Ely's Test: How to Check for Rectus Femoris Tightness

Ely's Test, or the Prone Knee Bend Test, is a common orthopedic test used by physiotherapists to assess for tightness or contracture of the rectus femoris muscle, a major part of the quadriceps.

1. Purpose

The primary purpose of Ely's Test (also known as the Prone Knee Bend Test) is to **test for** tightness or contracture of the Rectus Femoris muscle. This muscle is a two-joint muscle that both flexes the hip and extends the knee.

2. How to Perform

1. The patient is positioned in prone (lying on their stomach), with their legs straight and hips in a neutral position.
2. The examiner stands beside the patient, at the level of the test leg.
3. The examiner places one hand on the patient's pelvis or lower back to monitor for any movement.
4. With the other hand, the examiner slowly and passively flexes the patient's knee, bringing their heel toward their buttock.

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
A positive test (indicating rectus femoris tightness) is:

• As the knee is flexed, the hip on the same side (ipsilateral) spontaneously flexes, causing the buttock to lift off the table.
• This indicates that the rectus femoris muscle is tight and is pulling the pelvis into an anterior tilt as it is stretched over the knee.

Negative Sign (Test is NEGATIVE):
A negative test (indicating normal length) is:

• The patient's knee can be fully flexed (heel to buttock) without the hip lifting or the pelvis tilting.