Execution
- 1Position the patient side-lying or supine according to the chosen FAIR setup.
- 2Move the hip into flexion, adduction, and internal rotation.
- 3Apply gentle overpressure while monitoring buttock and posterior thigh symptoms.
- 4Palpate the sciatic notch or piriformis region during the manoeuvre.
- 5Compare symptom reproduction with the opposite side and with lumbar neurodynamic findings.
Positive outcome
Reproduction of buttock pain with possible posterior thigh symptoms is positive. In piriformis syndrome, symptoms may reflect sciatic nerve irritation by the piriformis rather than hip joint pathology. Familiar neural symptoms are more clinically important than simple deep gluteal stretch.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Fishman et al. (2002) | H-reflex operational definition | 88.1 | 83.2 | 5.24 | 0.14 |
CommentMagee lists active and seated piriformis stretch tests in the hip special-test section. Fishman’s FAIR evidence uses H-reflex delay as an operational standard, not a perfect clinical gold standard, so values should be interpreted cautiously. Lumbar radiculopathy and deep gluteal syndrome can mimic the response.
Moderate Clinical Value