Hall’s Test: aka- “Hall’s Test I” and/or the Iliopsoas/hip flexor- extension and rotation test
Patient position: Prone
Examiner grasps the subject’s thigh and attempts to extend the hip with the knee in the 90 degrees flexed position: a measurement is taken. Then, while in the maximally extended position, the femur is internally rotated: another measurement is taken. The two measurements make up the tests index score. Normal should be 30 degrees extension and 45 degrees internal rotation, or demarcated, as 30/45. Comparison to the other hip should always be accomplished. A "positive" test is a score less than 30/45 for children, teens, and adults under the age of 50. For patients over 50, normal is 20/30 and a "positive" test should be considered an index less than 20/30 (of either portion of the test). This lower index value accounts for age related inflexibility and mild amounts of age related hip degeneration.
The iliopsoas can be implicated in the decrease in internal rotation especially if the motion is different in the neutral vs. the maximally extended position. To differentiate and compare simple hip rotation while in the neutral position, the examiner can and should perform internal rotation with the hip in a neutral (0 degrees) position which would centralize the piriformis influence more so than the Iliopsoas.
Hall’s Test II (Test) … should always also be performed and is used to differentiate the rectus femoris component vs. the iliopsoas. This is done by the examiner placing the hip in the maximally extended position (usually by using examiners flexed knee or 6 inch foam roller under the patients thigh/knee), then flexing the knee from 90 to 120 degrees. (You must be sure that the ipsilateral AIIS remains in contact with the table for accurate assessment). If during the procedure, the hip flexes with the AIIS elevating from the table or if the thigh/knee descends due to increased tension/tightness, the primary muscle involved will then be elucidated to be the rectus femoris (vs. the iliopsoas). If no change occurs, the tightness or contracture is most likely due to the iliopsoas.
Comments: Hall’s Test I represents one of the most important signs for evaluating the hip, pelvis, and lumbar spine. Patients that present with low back pain almost always have dysfunction in the pelvis and hips. The Hall’s test is a reproducible and effective way to further ones diagnosis and analysis to consider the iliopsoas as well as the rectus femoris in the pathomechanics of low back and lumbopelvic dysfunction.
As a therapeutic approach to increasing the flexibility of the iliopsoas, Dr. Hall recommends sleeping on ones back. This will enable the hips to extend further throughout the night giving a gentle stretch. In fact, the PILLO1 original pillow has shown in an independent study to increase the back laying position by over 30%. This could be the perfect solution to you.
Hall's Test I and II were created by Dr. Raymond Hall, DC in 1995 and have been utilized and studied in his Sports Medicine Practice at the renowned Santa Monica Orthopaedic and Sports Medicine Group in Southern California.
About Dr. Raymond Hall:
Dr. Raymond Hall, DC is a celebrity chiropractor, sleep expert and the inventor of PILLO1. He is a member of the American Academy of Spine Physician, the California Chiropractic Association, and the American Chiropractic Association. He was recently honored by the “International Association of Chiropractors” with the prestigious award of the “TOP CHIROPRACTOR IN LOS ANGELES”. His extensive patient base includes top film and television actors, as well as several professional and Olympic athletes.
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