The Hip Extension Test measures how far the thigh moves behind the body. It is useful for assessing hip mobility, comparing sides, monitoring symptoms and tracking progress over time.
Hip extension range of motion is relevant to walking, running, sprinting, lunging, bridging, climbing stairs and many athletic movements. When hip extension is limited in a test position, the body may use lumbar extension, pelvic rotation or stride changes to complete a task.
A hip extension score should not be interpreted on its own. It is best used alongside symptoms, pelvic control, hip flexor flexibility, glute strength, gait or running findings, and the client’s baseline.
Measures hip movement behind the body.
Usually assessed in prone, side lying or modified Thomas-style positions.
Can be active or passive.
Pelvic and lumbar control are essential.
Record degrees, side, pain, symptoms and compensation.
The Hip Extension Test measures sagittal-plane hip extension. It can be assessed actively, where the client lifts or moves the thigh themselves, or passively, where the professional guides the limb into extension.
Prone testing is common because it allows the hip to move behind the body while the pelvis can be observed closely.
Hip extension testing is used to:
establish baseline hip mobility
compare left and right sides
monitor progress across sessions
observe lumbar or pelvic compensation
guide exercise range selection
provide context for running, walking, lunging and bridging
track symptom response with extension
The test measures hip extension ROM in degrees. It may be influenced by:
hip flexor and anterior hip tolerance
pelvic tilt
lumbar extension
glute strength and control
pain, apprehension or guarding
previous injury or surgery
warm-up and testing position
measurement tool and examiner technique
This test is useful for:
runners and field athletes
clients returning to sprinting or lunging
gym clients working on hip mobility
older adults where stride length and walking mechanics matter
post-injury monitoring when appropriate
professionals tracking hip ROM alongside strength and function
Firm plinth or mat
Inclinometer, goniometer or digital ROM tool
Pain scale
Measurz recording profile
Optional strap or towel for pelvic control
Position the client. Place the client prone with both legs relaxed and the pelvis level.
Set the pelvis. Monitor the pelvis and lumbar spine. The goal is hip extension, not lumbar arching.
Active ROM. Ask the client to keep the knee relaxed and lift the thigh slightly from the table without twisting the pelvis.
Passive ROM. If appropriate, gently guide the thigh into extension while keeping the pelvis stable.
Device placement. With a goniometer, align the axis near the greater trochanter, using the trunk and femur as reference lines. With an inclinometer, record exact placement and orientation.
End point. Stop at the first firm end point, symptom limit or loss of pelvic control.
Ask what the client feels. Record pain, stretch, anterior hip pressure, lumbar discomfort or apprehension.
Watch for compensation. Note lumbar extension, pelvic rotation, hip abduction, knee flexion change or trunk movement.
Trials. Use one familiarisation trial and one to three recorded trials.
Retest consistency. Use the same position, warm-up, device, side order and scoring convention.
Record hip extension in degrees. Higher values generally represent greater available hip extension in the test position. Lower values show less available range but do not explain the cause on their own.
Interpret with:
active versus passive ROM
side-to-side comparison
pain score
anterior hip or lumbar symptoms
pelvic control
hip flexor length context
glute strength findings
gait, running or lunge observations
baseline change
A small change between sessions may reflect measurement error unless the setup is consistent and the change is repeated.
Evidence level: Level 2 — closest available reference values.
General hip extension reference values are often reported around 10–15 degrees, but values vary by protocol, position, age, sex, activity level and whether pelvic movement is controlled. CDC joint ROM reference data support the broader point that ROM values vary by demographic group and should not be treated as a single universal normal value.
Because prone hip extension is highly affected by pelvic and lumbar compensation, practical interpretation should prioritise:
baseline score
left versus right difference
active versus passive range
pain and symptom response
pelvic control
relevance to walking, running, sprinting or lunging goals
Hip ROM reliability depends on standardised positioning, examiner consistency and measurement tool. A 2020 PLOS ONE reliability study found that reliability differs across ROM tests and devices, reinforcing the need to use the same method when tracking progress.
A 2022 study of smartphone goniometers for hip ROM reported high intra-rater reliability but lower inter-rater reliability, which means the same professional repeating the same standardised method may produce more consistent results than comparing between different testers.
No high-quality published MDC or MCID was found for this exact prone hip extension protocol across all populations. Small changes should be interpreted cautiously unless they are consistent, meaningful and aligned with symptoms or function.
Sensitivity and specificity are not usually applicable to hip extension ROM testing because it measures movement range rather than identifying a condition on its own.
allowing lumbar extension to inflate the result
poor pelvic stabilisation
inconsistent knee position
measuring hip abduction instead of pure extension
forcing passive range
ignoring anterior hip or lumbar symptoms
comparing prone and standing measurements directly
assuming all clients need the same hip extension value
Hip extension ROM can help with:
baseline mobility testing
running and gait context
lunge, bridge and hip thrust programming
monitoring anterior hip symptoms
comparing sides
tracking progress after mobility or strength work
identifying whether related hip flexor, strength or functional testing may add useful context
Record:
test name: Hip Extension ROM
side tested
active or passive ROM
score in degrees
client position
device used
pain score
symptom location
pelvic or lumbar compensation
comparison side
baseline score
trial number or best trial
related hip flexor, glute strength or functional findings
retest date
Example: “Right hip extension PROM 12°, prone, inclinometer, pain 0/10, mild lumbar extension near end range. Left 16°. Retest in four weeks.”
Hip Flexion Test
Hip Modified Thomas Test
Hip Abduction Test
Hip Adduction Test
Prone Hip Internal Rotation Test
Prone Hip External Rotation Test
What is normal hip extension ROM?
General references often report about 10–15 degrees, but values vary by protocol, age, activity level and pelvic control.
Why is pelvic control important?
If the pelvis tilts or the lumbar spine extends, the score may look better without reflecting true hip extension.
Should hip extension be measured actively or passively?
Both can be useful. Active ROM shows what the client can control, while passive ROM shows available range with assistance.
What does reduced hip extension mean?
It shows less available extension in that test position. It does not explain the cause without other findings.
Hip extension testing requires strict pelvic control.
Record active and passive ROM separately.
Compare sides, baseline and symptoms.
Do not treat one reference value as universal.
Centers for Disease Control and Prevention. (2023). Normal joint range of motion study. https://archive.cdc.gov/www_cdc_gov/ncbddd/jointrom/index.html
Charlton, P. C., et al. (2022). Clinical reliability and usability of smartphone goniometers for hip range of motion measurement. Journal of Physical Therapy Science, 34(6), 424–431. PMID: 35698549
Fraeulin, L., et al. (2020). Intra- and inter-rater reliability of joint range of motion tests using tape measure, digital inclinometer and inertial motion capturing. PLOS ONE, 15(12), e0243646. https://doi.org/10.1371/journal.pone.0243646
