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Flexion, Adduction, Internal Rotation (FAIR) Test

Purpose: To detect for irritation of the sciatic nerve by the piriformis.

Test position: Sidelying.

Performing the Test: Have the patient lay in the side-lying position with the tested hip on top. Passively move the patient's lower extremity into flexion (90 degrees), adduction, and internal rotation. A positive test occurs when pain is produced in the sciatic/gluteal area. Due to the position of the test, pain may produced in the anterior thigh as well as a result of femoral acetabular impingement, so be sure to ask where the patient is feeling pain!

Diagnostic Accuracy Sensitivity: .88; Specificity: .83; +LR: 5.2; -LR: .14 ("Piriformis syndrome: Diagnosis, treatment and outcome- a 10-year study," "Unilateral limitation of abduction of the hip: A valuable clinical sign for DDH?").

Importance of the Test: Sciatic nerve pain can originate from several factors including a disc herniation, sacroiliac joint dysfunction, degenerative joint disease, a tight piriformis, and more. If you are suspecting a patient's neural symptoms to be originating from a tight piriformis, the FAIR test can help strengthen your hypothesis. According to Neumann, the piriformis originates at the ventral surface of the sacrum and runs through the greater sciatic foramen to insert on the superior part of the greater trochanter, leading to the actions of hip external rotation, abduction, potentially slight extension (due to the posterior to anterior line of pull). The position of flexion, adduction, and internal rotation places a stretch on the piriformis muscle and, theoritically, compressing the sciatic nerve. Additionally, a ROM assessment, palpation skills, and movement analysis would be very beneficial in your physical examination.

Note: these tests should only be performed by properly trained health care practitioners.
Picture
References:
Fishman LM, Dombi GW, Michaelsen C, Ringel S, Rozbruch J, Rosner B, Weber C. "Piriformis syndrome: Diagnosis, treatment and outcome- a 10-year study." Arch Phys Med Rehab 2002; 83:295-201. Web. 08/25/2012.

Jari S, Paton RW, Srinivasan MS. "Unilateral limitation of abduction of the hip: A valuable clinical sign for DDH?" J Bone Joint Surg 2002; 84-B: 104-107. Web. 08/25/2012.

Neumann, Donald. Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation. 2nd edition. St. Louis, MO: Mosby Elsevier, 2010. 498. Print.

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Copyright © The Student Physical Therapist LLC 2023
  • Home
  • About Us
  • TSPT Academy
  • Online Courses
    • Hooper's Knee
    • Physical Therapist Entrepreneur Course
    • Physical Therapist Consultant Course
    • Orthopedic Management of the Cervical Spine
    • Return to Sport Essentials Course
  • Resources
    • Newsletter
    • Business Minded Sports Physio Podcast
    • Day in the Life of a Sports PT
    • Residency Corner
    • Special Tests >
      • Cervical Spine >
        • Alar Ligament Test
        • Bakody's Sign
        • Cervical Distraction Test
        • Cervical Rotation Lateral Flexion Test
        • Craniocervical Flexion Test (CCFT)
        • Deep Neck Flexor Endurance Test
        • Posterior-Anterior Segmental Mobility
        • Segmental Mobility
        • Sharp-Purser Test
        • Spurling's Maneuver
        • Transverse Ligament Test
        • ULNT - Median
        • ULNT - Radial
        • ULNT - Ulnar
        • Vertebral Artery Test
      • Thoracic Spine >
        • Adam's Forward Bend Test
        • Passive Neck Flexion Test
        • Thoracic Compression Test
        • Thoracic Distraction Test
        • Thoracic Foraminal Closure Test
      • Lumbar Spine/Sacroiliac Joint >
        • Active Sit-Up Test
        • Alternate Gillet Test
        • Crossed Straight Leg Raise Test
        • Extensor Endurance Test
        • FABER Test
        • Fortin's Sign
        • Gaenslen Test
        • Gillet Test
        • Gower's Sign
        • Lumbar Quadrant Test
        • POSH Test
        • Posteroanterior Mobility
        • Prone Knee Bend Test
        • Prone Instability Test
        • Resisted Abduction Test
        • Sacral Clearing Test
        • Seated Forward Flexion Test
        • SIJ Compression/Distraction Test
        • Slump Test
        • Sphinx Test
        • Spine Rotators & Multifidus Test
        • Squish Test
        • Standing Forward Flexion Test
        • Straight Leg Raise Test
        • Supine to Long Sit Test
      • Shoulder >
        • Active Compression Test
        • Anterior Apprehension
        • Biceps Load Test II
        • Drop Arm Sign
        • External Rotation Lag Sign
        • Hawkins-Kennedy Impingement Sign
        • Horizontal Adduction Test
        • Internal Rotation Lag Sign
        • Jobe Test
        • Ludington's Test
        • Neer Test
        • Painful Arc Sign
        • Pronated Load Test
        • Resisted Supination External Rotation Test
        • Speed's Test
        • Posterior Apprehension
        • Sulcus Sign
        • Thoracic Outlet Tests >
          • Adson's Test
          • Costoclavicular Brace
          • Hyperabduction Test
          • Roos (EAST)
        • Yergason's Test
      • Elbow >
        • Biceps Squeeze Test
        • Chair Sign
        • Cozen's Test
        • Elbow Extension Test
        • Medial Epicondylalgia Test
        • Mill's Test
        • Moving Valgus Stress Test
        • Push-up Sign
        • Ulnar Nerve Compression Test
        • Valgus Stress Test
        • Varus Stress Test
      • Wrist/Hand >
        • Allen's Test
        • Carpal Compression Test
        • Finkelstein Test
        • Phalen's Test
        • Reverse Phalen's Test
      • Hip >
        • Craig's Test
        • Dial Test
        • FABER Test
        • FAIR Test
        • Fitzgerald's Test
        • Hip Quadrant Test
        • Hop Test
        • Labral Anterior Impingement Test
        • Labral Posterior Impingement Test
        • Long-Axis Femoral Distraction Test
        • Noble Compression Test
        • Percussion Test
        • Sign of the Buttock
        • Trendelenburg Test
      • Knee >
        • Anterior Drawer Test
        • Dial Test (Tibial Rotation Test)
        • Joint Line Tenderness
        • Lachman Test
        • McMurray Test
        • Noble Compression Test
        • Pivot-Shift Test
        • Posterior Drawer Test
        • Posterior Sag Sign
        • Quad Active Test
        • Thessaly Test
        • Valgus Stress Test
        • Varus Stress Test
      • Foot/Ankle >
        • Anterior Drawer
        • Calf Squeeze Test
        • External Rotation Test
        • Fracture Screening Tests
        • Impingement Sign
        • Navicular Drop Test
        • Squeeze Test
        • Talar Tilt
        • Tarsal Tunnel Syndrome Test
        • Test for Interdigital Neuroma
        • Windlass Test
  • I want Financial Freedom
  • I want Professional Growth
  • I want Clinical Mastery