Manual Muscle Testing: Hip Flexion

Muscles Involved:

Psoas Major


Rectus femoris

Patient Positioning

  • Grades 3 to 5 - Patient is in short sitting with thighs supported
  • Grades 0-2 - Patient is in side lying ('gravity minimal' position)

Therapist Position

  • Therapist to stand next to test side
  • Palpation over hip flexors

To Test

  • Patient actively flexes the hip
  • For grades 4 to 5 apply resistance over the distal femur in a direction opposite to flexion[1]
  • To satisfy grade 5 'normal muscle' performance criteria, the patient must have the ability to move through complete range of motion (active resistance testing) OR maintain an end point range (break testing) against maximum resistance.


  1. Hislop H, Avers D, Brown M. Daniels and Worthingham's muscle Testing-E-Book: Techniques of manual examination and performance testing. Elsevier Health Sciences; 2013 Sep 27.