The FADIR Test, also called the FADDIR Test or anterior hip impingement test, is a hip pain provocation test performed by moving the hip into flexion, adduction and internal rotation. A positive test occurs when the movement reproduces the client’s familiar anterior hip or groin symptoms. The test is commonly used when assessing suspected femoroacetabular impingement syndrome or intra-articular hip pain, but it has limited specificity and does not diagnose FAI, labral pathology or hip joint pathology on its own.
Hip and groin pain can come from several overlapping sources, including the hip joint, adductors, iliopsoas, pubic region, lumbar spine, sacroiliac region, femoral neck stress injury, abdominal or inguinal region and surrounding soft tissues.
The FADIR Test is one of the most common clinical tests used in hip and groin assessment. FADIR stands for:
Flexion
Adduction
Internal Rotation
It is also called:
FADDIR Test
Anterior Impingement Test
Hip Impingement Test
The test is often used when femoroacetabular impingement syndrome, labral-related symptoms or intra-articular hip pain are being considered. However, the Warwick Agreement states that femoroacetabular impingement syndrome requires a combination of symptoms, clinical signs and imaging findings. A positive FADIR Test alone is not enough to diagnose FAI syndrome.
Test name: FADIR Test
Also known as: FADDIR Test, anterior impingement test
Region: Hip and groin
Test type: Pain provocation test
Client position: Supine
Movement: Hip flexion, adduction and internal rotation
Positive finding: Reproduction of familiar anterior hip or groin symptoms
Negative finding: No familiar symptoms reproduced
Common clinical use: Suspected FAI syndrome, intra-articular hip pain, labral-related symptoms
Key limitation: High sensitivity but generally low specificity, so it may be more useful for screening than confirming a diagnosis
The FADIR Test is a passive hip test where the examiner moves the hip into a combined position of flexion, adduction and internal rotation.
This position can increase contact or compression around the anterior hip joint region and may reproduce symptoms in clients with hip-related pain.
A positive result is usually reproduction of the client’s familiar:
anterior hip pain
deep groin pain
C-sign hip pain
pinching sensation
catching or sharp groin symptoms
The test can support assessment reasoning, but it should not be treated as a diagnosis. FAI morphology is common in asymptomatic people, and FAI syndrome requires symptoms, clinical signs and imaging findings rather than clinical signs alone.
The FADIR Test is used because many hip joint-related presentations are provoked by combined hip flexion and rotation.
It may help professionals:
reproduce familiar anterior hip or groin symptoms
identify whether hip joint loading positions are symptom provoking
compare left and right hip responses
assess symptom irritability
guide whether further hip assessment is needed
decide whether imaging or referral may be appropriate in context
monitor change over time
record findings consistently in Measurz
It is most useful when combined with:
history and symptom location
hip internal and external rotation range of motion
hip flexion range
FABER, hip quadrant or other hip tests
adductor and iliopsoas assessment
lumbar and pelvic screening
strength testing
sport or activity exposure
imaging findings where clinically indicated
The FADIR Test may assess symptom provocation related to:
anterior hip joint loading
femoroacetabular impingement-type positions
labral or chondral sensitivity
intra-articular hip irritability
hip flexion-adduction-internal rotation tolerance
hip and groin symptom behaviour
It may be associated with:
femoroacetabular impingement syndrome
labral-related hip symptoms
intra-articular hip pain
hip-related groin pain
anterior hip impingement-type symptoms
It does not directly assess or confirm:
cam morphology
pincer morphology
labral tear
cartilage injury
hip osteoarthritis severity
hip dysplasia
femoral neck stress injury
exact source of pain
readiness to return to sport
The FADIR Test may be useful for:
exercise professionals
allied health support teams
strength and conditioning coaches
sport and performance staff
movement assessment professionals
students learning hip assessment
professionals using Measurz or MAT for structured assessment recording
It may be relevant for clients with:
anterior hip pain
deep groin pain
hip pinching
hip pain with squatting
hip pain with sitting
hip pain during cutting, kicking or pivoting
symptoms during deep hip flexion
suspected hip joint-related symptoms
reduced hip internal rotation
C-sign hip pain description
It should be interpreted cautiously in clients with broad groin pain because multiple structures can be provoked in similar positions.
Use the FADIR Test when you want to assess whether combined hip flexion, adduction and internal rotation reproduces the client’s familiar symptoms.
