Execution
- 1Perform a straight leg raise until the patient’s familiar radicular symptoms are reproduced.
- 2Maintain the thigh in the same position.
- 3Flex the knee slightly, approximately 20°, until the symptoms reduce.
- 4Apply thumb or finger pressure into the popliteal fossa.
- 5Note whether the original radicular pain returns.
Positive outcome
Return of the same radicular symptoms when pressure is applied in the popliteal space is positive. Magee describes the sign as pressure or tension on the sciatic nerve and a modification of the straight leg raise test. The same concept may be performed seated by slightly flexing the knee after symptoms are produced, then pressing into the popliteal space.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Devillé et al. (2000) | NA | NA | NA | NA | NA |
CommentBowstring is best understood as a confirmation or retensioning manoeuvre after a positive SLR, not as a separate high-quality diagnostic test. Magee’s procedure is specific about symptom relief with knee flexion followed by symptom return with popliteal pressure. Formal diagnostic accuracy for Bowstring alone is not well established, so value remains low.
Low Clinical Value