BOWSTRING TEST

(CRAM TEST)

​• Test positioning

The client lies supine.

​• Action

The therapist performs a passive straight leg raise on the involved side.

If the client reports radiating pain with the straight leg raise the therapist then flexes the client's knee to approximately 20-degrees in an attempt to reduce painful symptoms.

The therapist then applies pressure to the popliteal area in an attempt to reproduce the radicular pain.

​• Positive finding

Paintful radicular reproduction following popliteal compression indicates tension on the sciatic nerve.

​• Special considerations & comments

It is important for the therapist to maintain the same degree of the client's hip flexion when flexion of the knee is performed.

The Bowstring Test, also known as the Cram Test, is based on the work of Dr. Robert Elvey in neural tension assessment and Dr. James Cyriax’s contributions to diagnosing lumbar radiculopathy and sciatica.