FAIR Test Deep Gluteal Syndrome Piriformis Syndrome

In this video I'm going to show you how to perform the Flexion-Adduction- Internal rotation test, abbreviated as FAIR Test for Deep Gluteal Syndrome Get our very own Assessment Ebook and Mobile App! Links are in the video description Hi and welcome back to Physiotutors! Deep Gluteal Syndrome, abbreviated as DGS is defined as pain in the buttock area caused from non-discogenic entrapment of the sciatic nerve in the subgluteal space. The structures that can be involved in sciatic nerve entrapment are not only the piriformis, but also fibrous bands containing blood vessels, gluteal muscles, hamstring muscles, the gemelli- obturator internus complex, vascular abnormalities and space-occupying lesions. For this reason the term "Deep Gluteal Syndrome" instead of "Piriformis Syndrome" is now preferred. Commonly reported symptoms include hip or buttock pain and tenderness in the gluteal and retro- trochanteric region. The pain is often described to be sciatica-like, often unilateral and excacerbated with rotation of the hip in flexion and knee extension. Other symptoms include intolerance of sitting for more than 20 to 30 minutes, limping, disturbed or loss of sensation in the affected extremity and pain at night getting better during the day. Fishman at al. in the year 2002 compared the FAIR test with its ability to delay the Hoffmann reflex also called H-reflex, which is sensitive, but not specific measure for nerve conduction They found sensitivity of 88% and specificity of 83% for the FAIR test when using delay of three standard deviations above the normal H-reflex As the H-reflex is not an accurate gold standard and no other studies have been conducted on this test yet, we give it questionable clinical value in practice Before you conduct the test make sure you have examined and excluded more prevalent pathologies in the lumbar spine and SI joint that could explain the patient's symptoms. To perform the tests like shown in the study of Fishman have the patient lie on the unaffected side with his upper hip flexed to 90 degrees, maximal adduction and the upper knee flexed to 90 degrees as well. While both the acetabulae are kept vertical, apply upward and lateral pressure to the shin while passively rotating the hip internally to 45 degrees or as near as the patient can tolerate. This test is positive, if the patient reports pain at the intersection of the sciatic nerve and the piriformis. Alright, this was our video on the FAIR test. If you want to learn about another test for this condition, click on the video right next to me! As always thank you very much for watching! If you like this video please give it "thumbs up", make sure to follow our channel and for more Physiotutors content head to our Facebook, Instagram or web page physiotutors.com. This was Kai for Physiotutors, I'll see in the next video - bye!