Hip Muscle Extensibility Evidence: confirmed

90-90 Straight Leg Raise Special Test

Orthopedic Physical Examination & Clinical Assessment Guide

90-90 Straight Leg Raise Orthopedic Special Test

What is it used for?

  • Assessing Hamstring Tightness.

How to Perform

  • Position: Patient lies supine with both hips and knees flexed to 90°. Patient grasps behind their own knees.
  • Action: Patient actively extends one knee as much as possible while keeping the hip at 90°.

Interpretation of Results

  • Positive Test: Inability to extend the knee to within 20° of full extension (i.e., knee angle is <160°).

Clinical Context & Limitations

The 90-90 Straight Leg Raise should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.

Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Hip region, combining the 90-90 Straight Leg Raise with complementary examination tests significantly improves overall diagnostic confidence.

References

  • Magee, D. J. (2021). Orthopedic Physical Assessment.