What is FABER Test used to assess?
FABER test is also known as Patrick’s Test or figure of 4 test. The FABER or Patrick’s test is used to assess the pathology or dysfunction at the hip joint, muscles around the hip joint, and at the sacroiliac joint.
In the word FABER, the F stands for Flexion, AB stands for Abduction, and ER stands for External Rotation. Examiner performs all three movements on the patient’s affected leg in a step-by-step manner. So that the patient’s affected leg would rest on the opposite leg distal thigh. This position is known as Faber or figure of 4 position. That’s why this test is also known as the figure of 4 test.
Procedure for Performing FABER (Patrick’s) Test/Maneuver
- The patient should lie in a supine lying position.
- The examiner then brings the affected leg’s hip and knee into 90 degrees of flexion.
- After that, the examiner will abduct the hip and finally externally rotate the hip so that the patient’s tested leg foot would rest on the opposite leg distal thigh. Not quite on the knee joint but on the distal thigh. This forms the Faber position or figure 4 position. That’s why this test is also called the figure of 4 test.
- The examiner then places one hand on the opposite ASIS to stabilize the pelvis.
- After that, the examiner places the other hand of the flexed knee (tested leg’s knee joint). The examiner then gently pushes the flexed knee in a downward direction towards the table.
- The examiner pushes the flexed knee towards the table until an end range of motion is not achieved. An additional few small-amplitude oscillations can be applied to test for pain provocation in the end range of motion. The FABER (Patrick’s) test is considered positive when the test reproduces the patient’s pain or limits range of motion.
What does a Positive Faber Test mean?
A positive Faber test means that the test reproduces the patient’s pain and limits range of motion (ROM). Limited ROM means there will be less movement around the area. The tested leg remains above the opposite leg, indicating the dysfunction around the affected side hip joint or SI joint or muscles around the hip joint (iliopsoas spasm).
What does a Negative Faber Test mean?
A negative Faber test means that the test doesn’t produces any pain or limits range of motion. The tested leg knee falls towards the table or at least remains parallel with the opposite leg.
Interpretation (Which areas might be causing this lack in Range of Motion)
As we said above, the dysfunction could be either in the hip joint or SI joint or muscles around the hip joint. So to solve this out, the examiner would ask the location of the pain from the patient.
Patient’s may say that pain feels in the front or on the anterior side, or they may complain pain is deep in the hip joint, then the examiner will look for the hip joint pathology or dysfunction.
Or some patients may complain that the thigh is quite sore, then it will give examiner a clue that some hip muscles are involved.
Some pateints may point the pain towards the back (posterior side) and may complain that it hurts at the bottom of their back (posterior pelvis region). It might indicate sacroiliac joint dysfunction.
Here what we need to do.
After asking the location of the pain from the patient. Here what we need to do is to learn to identify which area of the body is affected by the test.
So that we can able to determine our patient’s diagnosis and hopefully, we can able to diagnose pathology or dysfunction around the SI joint or hip joint or muscles around the hip joint.
How FABER Test assesses Hip and SI joint Dysfunction?
Faber test assesses both the hip and SI joint and can indicate pathology or dysfunction located in the hip or SI joint. And it also helps in clearing out the difference between hip and SI joint dysfunction.
This test assesses the hip as the forces being transferred through the joint. When the examiner forms the figure 4 position by placing the hip in a position of flexion, Abduction and external rotation. And when examiner gently pushes the flexed knee in a downward direction towards the table, it stresses the femoral-acetabular joint and produces pain if irritated.
Sacroiliac Joint Pathology
Faber exam or test also assesses the SI joint, as the horizontal abduction force goes through the femur, the soft tissues under pressure transfer the forces to the SI joint. Therefore, this test can indicate pathology or dysfunction located in the SI joint.