Faber Test (Patrick Test): Purpose, Procedure, and Clinical Use in Physical Therapy

Musculoskeletal assessments play a key role in clinical decision-making across rehabilitation settings. One widely used orthopedic test for evaluating hip and sacroiliac (SI) joint dysfunction is the Faber Test, also known as the Patrick Test. This test offers clinicians a practical method to assess joint pathology and support treatment planning.

This article will cover the purpose of the Faber Test, how it is performed, its clinical applications, and limitations to keep in mind during interpretation. By understanding the appropriate use of the Faber Test, healthcare professionals can apply it more accurately within the patient examination process.

What Is the Faber Test?

The Faber Test is a physical examination maneuver designed to detect pathology in the hip, sacroiliac joint, or surrounding structures. The name "FABER" serves as an acronym describing the position of the limb during the test: Flexion, ABduction, and ER (External Rotation) of the hip.

First described by Dr. Hugh Patrick in 1917, the test continues to be a standard orthopedic tool used by physical therapists, athletic trainers, and other healthcare providers to identify potential sources of lower back, buttock, or groin pain.

The Patrick Test, another name for the Faber Test; is valued for its simplicity and minimal need for equipment. When used appropriately, it provides valuable clues about underlying musculoskeletal dysfunction that may warrant further evaluation or targeted interventions.

How to Perform the Faber Test

Performing the Faber Test correctly is important to maximize its diagnostic utility. Here is the recommended procedure:

1. Patient Positioning: The patient lies supine on the examination table.

2. Leg Placement: The examiner flexes the patient's hip and knee, placing the foot of the tested leg on the opposite knee. This creates a "figure-four" position.

3. Stabilization: One hand stabilizes the opposite pelvis at the anterior superior iliac spine (ASIS) to prevent compensatory movement.

4. Downward Pressure: The examiner applies gentle downward pressure on the tested knee while stabilizing the pelvis.

Positive Findings:

• Groin pain may indicate intra-articular hip pathology, such as labral tears or osteoarthritis.

• Posterior pelvic pain may suggest sacroiliac joint dysfunction.

• Restricted range of motion without significant pain may reflect soft tissue restrictions.

Proper patient instruction during the maneuver is necessary to avoid guarding, which can compromise the accuracy of the test.

Communicating the Faber Test to Patients

Clear, empathetic communication during special tests like the Faber Test can improve patient comfort, reduce muscle guarding, and enhance the reliability of the results. Consider the following strategies when introducing the test to patients:

• Explain the Purpose: Briefly describe what the test evaluates. For example: “This test helps us understand if your hip joint or lower back might be contributing to your pain.”

• Describe the Steps: Let the patient know what to expect physically: “I’ll be moving your leg into a figure-four position and applying some gentle pressure—just let me know if you feel any discomfort.”

• Encourage Feedback: Invite the patient to report sensations in their own words. This helps differentiate between familiar vs. unfamiliar pain and may improve test accuracy.

• Normalize the Process: Reassure the patient that it's okay to feel slight discomfort during the test and that their response helps guide your treatment plan.

Taking a moment to set expectations can increase patient trust and reduce anxiety, allowing for a more accurate and cooperative assessment process.

Clinical Applications of the Faber Test

The Faber Test assists clinicians in differentiating between hip joint and sacroiliac joint problems. Some key clinical uses include:

1. Hip Joint Pathology Screening

A positive Faber Test that reproduces groin pain may indicate intra-articular hip pathology. Conditions associated with a positive Faber Test include:

• Femoroacetabular impingement (FAI)

• Acetabular labral tears

• Osteoarthritis of the hip

A systematic review found that while the Faber Test alone is not highly sensitive for diagnosing specific hip pathologies, it remains useful when combined with other clinical tests.¹ Clinicians often use the Faber Test as part of a battery of assessments for hip-related dysfunction.