It may be used during:
hip and groin assessment
anterior hip pain assessment
sport-related hip pain review
intra-articular hip symptom screening
FAI syndrome clinical reasoning
reassessment after rehabilitation or training modification
comparison with other hip provocation tests
It may be especially useful when the client reports pain during:
deep squatting
prolonged sitting
getting in or out of a car
cutting or pivoting
kicking
skating or stride positions
hip flexion with rotation
gym movements involving deep hip flexion
Use caution when the client has:
acute traumatic hip injury
suspected fracture
suspected femoral neck stress injury
severe unexplained groin pain
recent hip surgery without appropriate clearance
marked irritability with passive movement
neurological symptoms
systemic symptoms
inability to lie supine comfortably
pain that escalates sharply during testing
Stop the test if:
pain is severe
symptoms are unfamiliar or concerning
the client guards strongly
the client asks to stop
the test position cannot be reached safely
further medical review is more appropriate
The test should not be used as a stand-alone decision tool for diagnosis, imaging, treatment selection or return-to-sport clearance.
No specialised equipment is usually required.
Useful resources include:
plinth or firm surface
pain rating scale
body chart
goniometer or inclinometer if measuring hip range
Measurz recording workflow
optional video notes for movement-related symptoms
Explain the test before starting.
Example wording:
“We are going to move your hip into a flexed, crossed-in and rotated position to see whether it reproduces your familiar hip or groin symptoms. This test does not diagnose a condition on its own, but it helps us understand how your hip responds to this position.”
Position the client:
lying supine
pelvis level
non-tested leg relaxed
tested hip and knee relaxed
arms resting comfortably
spine comfortable
Stand on the side of the tested hip.
You need to be able to:
support the knee and lower leg
control hip flexion
move the hip into adduction
apply internal rotation gradually
monitor the client’s symptoms
stop quickly if needed
A common setup:
one hand supports the knee or distal thigh
the other hand supports the ankle or lower leg
the hip is brought to approximately 90 degrees of flexion
the hip is moved into adduction
the hip is internally rotated
Avoid forcing through pain or using fast end-range pressure.
Move the tested hip into:
Flexion: bring the knee toward the chest
Adduction: move the thigh across the midline
Internal rotation: move the lower leg outward while controlling the femur
The movement should be:
passive
slow
controlled
symptom-guided
compared with the other side where appropriate
Ask the client:
“Tell me if you feel pain.”
“Where do you feel it?”
“Is that your familiar symptom?”
“Is it pinching, stretch, pressure, catching or sharp pain?”
“Rate the symptom from 0 to 10.”
“Tell me if it becomes too uncomfortable.”
A positive FADIR Test is usually:
reproduction of the client’s familiar anterior hip or groin symptoms during flexion, adduction and internal rotation
Record whether symptoms are:
familiar or unfamiliar
anterior, lateral, posterior or deep groin
pinching, sharp, catching, aching or pressure
mild, moderate or severe
associated with apprehension or guarding
A negative FADIR Test is usually:
no reproduction of familiar hip or groin symptoms during the test
A client may still feel:
stretch
pressure
non-familiar discomfort
limited movement without pain
These should not automatically be interpreted as positive findings.
Stop the test if:
pain becomes sharp or severe
symptoms feel unsafe or unfamiliar
guarding prevents accurate testing
the client cannot relax
the movement is not tolerated
the client asks to stop
The FADIR Test should be performed carefully because it can be provocative. Avoid repeated end-range provocation in irritable hip presentations.
For highly irritable clients, record available range and symptom response rather than forcing the end position.
A positive FADIR Test means the test position reproduces the client’s familiar hip or groin symptoms.
A positive result may increase suspicion of hip joint-related pain when it is combined with:
anterior hip or deep groin pain
C-sign symptom description
limited hip internal rotation
pain during deep flexion activities
positive related hip provocation tests
imaging findings when clinically indicated
relevant sport or activity history
A positive result does not confirm:
FAI syndrome
labral tear
cartilage injury
cam or pincer morphology
hip osteoarthritis
need for surgery
need for imaging
return-to-sport readiness
The Warwick Agreement is clear that FAI syndrome is diagnosed using the triad of symptoms, clinical signs and imaging findings, not a single clinical test.
A negative FADIR Test means the test does not reproduce familiar hip or groin symptoms.
A negative result may reduce suspicion of hip joint-related provocation if:
the test reaches relevant range
other hip provocation tests are also negative
hip range of motion is not limited
functional hip flexion and rotation are tolerated
history is not suggestive of hip joint-related pain
However, a negative test does not fully exclude:
labral pathology
FAI morphology
intra-articular hip symptoms
load-dependent hip pain
symptoms that only occur at speed, fatigue or higher loads
other sources of groin pain
The FADIR Test is generally considered more useful for screening than for confirming diagnosis because it often has higher sensitivity and lower specificity.
