PT on the Net Research

Trendelenburg Test


Question:

Can you please define the Trendelenburg Test? What is it, what is it used for and how do you perform it?

Answer:

"Trendelenburg sign: an indication of hip abductor weakness as evidenced by the hip going into adduction when standing with full weight on the affected leg with the other foot off the floor. Initially, the Trendelenburg Test was used in diagnosing a dislocated hip. The Trendelenburg Gait is when the affected hip goes into adduction during each weight-bearing phase of the gait.(1)"


The Trendelenburg Test is a simple test to check specifically for Gluteus Medius strength/weakness. The individual is asked to simply balance on one leg. Ideally, the pelvis should remain level (diagram 1). If the pelvis drops toward the side of the lifted leg (diagram 2), this would be called a "Positive Trendelenburg Sign" and most likely means that the Gluteus Medius (as well as other muscles) on the side of the supporting leg is/are "weak." The major muscles of the body have been divided into four major slings or systems (see Paul Chek's PTN article "The Outer Unit"). The Gluteus Medius is a major player in the Lateral Sub-System and works in conjunction with the IPSIlateral TFL (Tensor Fascia Latae) and Adductor Complex, as well as the CONTRAlateral QL (Quadratus Lumborum). This is very important to understand because, if the body is experiencing frontal plane compensation in static fashion such as a Positive Trendelenburg Sign, the compensation that is occurring dynamically is undoubtedly being increased exponentially! Specifically, a weak Gluteus Medius can contribute to excessive prolonged pronation of the entire lower extremity during functional movement patterns. This can cause microtrauma which over time will eventually expose itself in injuries such as plantar fascitis, achilles tendon sprains, ankle sprains, Anterior Tibialis tendonitis (shin splints), patellar tendonitis, patello-femoral syndrome, etc.

For all of these reasons and many more, it is vital that a thorough musculoskeletal assessment be performed prior to programming. For more on assessments, please click here.

Reference:

  1. Kendall, McCreary, Provance. (1993). Muscles Testing and Function. Fourth Edition.