The Bragard Sign Test is a neurodynamic assessment used after a Straight Leg Raise. The examiner raises the leg until symptoms are reproduced, lowers it slightly below the symptom threshold, then dorsiflexes the ankle to assess whether familiar neural-type leg symptoms return. A positive finding may support suspicion of sciatic nerve or lumbosacral nerve-root mechanosensitivity when it matches the client’s history and neurological findings, but it does not diagnose lumbar radiculopathy, sciatica or disc herniation on its own.
Low-back-related leg pain can be difficult to interpret. Pain may travel into the posterior thigh, calf or foot, and symptoms may be influenced by lumbar nerve roots, sciatic nerve mechanosensitivity, hamstring sensitivity, hip symptoms or other factors.
The Bragard Sign Test, also called Bragard’s Test or Bragard’s Sign, is a neurodynamic test commonly used as a sensitising variation of the Straight Leg Raise. The key feature is adding ankle dorsiflexion after the leg is lowered slightly below the point of symptom reproduction.
The test can help explore whether a client’s familiar posterior leg symptoms are influenced by neural loading. It should not be used as a stand-alone diagnostic test.
The broader diagnostic literature around lumbar radiculopathy highlights that physical examination tests can help estimate probability, but they should be interpreted alongside history, neurological examination and symptom behaviour rather than used alone.
Test name: Bragard Sign Test
Also known as: Bragard’s Sign, Bragard Test, Braggard’s Test
Region: Lumbar spine, posterior thigh, sciatic nerve pathway
Test type: Neurodynamic / symptom provocation test
Common use: Low-back-related leg pain, suspected sciatic nerve mechanosensitivity, suspected lumbosacral radicular symptoms
Positive finding: Familiar neural-type leg symptoms return or increase when ankle dorsiflexion is added below the SLR symptom threshold
Negative finding: Ankle dorsiflexion does not reproduce familiar neural-type symptoms
Best used with: Straight Leg Raise, Slump Test, neurological screen, dermatomes, myotomes, reflexes, symptom history and lumbar movement findings
Key limitation: The test can support reasoning but does not confirm lumbar radiculopathy, sciatica or disc herniation
The Bragard Sign Test is a Straight Leg Raise variation that uses ankle dorsiflexion as a structural sensitiser.
A common sequence is:
The client lies supine.
The examiner performs a Straight Leg Raise.
The leg is raised until familiar symptoms or strong posterior tension occurs.
The leg is lowered slightly below the symptom threshold.
The examiner dorsiflexes the ankle.
The test is considered positive if familiar neural-type symptoms return or increase.
The purpose is to assess whether adding distal neural tension reproduces the client’s familiar symptoms after reducing the original Straight Leg Raise response.
This is different from simply recording hamstring tightness. The most relevant finding is reproduction of familiar leg symptoms, especially symptoms that travel beyond the posterior thigh or match the client’s usual complaint.
The Bragard Sign Test is used to help determine whether posterior leg symptoms may have a neural component.
It may help professionals:
explore low-back-related leg pain
compare hamstring stretch symptoms with neural-type symptoms
assess response to ankle dorsiflexion sensitisation
support reasoning around sciatic nerve mechanosensitivity
decide whether further neurological screening is needed
monitor symptom irritability over time
record reproducible findings in Measurz
It is most useful when combined with:
Straight Leg Raise
Slump Test
neurological screen
symptom distribution
lumbar movement testing
pain behaviour
dermatomes
myotomes
reflexes
function and activity tolerance
The Bragard Sign Test may assess:
neural mechanosensitivity
symptom response to sciatic nerve pathway loading
posterior leg symptom reproduction
response to ankle dorsiflexion
relationship between SLR symptoms and distal sensitisation
irritability of low-back-related leg symptoms
It may be associated with:
low-back-related leg pain
sciatic nerve mechanosensitivity
lumbosacral nerve-root irritation
suspected lumbar radicular symptoms
symptoms commonly described as sciatica
It does not directly assess or confirm:
lumbar disc herniation
nerve-root compression
exact spinal level
severity of neurological involvement
tissue damage
need for imaging
readiness to return to sport or work
The Bragard Sign Test may be useful for:
exercise professionals
strength and conditioning coaches
allied health support teams
movement assessment professionals
sport and performance staff
students learning neurodynamic assessment
professionals using Measurz or MAT for structured assessment recording
It may be relevant for clients with:
posterior thigh symptoms
calf or foot symptoms linked with back pain
suspected neural-type leg pain
symptoms provoked by SLR or Slump positions
low-back-related leg pain
leg symptoms affected by spinal position, sitting, bending or neural loading
Use within scope. If the client reports progressive neurological symptoms, severe weakness, saddle symptoms, bladder or bowel changes, unexplained severe pain or other red flags, further medical assessment is more appropriate.
