During the Thomas test interpretation, if the extended leg lifts off the table, what does this indicate?

During the Thomas test interpretation, if the extended leg lifts off the table, what does this indicate?

• A. Hamstrings are tight.
• B. Hip flexors are tight.
• C. Iliopsoas is lax.
• D. Gluteus medius weakness.

Answer: (B)

The main idea here is that the Thomas test checks hip flexor length, especially the iliopsoas. When you bring one knee toward your chest, the opposite leg should lie flat with the knee extended if the hip flexors are lengthened normally. If that extended leg rises off the table, it means the hip flexors are tight and pulling the leg into flexion even as you try to keep it flat. In other words, a positive sign indicates hip flexor tightness, not hamstring tightness or gluteus medius weakness. Tight hamstrings would more affect knee extension of the tested leg, and gluteus medius weakness would show issues in gait or pelvis control rather than this lifting response.

The main idea here is that the Thomas test checks hip flexor length, especially the iliopsoas. When you bring one knee toward your chest, the opposite leg should lie flat with the knee extended if the hip flexors are lengthened normally. If that extended leg rises off the table, it means the hip flexors are tight and pulling the leg into flexion even as you try to keep it flat. In other words, a positive sign indicates hip flexor tightness, not hamstring tightness or gluteus medius weakness. Tight hamstrings would more affect knee extension of the tested leg, and gluteus medius weakness would show issues in gait or pelvis control rather than this lifting response.