Hibb’s Test is often used to differentiate pain from the sacroiliac joint, hip joint and piriformis muscle or sciatic nerve impingement.
- Patient prone with knee flexed 90°
- Examiner then stabilises the patients pelvis with one hand and proceeds to slowly push the patients ankle laterally (causing internal rotation of the femur).
- Examiner then applies gentle downward pressure over the flexed knee.
Hibb’s test can be used to determine if pain originates from sacroiliac joint, hip or sciatica nerve impingement.
Positive Hibb’s Test
There are three interpretation for a positive Hibb’s Test.
- Sacroiliac pain: Typically local sacroiliac joint pathology.
- Hip pain: Hips lesion (strain/sprain, arthritis)
- Radicular pain: Consider piriformis entrapment of sciatic nerve.
Caution should be taken when dealing with patients with known knee pathologies, as the internal rotation motion of the femur will place stress on the medial collateral ligaments of the knee.
Internal rotation of the femur causes stretching of the piriformis muscle, which may in turn compress the sciatic nerve & potentially cause radicular symptoms.