Use the Bragard Sign Test when you want to understand whether ankle dorsiflexion changes familiar leg symptoms after Straight Leg Raise positioning.
It may be used during:
low-back-related leg pain assessment
neurodynamic assessment education
comparison with Straight Leg Raise
comparison with Slump Test
reassessment of neural symptom irritability
monitoring symptom response over time
It is most useful when symptoms include:
radiating posterior leg pain
posterior thigh, calf or foot symptoms
pins and needles or altered sensation
symptoms affected by sitting or bending
symptoms provoked by SLR or Slump-like positions
Use caution or avoid testing when the client reports:
severe or worsening neurological symptoms
progressive weakness
saddle anaesthesia
bladder or bowel changes
unexplained weight loss, fever or systemic symptoms
recent significant trauma
suspected fracture or serious pathology
severe pain at rest
highly irritable symptoms likely to flare with testing
Stop the test if:
symptoms become severe
symptoms spread unexpectedly
neurological symptoms increase
the client feels unsafe
the client asks to stop
the result would not change assessment reasoning
further medical review is more appropriate
No specialised equipment is usually required.
Useful resources include:
plinth or firm surface
pain rating scale
body chart
neurological screen record
Measurz recording workflow
optional goniometer or inclinometer for SLR angle
optional symptom irritability notes
Explain the test before starting.
Example wording:
“We are going to raise your leg like a Straight Leg Raise, then lower it slightly and move the ankle to see whether that reproduces your familiar leg symptoms. This test does not diagnose the cause on its own, but it helps us understand how your symptoms respond to neural loading.”
Position the client:
lying supine
head supported if needed
pelvis level
non-tested leg relaxed
tested leg relaxed before movement
arms resting comfortably
Stand beside the tested leg.
Ensure you can:
support the heel or ankle
keep the knee extended
control hip flexion
lower the leg slightly after symptom onset
dorsiflex the ankle smoothly
stop quickly if symptoms increase too much
A common setup:
one hand supports the heel or distal lower leg
the other hand stabilises above the knee if needed
keep the knee extended during the SLR phase
control the ankle when adding dorsiflexion
Avoid sudden ankle movement. The sensitising movement should be controlled and gradual.
Maintain:
controlled hip flexion
knee extension during the SLR phase
neutral pelvis where practical
relaxed upper body
consistent ankle position before sensitisation
no bouncing
clear communication throughout
Perform the test as follows:
Slowly raise the straight leg into hip flexion.
Ask the client to report when symptoms begin.
Identify whether the symptom is familiar.
Lower the leg slightly until symptoms reduce or ease.
Add ankle dorsiflexion.
Ask whether the familiar symptom returns or increases.
Record the response.
The movement components are:
passive hip flexion with knee extension
slight lowering below symptom threshold
ankle dorsiflexion as the sensitising movement
The ankle movement should be:
controlled
gradual
not forced
stopped if symptoms escalate sharply
Ask the client:
“Tell me when you first feel symptoms.”
“Where do you feel it?”
“Is it your familiar symptom?”
“Is it stretch, pain, tingling, numbness or something else?”