2. Sacroiliac Joint Dysfunction Identification

Pain localized to the posterior pelvis during the Faber Test may suggest SI joint dysfunction. The test stresses the SI joint by placing it in an anteriorly rotated position, and reproduction of familiar posterior pain is considered meaningful.

Research indicates that combining the Faber Test with other provocation maneuvers, such as the Gaenslen’s Test and Thigh Thrust Test, improves diagnostic accuracy for SI joint involvement.² Therefore, while the Faber Test alone may not confirm SI pathology, it offers valuable information as part of a broader sacroiliac evaluation.

3. Screening for Soft Tissue Restrictions

Limited hip range of motion without marked pain during the Faber Test may reflect tightness in soft tissue structures such as:

• Iliopsoas

• Sartorius

• Adductors
  

Identifying mobility restrictions early can inform treatment planning, particularly for patients with movement impairments impacting gait, athletic performance, or functional activities.

4. Monitoring Rehabilitation Progress

In rehabilitation settings, the Faber Test can be used periodically to monitor joint mobility, pain reproduction, and functional improvement over time. Physical therapists often document changes in hip external rotation and symptom severity during follow-up visits to guide treatment adjustments.

One reliability study found that when used to measure hip range of motion, the Faber Test demonstrates good to excellent intra-rater reliability and provides measurable benchmarks such as minimal detectable change (MDC), which can be helpful for tracking patient progress during rehabilitation.³

Limitations and Considerations

Although the Faber Test provides valuable clinical insight, several limitations must be considered when interpreting the results:

• Low Specificity: The Faber Test alone cannot precisely identify a single pathology. Pain provocation may stem from various structures around the hip and pelvis.

• Inter-Examiner Reliability: Studies report moderate inter-examiner reliability when performing the Faber Test, meaning technique and patient responses may vary among clinicians.^3,4

• Patient Factors: Age, flexibility, muscular guarding, and pre-existing conditions (e.g., arthritis) can influence test outcomes.
  

To address these limitations, clinicians should integrate Faber Test findings with a complete patient history, additional special tests, imaging (if needed), and clinical reasoning to form a well-rounded assessment.

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Using the Faber Test for Informed Clinical Decision-Making

The Faber Test remains a valuable orthopedic screening tool for physical therapists and other rehabilitation providers assessing hip or sacroiliac joint dysfunction. When used thoughtfully as part of a full examination process, it can guide clinical reasoning, support differential diagnosis, and inform targeted treatment strategies.

Incorporating accurate musculoskeletal screening tools like the Faber Test allows healthcare providers to better serve patients experiencing hip, groin, or low back pain. For organizations looking to strengthen their orthopedic assessment and clinical education resources, Medbridge offers a range of evidence-based courses designed to build clinical excellence and support better patient outcomes.

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References

1. Reiman, M. P., Goode, A. P., Cook, C. E., Hölmich, P., & Thorborg, K. (2015). Diagnostic accuracy of clinical tests for the diagnosis of hip femoroacetabular impingement/labral tear: a systematic review with meta-analysis. British journal of sports medicine, 49(12), 811. https://bjsm.bmj.com/content/49/12/811

2. Laslett M. (2008). Evidence-based diagnosis and treatment of the painful sacroiliac joint. The Journal of manual & manipulative therapy, 16(3), 142–152. https://www.tandfonline.com/doi/abs/10.1179/jmt.2008.16.3.142

3. Bagwell, J. J., Bauer, L., Gradoz, M., & Grindstaff, T. L. (2016). The reliability of Faber test hip range of motion measurements. International journal of sports physical therapy, 11(7), 1101–1105. https://pubmed.ncbi.nlm.nih.gov/27999724/

4. Rabin, A., Shashua, A., Pizem, K., & Dar, G. (2013). The interrater reliability of physical examination tests that may predict the outcome or suggest the need for lumbar stabilization exercises. The Journal of orthopaedic and sports physical therapy, 43(2), 83–90. https://www.jospt.org/doi/10.2519/jospt.2013.4310