03/02/2026
Respond with “FAI” in the comments below
HIP FLEXOR STRAIN? Don’t Skip This Test.
Everyone loves to label anterior hip pain as a “hip flexor strain.”
But can your clinical exam actually predict what shows up on MRI?
📚 Serner et al., BJSM 2016
“Can standardised clinical examination of athletes with acute groin injuries predict the presence and location of MRI findings?”
Here’s what matters:
🔎 In athletes with acute groin pain,
Resisted hip flexion in the Thomas test position showed:
• Sensitivity ≈ 0.72
• Specificity ≈ 0.67
Translation:
It’s reasonably good at identifying hip flexor involvement — but it’s not perfect.
💡 Even stronger indicators?
Clusters of multiple positive tests increased diagnostic accuracy.
🚫 One test ≠ diagnosis
✅ Patterns + load response + mechanism matter
⸻
Clinical takeaway:
If you suspect hip flexor strain, don’t just test at 90°.
Test resisted hip flexion in the Thomas position to bias iliopsoas.
But remember — groin pain is layered.
Adductors, re**us femoris, iliopsoas, and even abdominal wall can overlap.
Diagnose with intent. Not assumption.