“Tell me if symptoms increase too much.”
When adding dorsiflexion, ask:
“Does this reproduce the same leg symptom?”
“Is it the same location as your usual symptoms?”
“Rate the symptom from 0 to 10.”
A positive Bragard Sign Test is usually:
reproduction or increase of the client’s familiar neural-type leg symptoms when ankle dorsiflexion is added after lowering below the SLR symptom threshold
Record whether symptoms are:
familiar or unfamiliar
local or radiating
pain, tingling, numbness, burning or pulling
posterior thigh only or below the knee
changed by lowering the leg
changed by ankle dorsiflexion
A negative Bragard Sign Test is usually:
no reproduction or increase of familiar neural-type symptoms when ankle dorsiflexion is added
The client may still feel:
calf stretch
hamstring stretch
local ankle or calf tension
non-familiar discomfort
These should not automatically be interpreted as a positive neural finding.
Stop if:
symptoms are severe
symptoms spread or worsen significantly
neurological symptoms increase
the client reports distress
the client cannot relax
the position is not tolerated
symptoms are unclear and repeated testing is not appropriate
The test should be performed slowly and respectfully.
Avoid repeated provocation of severe symptoms. In highly irritable presentations, a gentler neurodynamic assessment may be more appropriate, or testing may be deferred.
A positive Bragard Sign Test means ankle dorsiflexion reproduces or increases the client’s familiar neural-type leg symptoms after the leg has been lowered slightly below the Straight Leg Raise symptom threshold.
A positive result may increase suspicion of:
sciatic nerve mechanosensitivity
lumbosacral nerve-root involvement
low-back-related leg pain with neural features
radicular-type symptom behaviour
A positive result is more meaningful when it matches:
posterior leg pain distribution
symptoms below the knee
neurological findings
positive SLR or Slump Test
symptom change with spinal position
dermatomal or myotomal findings
reflex changes where relevant
history consistent with nerve-root irritation
A positive result does not confirm:
lumbar disc herniation
lumbar radiculopathy
nerve-root compression
sciatica diagnosis
exact spinal level
need for imaging
need for surgery
Other factors may contribute to symptoms, including:
calf muscle stretch
hamstring sensitivity
peripheral nerve sensitivity
local posterior thigh pain
hip-related symptoms
high irritability
fear or guarding
A negative Bragard Sign Test means ankle dorsiflexion does not reproduce or increase familiar neural-type symptoms.
A negative result may reduce suspicion of neural mechanosensitivity if:
SLR is also negative
Slump Test is also negative
neurological screen is normal
symptoms are not below the knee
lumbar movement does not reproduce leg symptoms
functional tasks do not reproduce neural-type symptoms
However, a negative result does not fully exclude:
lumbar radiculopathy
disc-related symptoms
intermittent nerve-root irritation
load-dependent leg symptoms
symptoms that only occur in sitting, bending, fatigue or higher loads
The Bragard Sign Test should be interpreted carefully. Evidence is stronger for related neurodynamic testing than for using Bragard as a stand-alone diagnosis.
A study of the Modified Bragard Test compared diagnostic accuracy with the Straight Leg Raise in people with clinical lumbosacral radiculopathy and electrodiagnostic evidence of L5 or S1 nerve-root compression. It reported that the Modified Bragard Test added diagnostic value in that selected population.
This evidence is useful but should be applied cautiously because:
it studied a modified Bragard version
the population had clinical radiculopathy features
electrodiagnosis was used as the reference standard
results may not apply to general back pain or non-specific posterior thigh symptoms
it does not mean the test confirms radiculopathy on its own
A 2020 diagnostic validity study of 864 participants with suspected lumbar or lumbosacral radiculopathy examined eight neurodynamic or orthopaedic tension tests using MRI as the reference standard. The study reported that Straight Leg Raise and Bragard performed in a multiple parallel way had high sensitivity of 97.40%, high negative predictive value of 96.64% and a negative likelihood ratio of 0.05. The authors concluded this combination had clinical validity to help discard lumbar or lumbosacral radiculopathy.
