Execution
- 1Position the patient supine near the end of the table.
- 2Ask the patient to bring one hip and knee toward the chest and hold it firmly.
- 3Ensure the lumbar spine flattens against the table to control pelvic tilt.
- 4Observe the opposite thigh and hip position relative to the table.
- 5Note hip flexion, hip abduction, hip external rotation, or knee extension to differentiate iliopsoas, tensor fascia latae, and rectus femoris tightness.
Positive outcome
The test is positive for iliopsoas tightness when the opposite hip does not extend to neutral and the thigh remains lifted off the table. Abduction or external rotation suggests lateral hip or TFL contribution, while knee extension suggests rectus femoris tightness. This entry frames the Thomas test as a muscle-length test, not an FAI provocation test.
CommentThe Thomas test appears again in the FAI / labrum section with a different interpretive lens. In this muscle-testing context it is primarily an iliopsoas length assessment. Pelvic control is essential because anterior pelvic tilt can falsely normalize the apparent hip extension range.
Low Clinical Value