Ober test

The Ober Test is used to test for iliotibial band syndrome (Tight ITB) or for tensor fascia latae…
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 Ober test

What is Ober test?

  • The Ober Test is used to test for iliotibial band syndrome (Tight ITB) or for tensor fascia latae (TFL) muscle contraction or inflammation.

How it's Performed?

  • The patient is in lateral position with the affected hip upward.
  • unaffected knee and hip should be flexed to flatten the lumbar spine curve.
  • The examiner Stands behind the patient and firmly stabilizes the pelvis/greater trochanter with the left hand to prevent movement of the pelvis.
  • Then Grasps the distal end of the patient’s affected leg with his right hand and flexes the leg to a right angle at the knee joint.
  • Extends and abduct the hip joint.
  • Slowly lowers the leg toward the table -adducting the hip- until motion is restricted.
  • Make sure that the hip does not internally rotated and flexed during the test, and the pelvis must be stabilized, as allowing the thigh to drop in flexion and internal rotation would ‘give in’ to the tight tensor fascia latae TFL and not accurately test the length.

What does a positive Ober test mean?

Ober test is considered positive or negative in these conditions:

  • If the ITB is normal, the leg will adduct with the thigh dropping down slightly below the horizontal and the patient won’t experience any pain; in this case, the ober test is called negative.
  • If the ITB is tight, the leg would remain in the abducted position and the patient would experience lateral knee pain, in this case, the ober test is called positive.

Sensitivity & Specificity

  • There are No studies support the accuracy of the Ober test for measuring iliotibial band tightness.

Notes

  • A contracted, nonelastic quadriceps muscle and shortened hamstring muscles cause an increase in the retropatellar pressure.
  • Shortening of the iliotibial tract can lead to chronic pain on the lateral side and over its connection to the lateral patellar retinaculum as well as leading to functional disturbances in the femoro-patellar joint.
  • Stretching the iliotibial tract often helps in lateral displacement of the patella with excessive lateral pressure.
  • Even though the tension in the iliotibial tract is greater when the knee is extended, Ober described the test with flexed knee.
  • In addition, when the knee is bent, the femoral nerve may be stretched during the course of the ober test.
  • If neurologic symptoms occur, such as paresthesias and/or radiating pain, then there is suspicion of L3–L4 nerve root irritation.
  • Pain over the greater trochanter suggests trochanteric tendinopathy or bursitis.

Related Anatomy:

 Tensor fasciae latae (tensor fasciae femoris):

  • Tensor fasciae latae originates from Anterior iliac crest.
  • It inserts on Iliotibial band.
  • Innervated by the Superior gluteal nerve (L4-S1).

Iliotibial Band:

  • The iliotibial band is a thickening of fascia that runs over the lateral side of the femur.
  • It’s also known as Maissiat’s band.
  • Proximally, it originates from the deep fascia of the thigh, gluteus maximus, and tensor fascia lata (TFL).
  • Distally it inserts on Gerdy’s tubercle on the proximal/lateral tibia.
    1. Hip extension
    2. Hip abduction
    3. Lateral hip rotationProximal ITB function includes:
  • Distally, ITB function depends on the position of the knee joint:
    • 0 degrees/full extension to 20 to 30 degrees of flexion

      • Active knee extensor: The ITB lies anterior to the lateral femoral epicondyle.
    • 20 to 30 degrees of flexion to full flexion ROM

      • Active knee flexor: ITB lies posterior relative to the lateral femoral epicondyle

Reference

  • Orthobullets
  • Campbel's Operative Orthopaedics 13th Book
  • Clinical Tests for the Musculoskeletal 3rd Ed. Book
  • Willett, Gilbert M.; Keim, Sarah A.; Shostrom, Valerie K.; Lomneth, Carol S. (11 January 2016). "An Anatomic Investigation of the Ober Test". The American Journal of Sports Medicine. 44 (3): 696–701.
  • Ober, F. R. (1936). "The role of the iliotibial band and fascia lata as a factor in the causation of low-back disabilities and sciatica". Journal of Bone and Joint Surgery. 18: 105–110.
  • https://www.ncbi.nlm.nih.gov/books/NBK537097/

ober test
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