Ely’s Heel to Buttock Test, also called Ely’s Sign, is used to determine if femoral nerve or root compression is present. The examination can also indicate a quadriceps muscle contracture or iliopsoas muscle strain.

Procedure

  1. Patient prone with legs relaxed.
  2. Examiner passively flexes knee approximating heel to contralateral buttock.
  3. Examiner then extends hip by elevating the knee.
Elys Heel to Buttock Test for Femoral nerve or root compression.

Examiner passively flexes knee approximating heel to contralateral buttock. Examiner then extends hip by elevating the knee.

Interpretation

Positive Ely’s Heel to Buttock Test

  1. Pain with knee flexion: Femoral nerve or root compression, quadriceps muscle contracture
  2. Pain with hip extension: Femoral nerve or root compression, iliopsoas muscle strain or inflammation

Clinical Notes

It is possible with L1-L3 disc herniation to have radicular symptoms radiate to the anterior thigh and groin.