A 2015 systematic review with meta-analysis on hip clinical tests reported that impingement tests, including FADIR-type tests, generally show high sensitivity but limited specificity for FAI/labral tear presentations.
A review specifically focused on FADIR for FAI reported that the test’s diagnostic usefulness remained unclear because of substantial variability between studies. One included study reported sensitivity of 0.75 and specificity of 0.43 compared with magnetic resonance arthrography for labral lesions.
A clinical test review summary reported pooled sensitivity as high as 99% with very low specificity around 5% in some evidence syntheses, suggesting the test may be useful for exclusion screening when negative, but poor for confirming FAI when positive.
A 2020 systematic review on clinical tests for cam or pincer morphology found that available clinical tests had limited ability to confirm cam or pincer morphology on their own. This is important because morphology can be present without symptoms and does not equal FAI syndrome by itself.
A 2025 systematic review of physical examination tests for prearthritic intra-articular hip pathology reported wide variability in test performance. For FAI, it reported that the Internal Rotation Over Pressure test showed the highest sensitivity at 91%, while the FADIR test showed the highest specificity at 47% in the included comparisons.
For FADIR:
Condition or presentation: suspected FAI syndrome, labral pathology or intra-articular hip pain
Population: mostly symptomatic hip/groin pain or specialist hip cohorts
Reference standards: variable, including imaging and surgical findings in some studies
Sensitivity: often moderate to high, but variable
Specificity: generally low to modest
Best use: screening and symptom provocation
Main limitation: positive findings are not specific to one diagnosis
A positive FADIR Test is common in several hip and groin presentations. It should increase attention to hip-related symptoms, but it should not be used to confirm FAI, labral tear or intra-articular pathology.
A negative FADIR Test may reduce suspicion of some hip joint-related presentations, especially when combined with negative related tests and a non-suggestive history.
Reliability depends on standardised positioning and clear symptom criteria.
A study on quantification and reliability of hip internal rotation and the FADIR Test in supine position used a smartphone application and investigated intrarater and interrater reliability for hip internal rotation range and FADIR positioning. This highlights the importance of standardising hip and knee position when using FADIR as a repeatable clinical measure.
Validity is strongest when the FADIR Test is interpreted in relation to:
symptoms
clinical signs
imaging where appropriate
hip range of motion
functional movements
sport or activity demands
The Warwick Agreement supports this broader approach by defining FAI syndrome through symptoms, clinical signs and imaging findings together.
Reliability is stronger when you standardise:
client position
hip flexion angle
amount of adduction
internal rotation force
speed of movement
symptom wording
criteria for positive test
pain score recording
side tested first
retest conditions
Common errors include:
calling FADIR diagnostic by itself
recording any stretch as positive
not asking whether symptoms are familiar
applying excessive end-range force
not recording symptom location
not comparing with the other side
ignoring hip range of motion
ignoring lumbar, adductor or iliopsoas contributors
using the test as return-to-sport clearance
over-interpreting a positive result without imaging or broader findings
Limitations include:
low specificity
multiple hip and groin conditions can provoke symptoms
asymptomatic FAI morphology is common
test force and range vary between examiners
symptoms may be influenced by irritability or guarding
imaging findings do not always equal symptoms
a negative result does not rule out all hip pathology
a positive result does not confirm a labral tear or FAI syndrome
The FADIR Test can support:
hip and groin assessment
symptom provocation mapping
intra-articular hip pain reasoning
FAI syndrome clinical reasoning
comparison with other hip tests
activity modification planning
reassessment after rehabilitation
Measurz documentation
It may help guide discussions around:
squat depth
sitting tolerance
kicking or cutting exposure
hip rotation demands
return to gym positions
running or sport exposure
whether further assessment is needed
For athletes, FADIR can be useful when interpreted alongside sport-specific tasks such as:
sprinting
change of direction
kicking
skating
deep squatting
loaded hip flexion
pivoting or rotation
Record:
test name: FADIR Test / FADDIR Test / Anterior Impingement Test
side tested: left or right
result: positive, negative, unclear or unable to test
hip flexion angle if measured
adduction position
internal rotation range or end position
pain score
symptom location:
anterior hip
deep groin
lateral hip
posterior hip
thigh
other
symptom quality:
pinch
sharp
catch
ache
pressure
stretch
whether symptoms are familiar
whether symptoms match the client’s main complaint
range limitation
guarding
side-to-side comparison
related findings:
hip internal rotation ROM
hip external rotation ROM
FABER
hip quadrant
McCarthy Test
adductor squeeze
lumbar screen
sport or activity aggravators
imaging findings if available
interpretation notes
retest date
referral or further assessment notes if appropriate
Recording these details improves:
repeatability
communication
client education
assessment reasoning
monitoring over time
team consistency
reporting quality
A positive FADIR Test is reproduction of the client’s familiar hip or groin symptoms during hip flexion, adduction and internal rotation.
