. I googled what is the name of that muscle and I found this video. I am not sure if it is liopsoas or gluteus, but since you are a doctor, and your videos are great i think you can help me, and tell me how to treat and train that muscle so this never happens again. I also feel weakness now when i pass the ball and im too afraid to shoot. If you see this and reply thanks!
@@Physiotutors A hand should be put behind the lumbar spine to feel for obliteration of lordosis with hip flexion. After you obliterate the lumbar lordosis, then check for the FFD of the contralateral side. The angle formed btw the thigh and the bed will give you the angle of FFD.
He said it like that because abducting can sound like adducting. He has a pretty thick accent as well. We normally make that distinction in the therapy field
![Your Psoas Isn't Just Tight, It's WEAK [Don't Stretch, Do These Instead]](/img/n.gif)
What if the extended leg doesn't move much, but the groin of the knee that is against the chest hurts/is stretched.
How many types of Thomas tests are there? Some people are showing this test by the patient standing right on the edge of the table and lifting their knee and gradually falling back on the couch and then measuring by how much the other leg is extending straight, angular or perpendicular. So, which one is the correct Thomas Test, please? Thank you.
Smart AND handsome-seems like this physical therapist is a jackpot
isnt it more usefull to test this with the the lower leg (under the knee) hanging off the table, that way you can differentiate betweet Rectus Femoris and Iliopsoas as well?
Hey Lieven, that's surely a way you could do that in practice, but:
The reason why the Thomas Test is done with a straight leg is to take the rectus femoris out of the equation completely. This enables you to possible measure an angle of contracture as well.
With the leg hanging off of the table, we can see following problem:
If the patient has a tight rectus femoris, he could compensate by lifting the leg off the table or by extending the knee. Then you won't know if the test is positive because of a short (ilio)psoas or a short rectus femoris.
@@Physiotutors if the leg is lifting, you could passivly extend the knee and see if the leg is getting down. if so, the tightness is refered to the RF. if the leg stays up, the iliopsoas is tightned. isnt it?
@@Physiotutors When I lift my left leg, I don't feel any stretch in my right leg? What does that mean. Althought have pain and straining in my right knee.
@@luminouslink777 try it with the bottom leg hanging off the table. If you perform the movement and you're able to lower the leg to the table, it'd indicate tightness of two joint hip flexors, if there's no change, it'd indicate tightness of the one joint hip flexors
@@Physiotutors I feel a pull in my opposite leg groin!.
By groin I mean the inner leg just below the private parts ,
It kinda hurts...
But I am not using a pillow...
Does this mean something?..
What a great channel
Kurz & knackig, hilfreich 👍
Hi. I always like yours videos. But here my question is that u didn't check the obliteration of the lumbar lordosis by putting ur palmar hand under the lumbar spine of patient which is I think very necessary to tell the point to which u would flex the hips initially & then straighten the one hip. What is your opinion? Regards.
You definitely have a point here Rehan!
Physiotutors thank u for ur kind 😍😍😍
What if there's both a tight ITB and psoas?
GET TO DA CHOPPPER!!!!!
Hahahahaha
Hahaha I can't stop laughing !!! 3 years later this is still funny ...
@@graciie hahahah im such an idiot
@@Edumacation95 I was going to as AH in a funny way but I didn't want to get band from YT ....
@@Edumacation95what does this mean lol
If psoas shortness were the culprit in anterior tilt, one would expect to see a positive Thomas test concurrent with APT. I test many patients, athletes and clients in the Thomas position, and very very rarely find a positive outcome that correlates with an APT presentation.
Mark Comerford (among other Physiotherapists and researchers) assert that Anterior Pelvic Tilt stems from weakness of the psoas, rather than from shortness - despite long-standing conventional wisdom to the opposite.
I am curious. PhysioTutors, what are your thoughts on anterior pelvic tilt in asymptomatic and in LBP cohorts? Should it be assessed, with a view to correction? Is it a remarkable finding? Is it relevant?
Take a look at our "Muscle Tightness" video. I think we kind of explain our view on the whole topic of "tightness" vs. "shortness" and muscle weakness in general. So in general, we think that most of the muscles we perceive as "tight" are just overloaded and weak. I think with the psoas it's the same story like with the upper traps.
I personally focus on other things in back pain patients to be honest.
Do you strengthen or stretch it?
Cheers, Kai
@@Physiotutors muscle tightness
So do the patient here actually has a positive test?
I don't know if you are going to read this but I need help. I am a soccer player and one day I didn't strech and also I didn't train for 2 months (it was summer), I shot the ball with full power and, heard a crack in my muscle and fell on the ground from pain. After 2 months of recovery I finnaly got back to soccer practice. Next time I had a big game against best team in our league. In the last minute of the game I wanted to pass long ball, my leg slipped and i heard a crack again. My leg was injured again... After a month of therapy I was back on the pitch and after 6 months of playing this april I went outside with friends to play football. Because of COVID-19 season was stopped for a month and I wasn't in form i shot the ball and my muscle cracked again, I didn't go on therapy and my muscle isn't ready for soccer yet. I googled what is the name of that muscle and I found this video. I am not sure if it is liopsoas or gluteus, but since you are a doctor, and your videos are great i think you can help me, and tell me how to treat and train that muscle so this never happens again. I also feel weakness now when i pass the ball and im too afraid to shoot. If you see this and reply thanks!
Would recommend you to see a local physio or get in touch with our partner at yourphysio.online
Woww😯🤩🤩 amazing
from Iraq🇮🇶 thanks
Thank you so much
Thanks for nice helpful video
Ur welcome Hosam!
Are you raising the affected or unaffected leg ?
flexed hip = unaffected side
It helped a lot. but, the video is short
Is that patient Lucas Podolski of Germany?
It’s Just Andy but he comes from the same region in Germany 😜
Cool. Nice video by the way...Studying Hip Joint clinical exam, very helpful video. Much appreciation from South Africa (Wits Medical school).
You are perfect guys!
So are you Zhaleh 🙏🏼
What muscles do we asses in the Thomas Test?
read the title of the video...
Massive thanx Sir.
+Sneha Singh you're welcome!
Thanks
Ur welcome!
What is it he says could be happening to the straight leg? Sounds like "A B ducting" what dos that mean?
Abduction. Just stressing the AB as it can otherwise be confused with ADDuction.
What in the Hella avi-ducting?..
Or whatever it is you said at 41 second
I don't feel a stretch in the opposite leg, nor does it rise. Am I dead, LOL?
No, it does mean that the test is negative. Which means that your hip flexors, aka your ilipsoas, isn't shortened, and is flexable enough.
Thankyou from india
00:14 d
Sry to say but this test is performed wrongly in this video.
Nope, this is the original description of the thomas test
@@Physiotutors A hand should be put behind the lumbar spine to feel for obliteration of lordosis with hip flexion. After you obliterate the lumbar lordosis, then check for the FFD of the contralateral side. The angle formed btw the thigh and the bed will give you the angle of FFD.
A shame that we didn't see on the side you were showing us all we see is a bent leg!
A-B-ducting. Interesting
Just to stress that it’s not adduction
Ur welcome sir
Asbongeee!!!
Weak prosaic test
bооoоn
It was The Helpful video but it sucked you couldn't use regular words
The content is intended for Health care professionals and students so the language used is appropriate
lol what is A.B.-ducting? It's abducting.
He said it like that because abducting can sound like adducting. He has a pretty thick accent as well. We normally make that distinction in the therapy field
It’s to differentiate ab from ad since they are phonetically similar. Leave your condescension to yourself 🙄
It's said by most medical pple not to make confusion with adduction