Execution
- 1Ask the patient to stand upright and tests the uninvolved side first.
- 2Ask the patient to stand on one leg for 6 to 30 seconds.
- 3Observe the pelvis from behind while the patient maintains single-leg stance.
- 4Note whether the pelvis on the non-stance side rises, stays level, or drops.
- 5Add a single-leg squat or corkscrew movement to challenge hip and pelvis control.
Positive outcome
The test is positive when the pelvis drops on the non-stance side, especially if the drop is more than about 2 cm. The finding suggests weakness or poor control of the stance-side hip abductors or an unstable hip. Pain reproduction during a 30-second single-leg stance may also support greater trochanteric pain syndrome.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Bird et al. (2001) | acceptable intraobserver reliability | 72.7 | 76.9 | 3.15 | 0.35 |
| Grimaldi et al. (2017) | NA | 38 | 100 | infinity | 0.62 |
CommentMagee describes Trendelenburg as a hip abductor and pelvic stability test. Bird’s MRI study supports moderate value for gluteus medius tears in a GTPS population, while Grimaldi’s pain-based single-leg stance version was highly specific but not sensitive. Do not treat a negative Trendelenburg sign as exclusion of gluteal tendinopathy.
Moderate Clinical Value