It assesses whether a combined hip flexion, adduction and internal rotation position reproduces symptoms. It is commonly used when hip joint-related pain, FAI syndrome or labral-related symptoms are being considered.
No. FAI syndrome requires symptoms, clinical signs and imaging findings. A positive FADIR Test alone does not diagnose FAI.
Because FADIR often has higher sensitivity than specificity, a negative result may help reduce suspicion in some contexts, especially when other findings are also negative. It does not rule out all hip pathology.
The position can provoke symptoms from multiple hip and groin presentations, not just FAI or labral pathology.
The most meaningful positive finding is reproduction of the client’s familiar anterior hip or groin symptom. Non-familiar stretch or pressure should not automatically be recorded as positive.
It can support assessment reasoning, but it should not be the only measure. Return-to-sport decisions should also consider strength, range of motion, symptoms, workload, sport-specific testing, confidence and professional judgement.
The FADIR Test is a hip pain provocation test using flexion, adduction and internal rotation.
A positive finding is reproduction of familiar anterior hip or groin symptoms.
It is commonly used when considering FAI syndrome or intra-articular hip pain.
FADIR generally has higher sensitivity and lower specificity, so it is not a strong stand-alone confirmatory test.
FAI syndrome requires symptoms, clinical signs and imaging findings.
A positive FADIR does not confirm FAI, labral tear or cartilage pathology.
Measurz should record side, symptom location, pain score, familiar symptom response, range, guarding, related tests and interpretation notes.
Caliesch, R., Sattelmayer, M., Reichenbach, S., Zwahlen, M., & Hilfiker, R. (2020). Diagnostic accuracy of clinical tests for cam or pincer morphology in individuals with suspected FAI syndrome: A systematic review. BMJ Open Sport & Exercise Medicine, 6, e000772. https://doi.org/10.1136/bmjsem-2020-000772
Keeney, J. A., Peelle, M. W., Jackson, J., Rubin, D., Maloney, W. J., & Clohisy, J. C. (2004). Magnetic resonance arthrography versus arthroscopy in the evaluation of articular hip pathology. Clinical Orthopaedics and Related Research, 429, 163–169.
Reiman, M. P., Goode, A. P., Cook, C. E., Hölmich, P., & Thorborg, K. (2015). Diagnostic accuracy of clinical tests for the diagnosis of hip femoroacetabular impingement/labral tear: A systematic review with meta-analysis. British Journal of Sports Medicine, 49(12), 811. https://doi.org/10.1136/bjsports-2014-094302
Shanmugaraj, A., et al. (2019). How useful is the flexion-adduction-internal rotation test for diagnosing femoroacetabular impingement: A systematic review. Clinical Journal of Sport Medicine, 29(1), 76–82.
St-Pierre, M.-O., et al. (2020). Quantification and reliability of hip internal rotation and the FADIR test in supine position using a smartphone application. Journal of Manipulative and Physiological Therapeutics, 43(1), 68–75.
Tijssen, M., van Cingel, R., Willemsen, L., & de Visser, E. (2012). Diagnostics of femoroacetabular impingement and labral pathology of the hip: A systematic review of the accuracy and validity of physical tests. Arthroscopy, 28(6), 860–871. https://doi.org/10.1016/j.arthro.2011.12.004
Wörner, T., et al. (2021). Combining results from hip impingement and range of motion tests can increase diagnostic accuracy in patients with FAI syndrome. Knee Surgery, Sports Traumatology, Arthroscopy, 29, 3382–3392.
Youngman, T. R., et al. (2025). Sensitivity and specificity for physical examination tests in diagnosing prearthritic intra-articular hip pathology. Arthroscopy, Sports Medicine, and Rehabilitation. https://doi.org/10.1016/j.asmr.2025.101117
Griffin, D. R., Dickenson, E. J., O’Donnell, J., Agricola, R., Awan, T., Beck, M., Clohisy, J. C., Dijkstra, H. P., Falvey, E., Gimpel, M., Hinman, R. S., Hölmich, P., Kassarjian, A., Martin, H. D., Martin, R., Mather, R. C., Philippon, M. J., Reiman, M. P., Takla, A., Thorborg, K., Walker, S., Weir, A., & Bennell, K. L. (2016). The Warwick Agreement on femoroacetabular impingement syndrome: An international consensus statement. British Journal of Sports Medicine, 50(19), 1169–1176. https://doi.org/10.1136/bjsports-2016-096743
