Noble Compression Test: How to Check for IT Band Syndrome

The Noble Compression Test is a provocative orthopedic test used to diagnose Iliotibial Band Friction Syndrome (ITBFS). It reproduces pain by compressing the IT band against the lateral femoral epicondyle during knee extension.

1. Purpose

The primary purpose of the Noble Compression Test is to **detect** Iliotibial Band Friction Syndrome (ITBFS). It helps identify if the IT band is causing pain as it passes over the lateral femoral epicondyle.

2. How to Perform

1. The patient is positioned in supine (lying on their back).
2. The examiner flexes the patient's hip and knee to 90 degrees.
3. The examiner places their thumb firmly over the lateral femoral epicondyle (just above the lateral joint line).
4. While maintaining this pressure, the examiner passively extends the patient's knee from 90 degrees towards full extension.

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
A positive test (indicating IT Band Syndrome) is:

• Reproduction of severe pain under the examiner's thumb, typically occurring at approximately 30 degrees of knee flexion.
• This is the point where the IT band passes over the epicondyle.

Negative Sign (Test is NEGATIVE):
A negative test is when the knee can be fully extended without pain at the lateral epicondyle.