Manual Muscle Testing: Hip Internal Rotation

Original Editor - Claire Knott

Top Contributors - Claire Knott and Wanda van Niekerk  

Muscles Involved:

Patient Positioning

  • Grades 3 to 5 - Patient is in short sitting on plinth with test-side knee flexed to 90°, Ideally the foot should be suspended off the floor i.e. sitting on edge of high plinth
  • Grades 0-2 - Patient is in supine ('gravity minimal' position)

Therapist Position

  • Therapist to kneel beside the patient in sitting position and stabilise at the distal thigh medially.
  • Therapist to stand on test side if in supine

To Test

  • Patient actively internally rotates the hip
  • For grades 4 to 5 apply resistance through the lateral ankle through range in a direction opposite to internal rotation[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.