QUADRATUS, ILIOPSOAS,

AND PIRIFORMIS LAB

Raymond D. Seifert, D.O.
March 19, 2019
 Psoas Testing

Strength,(laxity)
Fig. 9.1, DiGiovanna, p. 69
Pt supine, arms folded, legs
extended
Dr. holds feet and instructs pt
to sit up
Up to 30 degrees is upper
abd’s
60 degrees or more then
psoas is being tested
Should be able to hold for
10 seconds
Tightness, Thomas Test
Supine
 Treatment Weak Psoas
 Pt supine
 Dr. Hand underneath enlarged lumbar curve
 Pt instructed to push lower back against Dr’s
hand without using abd muscles, count to 10
 Can use hand towel if alone
 Repeat 3-5 times
 Perform 3-4 times daily
 Should see improvement, decreased lordotic
curve and pain in one month
Philip Greenman, D.O.
Principles of Manual
Medicine, 3rd ed.
2010,
Contract Abdominal
and gluteus max.
Holding gluteal
contraction, lean
forward maintaing 12 o
clock pelvic tilt until
stretch is felt.
Maintain stretch for
30 sec, repeat 2-3 times,
Then repeat on opposite
Side

Can also perform on

stairs if patient is
unsteady. Kneel on
affected leg
 Thomas Test
 Assessment for contralateral restricted or shortened
iliopsoas muscle
 Flex both thighs up to abdomen, straighten one leg
 Considered positive if opposite knee lifts off table
 Can be active or passive. Always check both sides
Treatment for

Tight Psoas

Repeat 5-7 times

Nicholas, p. 297
 Piriformis Testing
Pt prone: Knees flexed to 90 degrees
Dr. tests for internal rotation,(pushing ankles
laterally), noting restrictions

Supine: Dr. grasps ankles and lifts legs about 6

inches off of table. Dr. individually internally
rotates leg noting restrictions.
Restriction to internal rotation indicates tight
piriformis muscle
Nicholas 3rd ed.
PICR, pp. 317

NOTE: Reciprocal Inhibition

Requires D.O. to push toward
The midline and pt pushes
Away from midline.
pp. 315
ME tight Piriformis
PICR

Nicholas 3rd ed., p.

318-319.

DO may stand or sit

on either side

Repeat 3-5 times

Counterstrain for Piriformis Tenderpoint
 Locate PSIS and ILA
 Draw imaginary line between them
 Pick half-way point
 From this point, locate Greater Trochanter
 Find mid-point on this line and THAT is where
the Piriformis tenderpoint should be
Nicholas 3rd ed.,
pp. 199
Nicholas 3rd ed. pp. 205

F ABD ER
 Dr. Extends,
Abducts, and
Externally
rotates hip.
Fine tunes in
small arcs, with
more or less
aBd, Extension,
or Ext Rotation.
Goal is near
100% as
possible with
70%
improvement
minimum.

Nicholas 3rd ed.,

p. 198

E ABD ER
Nicholas 3rd ed. Pp. 191

F ST slER
NOTE: Should add
Slight ER so push
Ankle closest to DO
Away from DO

TP is 2/3 distance
from ASIS to
midline
TP is 1/3 distance
From ASIS to
midline

Nicholas 3rd ed.

pp.192

F ER