UNILATERAL STRAIGHT LEG RAISE TEST

​TEST POSITIONING

The client is supine with both hips and knees extended.

The therapist is standing with the distal hand around the client's heel and the proximal hand on the client's distal thigh (anteriorly) to maintain knee extension.

ACTION

With the client completely relaxed, the therapist slowly raises the test leg until pain or tightness is noted.

The therapist slowly lowers the leg until the pain or tightness resolves, then dorsiflexes the ankle and instructs the client to flex the neck.

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POSITIVE FINDING

Leg and/or low back pain occurring with dorsiflexion and/or neck flexion is indicative of dural involvement.

A lack of pain reproduction with dorsiflexion and/or neck flexion is indicative of either hamstring tightness or possible lumbar spine or sacroiliac joint involvement.

Additionally, pain occurring at hip flexion angles greater than 70 degrees is indicative of lumbar spine or sacroiliac joint involvement.

If the latter is determined, proceed to the bilateral straight leg raise test to differentiate between lumbar spine and sacroiliac joint involvement.

CONSIDERATIONS & COMMENTS

The client must be completely relaxed, as contraction of the hip flexor muscles could increase the stress placed on the lumbar spine and sacroiliac joint, thus creating false-positive findings.

Additionally, during the unilateral straight leg raise test, pain may be noted in the contralateral leg and/or lumbar spine.

This finding should be referred to as a positive crossed straight leg raise test.