Trendelenburg’s Sign

Orthopedic Exam / Special Tests for Physical Therapy: HIP Tests / PELVIS Tests

Trendelenburg’s Sign:

Trendelenburg’s sign is found in people with weak or paralyzed abductor muscles of the hip, namely gluteus medius and gluteus minimus. The gluteus medius is very important during the stance phase of the gait cycle to maintain both hips at the same level.

The Trendelenburg sign is said to be positive if, when standing on one leg, the pelvis drops on the side opposite to the stance leg to reduce the load by decreasing the lever arm. By reducing the lever arm, this decreases the work load on the hip abductors. The muscle weakness is present on the side of the stance leg.  The body is not able to maintain the center of gravity on the side of the stance leg. Normally, the body shifts the weight to the stance leg, allowing the shift of the center of gravity and consequently stabilizing or balancing the body. However, in this scenario, when the patient/person lifts the opposing leg, the shift is not created and the patient/person cannot maintain balance leading to instability.
https://en.wikipedia.org/wiki/Trendelenburg’s_sign

Trendelenburg’s Sign/ Trendelenburg’s Test:

PURPOSE:

  • Testing for: the strength of the Gluteus Medius Muscle


Video Demo Instructions, Procedure, Positive Test:

Trendelenburgs Sign/ Trendelenburg’s Test: Video Demo (Procedure below)

Trendelenburgs Sign/ Trendelenburg’s Test: PROCEDURE:

  • Patient is standing
  • Therapist stands behind patient, paying attention to the patient’s PSIS and Iliac Spines
  • Patient stands on the affected leg

Trendelenburg’s Sign/ Trendelenburg’s Test: POSITIVE SIGN:

  • Gluteus medius is weak if the pelvis on the affected side pops out or drops