The FABER test is a quick, hands-on exam I use to track down the source of hip, groin, and pelvic pain. The letters stand for the three movements it uses: Flexion, ABduction, and External Rotation of the hip. In a single motion, this exam loads both the hip joint and the sacroiliac joint and shows me whether your familiar pain returns. It takes less than a minute and needs no equipment. The FABER test cannot diagnose a problem by itself, but it is one of the sharpest screening tools I have for deciding where to look next.
If hip or groin pain has been bothering you in Franklin, Brentwood, or anywhere across Middle Tennessee, here is how this test works and what your results can tell us.
What Is the FABER Test?
The FABER test, also known as Patrick’s test or the figure-four test, is a physical exam maneuver for the hip and pelvis. The name is an acronym for the leg position: Flexion, ABduction, and External Rotation. An American neurologist, Dr. Hugh Patrick, first described it in 1917, and it is still a standard part of orthopedic and physical therapy practice.
The test does its job by stressing two areas at the same time. When I guide your leg into the figure-four shape and add a little pressure, I load the hip joint and the sacroiliac joint, where your spine connects to your pelvis. When a structure in either spot is irritated, this position often brings your pain right back.
I rely on this exam because it is fast and gives me a clear place to start. It does not take the place of imaging or a full workup, but it points me in the right direction. I use it for athletes with groin pain, older adults with stiff, aching hips, and anyone whose pain could be coming from either the hip or the lower back.
How I Perform the FABER Test
Good technique matters here, since a careless setup can produce a misleading result. This is the sequence I follow in the office.
- Positioning: You lie flat on your back on the exam table.
- Leg placement: I bend your hip and knee and rest the ankle of the tested leg just above your opposite knee. The result is a figure-four shape, much like sitting with one leg crossed.
- Stabilizing the pelvis: I rest one hand on the front of your opposite hip bone, the anterior superior iliac spine, to hold your pelvis level and keep it from twisting.
- Gentle pressure: I lower the bent knee toward the table. If that alone does nothing, I add light downward pressure until I reach a natural stop, and I never push past your pain.
Why I Test the Pain-Free Side First
I almost always start with your pain-free side so I have a baseline to measure against. Then I move to the painful side and repeat the same steps while watching how you respond.
Your feedback drives the whole exam. Speak up the second you feel anything, and tell me whether it matches the pain that brought you in.
What a Positive FABER Test Means
A positive FABER test happens when the maneuver brings back your pain or clearly limits how far your knee can drop. A negative test means nothing came back. Since pain levels do not always match how much tissue is damaged, I take any reproduced pain seriously.
What a Positive FABER Test Tells Me
A positive result does not name the exact tissue at fault. It tells me something in the hip or pelvis is irritated and that I owe you a closer look. That is the reason I never rest a diagnosis on this one test.
Restricted motion with little or no pain sends me down a different path. More often than not, it means tight soft tissue rather than a damaged joint.
What the Location of Pain May Indicate
The real value of this exam is where the pain lands. The location helps me separate hip joint problems from sacroiliac joint problems and from simple muscle tightness.
Groin or Front-of-Hip Pain
Pain here points to trouble inside the hip joint. Common culprits include femoroacetabular impingement, where extra bone narrows the joint, a labral tear in the cartilage ring that helps seat the ball in the socket, or hip osteoarthritis.
Pain in the Back of the Pelvis
Pain near the sacroiliac joint suggests that joint is the likely source. It can reflect sacroiliac joint dysfunction or inflammation, and it tends to sit low and to one side of the lower back.
Limited Motion With Little Pain
When your knee will not drop and you feel tightness more than pain, the problem usually lives in muscles like the iliopsoas, the adductors, or the sartorius rather than the joint.
These patterns steer my next move, but they are clues, not verdicts. Plenty of patients carry more than one source of pain at once.
The Limits of the FABER Test
Using any exam well means knowing where it stops being reliable. The FABER test earns its place, but a few clear limits shape how I read it.
- Low specificity: A positive result cannot single out one cause. The pain might come from the hip joint, the sacroiliac joint, or nearby soft tissue, and the test alone cannot tell them apart with certainty.
- Mixed reliability: When one trained examiner measures hip motion, the numbers stay fairly steady, with reported reliability as high as 0.91 using an inclinometer. Agreement between different examiners using it as a pain test is much weaker, with one study reporting a kappa of just 0.47.
- Modest accuracy for the sacroiliac joint: Tested against confirmed sacroiliac joint pain, it showed a sensitivity near 50 percent and a specificity near 56 percent. That is why I pair it with other provocation tests, such as the thigh thrust and compression tests, before I blame the sacroiliac joint.
- Patient factors: Age, flexibility, muscle guarding, and existing arthritis can all shift the outcome. A tense patient can show a falsely limited test from guarding alone.
Because of these gaps, I always read the result alongside your full history, a complete exam, and imaging when it is warranted. One maneuver is a single piece of the puzzle, not the finished picture.
What Happens After a Positive Test
A positive result is a starting line, not a finish line. Once the exam brings back your pain, my job is to find the responsible structure and map out a plan.
The next step usually follows where you felt the pain. For groin pain that suggests a hip joint problem, I often order an X-ray to check joint space and bone shape, and sometimes an MRI to study the labrum and cartilage. For pain near the sacroiliac joint, I add more provocation tests and may use a targeted injection to confirm the source.
Treatment then follows the cause. Many patients turn the corner with rest, activity changes, physical therapy, and anti-inflammatory care. When the issue is structural, such as a labral tear or advanced arthritis, we weigh options that can include injections or surgery. The exam makes that whole path more focused, so you are not chasing the wrong problem.
I tell my patients to picture this test as a flashlight. It does not name the issue, but it lights up the right area so we spend our time and your money wisely.
When to See a Specialist About Hip Pain
Most brief hip and groin aches fade with rest and time. A few patterns, though, call for a closer look from an orthopedic specialist.
Schedule an appointment if you notice:
- Hip or groin pain that lingers more than a few weeks
- Pain that limits walking, stairs, or sleep
- Catching, clicking, or a sense that the hip might give out
- Stiffness that keeps you from crossing your legs or putting on shoes
- Pain that keeps coming back after it seems to settle
Seek prompt medical care if you have:
- Severe pain after a fall or injury
- An inability to bear weight on the leg
- A hip that looks deformed or out of place
- Fever along with a hot, swollen, painful joint
An early evaluation often means simpler treatment and a quicker return to the things you love.
Key Takeaways
- The FABER test moves your hip into flexion, abduction, and external rotation to stress the hip and sacroiliac joints.
- A positive test means your pain or limited motion came back during the maneuver.
- Groin pain usually points to the hip joint, while pain in the back of the pelvis points to the sacroiliac joint.
- The test is a screening tool, not a diagnosis, and works best with a full exam and imaging.
- Lasting hip or groin pain is worth an evaluation by a specialist.
Last updated: June 10, 2026
Medical Disclaimer: This information is for educational purposes only and should not replace professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider before making any decisions about your health or medical conditions.
Get a Clear Answer for Your Hip Pain
If hip or groin pain is slowing you down, you do not have to guess at the cause. As a board-certified orthopedic surgeon serving Franklin, Brentwood, Nashville, and the wider Middle Tennessee area, I can help you find the source and build a plan that fits your life. Request an appointment to get started.
About the Author
Cory Calendine, MD, is a board-certified orthopedic surgeon and joint replacement specialist at the Bone and Joint Institute of Tennessee in Franklin. He focuses on hip and knee care, including robotic-assisted joint replacement, for patients across Middle Tennessee.
