Hyperextension Test of Lumbar Spine

What is the hyperextension test of the lumbar spine?

The hyperextension of the lumbar spine indicates or pinpoints lumbar spine syndrome.

The procedure of Performing a hyper extension test of the lumbar spine

This test is performed by two methods. One is the active hyperextension method, and the other is the passive hyperextension and rotation method.

Position of the Patient – The patient lies in a prone position.

First, let me explain to you the active hyperextension method. 

Active hyperextension (by own) method 

The examiner or therapist immobilizes both the legs of the patient and asks the patient to raise his or her torso. Torso means the major part of the body that contains the back, pelvis, abdomen, and chest.


Passive (by examiner’s help) Hyperextension and Rotation method

  • In this method, the examiner or therapist passively extends the patient’s spine and adds a rotational movement.
  • The examiner’s other hand rests on the patient’s lumbar spine. As it is used to assess both the mobility in the lumbar spine and the level of the painful site.


Test Results of the hyperextension test of the lumbar spine

The test result of the Active hyperextension method 

When segmental dysfunction is present in the lumbar spine, active extension (by own) of the lumbar spine will elicit or increase pain.

The test result of the Passive hyperextension and Rotation method 

The passive extension with an additional rotational movement allows the examiner to assess diminished regional or segmental mobility.

A hard endpoint of the range of motion indicates degenerative changes, whereas a soft endpoint more probably indicates shortening of the iliocostalis lumborum muscle and longissimus thoracis muscle.

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Sacroiliac Joint Tests

Springing Test – To detect functional impairment in the Thoracic & Lumbar spine & Sacroiliac Joint

Gaenslen’s Test – To detect any pathology or dysfunction around the sacroiliac joint.

Standing Flexion Test/ Standing Forward Flexion Test – To assess sacroiliac joint dysfunction.

Faber Test / Patrick’s Test – Used to assess the pathology or dysfunction at the hip joint, muscles around the hip joint, and at the sacroiliac joint.

Cervical Tests 

Cervical Flexion Compression Test –  To identify if there is a Herniated disk in the Cervical spine.

Jackson Compression Test –  To Detect Cervical Radiculopathy (Cervical Nerve Root Compression).

Spurling Test – For Diagnosing Cervical Radiculopathy.

Cervical Distraction Test – To detect the presence of cervical radiculopathy.

O’Donoghue Test – Helps in differentiating between muscular pain (strain) and ligamentous pain (articular problem) in the cervical spine.

Soto Hall Test – For Detecting Problem in Patient’s Neck (Cervical Spine).

Maximum Compression of the Intervertebral Foramina Test of Cervical Spine – For Detecting Facet Joint Dysfunction in the Cervical Spine.

Some other Tests

Adam’s Forward Bend Test – For detecting the presence of scoliosis (either functional or structural).

Noble Compression Test/Noble Test –  To assess pain coming from iliotibial band syndrome.

Neer Test –  For detecting the presence of shoulder impingement syndrome.


Clinical Tests for the Musculoskeletal System: Examinations-Signs-Phenomena by K. Buckup

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