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This is Brent of the Brookbush Institute, and in
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this video we're doing the FABER test.
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This is a special or orthopedic test for the hip.
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FABER being an acronym for flexion, abduction, external rotation. This is also
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sometimes referred to as the Patrick's test. I'm going to have my friend Crystal
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come out, she's going to help me demonstrate this test. This is not a difficult
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special test to perform,, and it is definitely helpful in a clinical setting.
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All you're going to do is have your your patient or client lie down, bring the
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ankle of the side of the hip that you're testing over the opposite knee, so they
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create this figure four position. Now you do have one text McGee, that has the foot
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placement on the medial thigh, but honestly McGee is the only place I've
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seen that. I think this is probably the more conventional position that you guys
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will see in the research and other texts, so we'll stick with this for now. I'm
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then going to face her knee, I'm going to brace the opposite ASIS all righ,t so if
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I brace the opposite ASIS when she lowers this leg, it'll keep her from
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flipping off the table. If you flip people off tables they don't come back.
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Alright and what you guys will notice pretty quickly here if you are you're
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good at your kinesiology you guys are good at your functional anatomy is, by
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pushing down this way right, I have taken her into flexion, and now I'm
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pushing her into abduction and external rotation of her femur, hence why this is
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called the flexion, abduction, external rotation test. Alright now as far as what
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is a positive versus what is a negative test, well if I slowly let her leg down,
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just be like Crystal just let it fall all the way down to the table. That
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might be enough alone to cause a provocation of her symptoms, which is
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what we're looking for right. We want to see if this is her concordant sign, the
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sign that replicates what she came in complaining about. Is this the symptoms
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you were talking about, do you feel anything? You, you do feel something and
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it's in the front of your hip. Alright so we already have a positive FABER. Now
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if she had gotten down that far and didn't feel anything,
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personally I think it would be good practice to add a little overpressure,
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try to make sure they're getting down pretty close to parallel with the table
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before you would say it's clear and a negative FABER test right. So I not only
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want her to not feel any pain, I want her to not feel any pain with a little
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overpressure before I'm going to say okay she's negative, this this isn't a problem.
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Now what does a concordant sign, her symptoms being provocated in her
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anterior hip with this test tell us? That's actually kind of interesting when
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you look at the research. This this test has been used for one of two reasons;
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it's either been used for hip issues or sacroiliac joint issue issues. Now I'm
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going to say for sacroiliac joint dysfunction this test by itself is
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probably not very reliable, but if she was complaining about pain in the back
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of her hip, like her SI joint right, like they they start touching that spot like
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that's like low back top of butt area right, then I would go okay let me follow
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this up. I'm going to use this as kind of a pivot point in my evaluation. I'm going to
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follow this up with my sacroiliac joint testing cluster if it's anterior hip. Now
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I'm start start thinking hip issues, is this for example hip impingement, is this
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some sort of small labral tear, since you know I know you guys don't know Crystal
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but she she walked in here and she was not in pain while she walked so I'm
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going to assume it's nothing too serious at this point all right. But if she has
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anterior hip pain, impingement, trochanteric bursitis right is is a
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commonly as a common diagnosis, we already said labral tears, osteoarthritis
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or some sort of some sort of joint inflammation. We could maybe think of
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like psoas tendinitis. Here's the problem, all of those are possible, and this test
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doesn't tell me which one of those it is, and honestly when we look at our hip
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tests they do a really bad job of differentiating
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which pathology we have. As long as we say that this test is for hip pathology
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then it is both sensitive and specific. If we try to get more specific than
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generalized hip pathology, this test is sensitive but not very specific, so I
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hope you guys kind of followed the logic there, and of course we'll post the
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research for you guys when we post this in our articles and our courses. For now
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just know conceptually what we're doing, what we're using this for. Now how I use
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it in clinic is this is a wonderful quick test, remember I'm always trying to
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find that one test that is there concordant sign right, it replicates
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their symptoms so that I can then use it as a pretest post-test
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as I start working through various modalities, and exercises and
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interventions to see what's going to work for Crystal. So if I know okay
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FABER tests boom, FABERs test was positive, this is a great strong
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concordance sign for us. Cool all right positive, do all my techniques right,
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maybe I release her psoas, maybe I release her TFL, maybe I do some glute
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strengthening right. We can go through all of that lumbo-pelvic hip complex
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dysfunction interventions, and then after I've done those interventions I'm going to
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retest. I want to know if it worked, in fact I could even get more specific than
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that, maybe I just want to try a couple things.
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Maybe Crystal thinks that she's had psoas issues in the past, so we're just
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going to release her psoas and then retest. And if it didn't get better then we know
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that that was probably not the issue, and being that psoas release is kind of
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uncomfortable probably not going to do that technique again. So there you guys
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go, I'm going to demonstrate this technique one more time right.
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We're going to take her into flexion by putting her opposite ankle above her
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knee, I'm going to stabilize her opposite ASIS so I don't her roll off the table. I'm
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going to ask her to let her knee fall towards the table, and I'm going
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to add a little bit of an overpressure if I need to, and be like hey Crystal how
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does that feel/ It's uncomfortable, is that the symptoms you were talking about?
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Okay and where do you feel them, okay so if this is the symptoms she was talking
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about when she came in, there in the front of her hip. This makes this a great
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quick test for us, and because they're in the front of the hip I may not have to
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follow up with my sacroiliac joint cluster, I'm going to assume that there
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is some sort of hip issue going on. I hope you guys enjoyed this video. I hope