Physical Exam

Hip Strength

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Video coming September 2026

How to Perform

With the patient seated, test hip strength against resistance in flexion, extension, abduction, adduction, and internal and external rotation. For each movement, compare both sides before moving to the next. Grade strength and note any pain or give-way weakness.

How to Interpret

Cushing Syndrome

Proximal muscle weakness

Rule in

Somewhat helpfulDerived CI

Rule out

Not helpfulDerived CI

Evidence:Limited

Gluteal Tendinopathy

Lateral hip pain (with or without weakness) reproduced on resisted hip abduction

Rule in

InconclusiveWide CI

Rule out

Somewhat helpful

Evidence:Limited

Lateral hip pain reproduced on the resisted external-derotation test

Rule in

InconclusiveNo CI, small study

Rule out

InconclusiveNo CI, small study

Evidence:LimitedResearch in progress

Lumbosacral Radiculopathy

L5 Radiculopathy

Hip abductor weakness in a patient with foot drop

Rule in

Very helpfulDerived CI

Rule out

HelpfulDerived CI

Evidence:Limited

References

Research in progress on one or more findings above; ratings may change.

Reiman MP, Goode AP, Hegedus EJ, Cook CE, Wright AA. Diagnostic accuracy of clinical tests of the hip: a systematic review with meta-analysis. Br J Sports Med. 2013;47(14):893-902. doi:10.1136/bjsports-2012-091035. PMID 22773321.
Lequesne M, Mathieu P, Vuillemin-Bodaghi V, Bard H, Djian P. Gluteal tendinopathy in refractory greater trochanter pain syndrome: diagnostic value of two clinical tests. Arthritis Rheum (Arthritis Care Res). 2008 Feb 15;59(2):241-246. doi:10.1002/art.23354. PMID 18240186.
Al Nezari NH, Schneiders AG, Hendrick PA. Neurological examination of the peripheral nervous system to diagnose lumbar spinal disc herniation with suspected radiculopathy: a systematic review and meta-analysis. Spine J. 2013 Jun;13(6):657-674. doi:10.1016/j.spinee.2013.02.007. PMID 23499340.
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Hölmich P, Hölmich LR, Bjerg AM. Clinical examination of athletes with groin pain: an intraobserver and interobserver reliability study. Br J Sports Med. 2004 Aug;38(4):446-451. doi:10.1136/bjsm.2003.004754. PMID 15273182.
Sutlive TG, Lopez HP, Schnitker DE, et al. Development of a clinical prediction rule for diagnosing hip osteoarthritis in individuals with unilateral hip pain. J Orthop Sports Phys Ther. 2008;38(9):542-550. PMID: 18758047.
Thomas JE, Cascino TL, Earle JD. Differential diagnosis between radiation and tumor plexopathy of the pelvis. Neurology. 1985;35(1):1-7. PMID: 2981416.
Parasiliti-Caprino M, Bioletto F, Frigerio T, et al. A New Clinical Model to Estimate the Pre-Test Probability of Cushing's Syndrome: The Cushing Score. Front Endocrinol (Lausanne). 2021;12:747549. doi:10.3389/fendo.2021.747549. PMID: 34675882. PMC8524092 (open access).
Jeon CH, Chung NS, Lee YS, Son KH, Kim JH. Assessment of hip abductor power in patients with foot drop: a simple and useful test to differentiate lumbar radiculopathy and peroneal neuropathy. Spine (Phila Pa 1976). 2013;38(3):257-263. PMID: 22805342.
Suri P, Rainville J, Katz JN, Jouve C, Hartigan C, Limke J, Pena E, Li L, Swaim B, Hunter DJ. The accuracy of the physical examination for the diagnosis of midlumbar and low lumbar nerve root impingement. Spine (Phila Pa 1976). 2011;36(1):63-73. doi:10.1097/BRS.0b013e3181c953cc. PMID: 20543768.
Stone J, Warlow C, Sharpe M. The symptom of functional weakness: a controlled study of 107 patients. Brain. 2010 May;133(Pt 5):1537-1551. doi:10.1093/brain/awq068. PMID 20395262.
Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 10, 2026.