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Hip Special Test: Sign of the Buttock

A comprehensive video explaining how to perform the Sign of the Buttock test: a simple physical test to help diagnose hip disorders. Learn how to test for greater trochanteric pain, snapping hip syndrome and FAI.

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Transcript

00:04 - 00:08This is Brent of the Brookbush Institute, and in this video we're going over the sign of
00:08 - 00:14the buttock, a very simple test but something everybody should have in their
00:14 - 00:19repertoire because this is one of those red flag issues. I'm going to have my friend
00:19 - 00:23Melissa come out she's going to help me demonstrate, and then I will explain what
00:23 - 00:28the appropriate action is if you find this sign. So the sign of the buttock
00:28 - 00:32basically goes like this, I was doing a straight leg raise,
00:32 - 00:36maybe I was doing a straight leg raise to check her hamstring flexibility,
00:36 - 00:40maybe I was doing a straight leg raise to check if she has sciatic nerve
00:40 - 00:45symptoms see if I could provoke those symptoms again, maybe checking to see if
00:45 - 00:51there's something going on with her low back, either way I get up so far and
00:51 - 00:55then I get stuck. Well me having the ability to
00:55 - 01:00do some deductive reasoning go, well we want to see if it's either sciatic nerve
01:00 - 01:05or biceps femoris, the way I could get those two structures out is I could bend
01:05 - 01:09the knee and this is where things get a little weird. I take those structures out
01:09 - 01:15which in most people gives them all sorts of hip flexion back, but this time
01:15 - 01:20I try to get them more hip flexion and nothing; and maybe even with that nothing
01:20 - 01:26they get a little pain in their backside like around their gluteal fold. This
01:26 - 01:33is one of those things where you need to take a step back and go what could
01:33 - 01:39possibly prevent somebody in their hip from getting hip flexion, and this is
01:39 - 01:42where things get a tad more serious, although you're gonna hide this from
01:42 - 01:47your client or patient initially. This is where we have to start thinking is this
01:47 - 01:52a neoplasm, is this an abscess, is this osteomyelitis.
01:52 - 02:00Is this something potentially very very serious, and you only have one recourse,
02:00 - 02:10refer out. Now keep in mind it could just be arthritis ,it could just be capsular
02:10 - 02:18tightness, it could be hip dysfunction from something like a loose
02:18 - 02:23body blocking you from getting into hip flexion, and all of those things are
02:23 - 02:29fairly benign and just orthopedic issues that we can help with.
02:29 - 02:39But because the sign of the buttock can also be related to cancer, infection of
02:39 - 02:47the bone, avascular necrosis, we have to go okay look it's a little
02:47 - 02:52weird so we're going to go through today but I want you to set up
02:52 - 02:56an appointment with your physician soon, okay and let's let's get this hip
02:56 - 03:00cleared before we start messing around with it; and that's probably about all I
03:00 - 03:04would tell my client initially. I probably wouldn't go hey that's a sign
03:04 - 03:09of cancer, don't do that. That is a terrible thing to do to somebody, you
03:09 - 03:12will have their heart drop. I don't even think I would be like hey this could be
03:12 - 03:16serious unless they started pushing back at me and saying that they don't want to
03:16 - 03:20go to their physician, or they're not going to make an appointment with their
03:20 - 03:22doctor. I'm not even going to mention it's serious, I'm just going to be like hey
03:22 - 03:26there's a couple things that could be going on with your hip in this
03:26 - 03:32particular sign that I I can't help you with, so let's make sure your physician
03:32 - 03:36gets you some imaging and we'll make sure that you're not wasting
03:36 - 03:41money with me when maybe there's something else that would treat this
03:41 - 03:45better, and I would just leave it at that. So once again the sign of the
03:45 - 03:51buttock is essentially hip flexion restriction after you do your straight
03:51 - 03:59leg raise and bend the knee, it doesn't get better. They may or may not have some
03:59 - 04:04pain in their buttock, which is why it's referred to as the sign of the buttock.
04:04 - 04:10It's more that hip flexion restriction that just makes you kind of go -that's
04:10 - 04:14not normal, and being a red flag issue you're always
04:14 - 04:19going to refer out. I hope you enjoyed this video and feel free to leave
04:19 - 04:23questions in the comment section, I know this type of test
04:23 - 04:27definitely leads to a lot of questions I'm more than happy to answer. Thank you Melissa.

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