Gaenslen's sign (Gaenslen's test)

When the hip is hyperextended and the pelvis fixed by flexion of opposite hip, pain occurs on the affected side in lumbosacral disease. Specifically, Gaenslen's test can indicate the presence or absence of a SIJ lesion, pubic symphysis instability, hip pathology, or an L4 nerve root lesion. It can also stress the femoral nerve.

 Gaenslen's sign

The patient begins positioned in supine with the painful leg resting on the edge of the treatment table. The examiner sagitally flexes the non symptomatic hip, while the knee also flexed (up to 90 degrees). The patient should hold the non-tested (asymptomatic) leg with both arms while the therapist stabilizes the pelvis and applies passive pressure to the leg being tested (symptomatic) to hold it in a hyperextended position. A downward force is applied to the lower leg (symptomatic side) putting it into hyperextension at the hip, while a flexion based counterforce is applied to the flexed leg pushing it in the cephalad direction causing torque to the pelvis.  

If the patient’s normal pain is reproduced, the test is considered positive for a SIJ lesion, hip pathology, pubic synthesis instability, or an L4 nerve root lesion. Meanwhile, the femoral nerve may also be stressed by this test.

It is recommended to test both sides if the patient complains of pain bilaterally. Importantly, at least three positive signs of the SIJ provocation tests are required before a possible diagnosis of SIJ pathology.

More details:  📖 Stoller’s Orthopaedics and Sports Medicine: The Hip

Frederick Julius Gaenslen (1877 - 1937), American surgeon.

Frederick J. Gaenslen

Frederick J. Gaenslen, MD served as the first chair of the orthopedic surgery department (1926–1933). Dr. Gaenslen earned a bachelor’s degree from the University of Wisconsin in 1899, completed his medical degree at Johns Hopkins (1903), spent three years at the German Hospital in New York, and repeated visits to active clinics in the United States and Europe. He joined the hospital staff as a part-time surgeon in the 1920s, traveling by train from his home in Milwaukee to Madison once a week to see patients. On his weekly trips to Madison, he would review cases with his younger associates in the evening and be up bright and early the next morning to start his work at the Bradley Hospital.

Throughout his career, Dr. Gaenslen contributed an extensive series of papers, some on new techniques, others on congenital malformations and essays on preventative medicine and physical therapy. He was one of the seven original founders of the American Academy of Orthopedic Surgeons in 1931.

References

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