Ely test interpretation: hip flexion or pelvic lifting during knee flexion indicates which tightness?

Ely test interpretation: hip flexion or pelvic lifting during knee flexion indicates which tightness?

• A. Iliopsoas tightness
• B. Rectus femoris tightness
• C. Hamstring tightness
• D. Quadriceps weakness

Answer: (B)

The test is looking at how a two-joint muscle behaves when a knee is flexed. In Ely’s test, if the hip flexes or the pelvis lifts as the knee bends, it points to tightness of the rectus femoris. Rectus femoris crosses both the hip and knee, so when the knee is actively flexed, a tight rectus femoris shortens and pulls on its hip attachment, causing the hip to flex or the pelvis to rise. This sign is specific for rectus femoris tightness. By contrast, hamstring tightness would mainly make knee flexion difficult, not cause hip flexion; iliopsoas tightness would flex the hip but wouldn’t produce the same pelvis-raising response during knee flexion; quadriceps weakness isn’t a tightness and wouldn’t create this pattern.

The test is looking at how a two-joint muscle behaves when a knee is flexed. In Ely’s test, if the hip flexes or the pelvis lifts as the knee bends, it points to tightness of the rectus femoris. Rectus femoris crosses both the hip and knee, so when the knee is actively flexed, a tight rectus femoris shortens and pulls on its hip attachment, causing the hip to flex or the pelvis to rise. This sign is specific for rectus femoris tightness. By contrast, hamstring tightness would mainly make knee flexion difficult, not cause hip flexion; iliopsoas tightness would flex the hip but wouldn’t produce the same pelvis-raising response during knee flexion; quadriceps weakness isn’t a tightness and wouldn’t create this pattern.