Important limitations:
this applies to SLR and Bragard used in parallel, not Bragard alone
MRI findings may not always match symptoms
the study population was selected for suspected radiculopathy
a high-sensitivity combination may be more useful for reducing suspicion when negative than for confirming a condition when positive
the result does not replace neurological examination or clinical reasoning
Straight Leg Raise is one of the most commonly used tests for low-back-related leg pain, but research shows variable diagnostic accuracy, with higher sensitivity and lower or heterogeneous specificity in many settings.
A 2021 study of an extended Straight Leg Raise using structural differentiation movements, including ankle dorsiflexion, reported sensitivity of 0.61 and specificity of 0.75 for lumbar disc herniation, and sensitivity of 0.60 and specificity of 0.67 for nerve-root compression when MRI was used as the reference standard.
For Bragard-style testing:
Condition or presentation: suspected lumbar or lumbosacral radiculopathy / low-back-related leg pain
Test variation: SLR followed by ankle dorsiflexion sensitisation; modified versions exist
Reference standards used in research: MRI or electrodiagnostic evidence, depending on study
Most useful role: supporting suspicion or reducing suspicion when combined with other findings
Best interpretation: cluster with SLR, Slump Test, neurological screen and history
Main limitation: not a stand-alone diagnostic test
Reliability evidence for the exact Bragard Sign Test is less developed than for the Straight Leg Raise and related neurodynamic tests.
The 2020 MRI-based diagnostic validity study examined multiple neurodynamic and orthopaedic tension tests, including Bragard, and reported that only limited tests performed independently showed external validity, while the SLR and Bragard combination in parallel performed better for ruling out radiculopathy.
A 2021 extended Straight Leg Raise study noted that adding structural differentiation movements such as ankle dorsiflexion was designed to help differentiate neural symptoms from musculoskeletal symptoms. It also reported that the extended SLR had previously shown almost perfect inter-rater reliability, although that evidence relates to an extended SLR protocol rather than traditional Bragard alone.
Reliability is stronger when you standardise:
SLR angle
point of symptom onset
amount the leg is lowered before dorsiflexion
ankle dorsiflexion range
speed of movement
symptom criteria
side tested first
pain rating method
whether symptoms must be familiar
whether symptoms travel below the knee
Validity is stronger when the test is interpreted with:
neurological screen
Straight Leg Raise
Slump Test
symptom distribution
reflexes
myotomes
dermatomes
lumbar movement findings
functional behaviour
Common errors include:
calling the test diagnostic on its own
adding ankle dorsiflexion too aggressively
not lowering the leg below the SLR symptom threshold
recording calf stretch as a positive test
failing to ask whether symptoms are familiar
not recording symptom location
not comparing with SLR or Slump findings
not screening neurological status
not recording SLR angle
moving too quickly
repeatedly provoking severe symptoms
ignoring red flags or progressive neurological symptoms
Limitations include:
diagnostic accuracy varies by population and reference standard
modified Bragard evidence may not apply to all Bragard protocols
positive findings may reflect non-neural structures
calf or hamstring stretch can confuse interpretation
symptom irritability can change results
findings may vary between examiners
a negative result does not exclude lumbar radiculopathy
the test does not identify the exact spinal level or structure
The Bragard Sign Test can support:
low-back-related leg pain assessment
neurodynamic assessment education
comparison between hamstring/calf stretch and neural symptoms
symptom irritability tracking
structured Measurz recording
clinical reasoning about whether further neurological assessment is needed
It may be useful in clients with:
posterior thigh symptoms
calf or foot symptoms
symptoms affected by sitting or bending
symptoms reproduced by Straight Leg Raise
suspected sciatic nerve mechanosensitivity
It is less useful when:
symptoms are local only
ankle dorsiflexion creates calf stretch only
symptoms are highly irritable
neurological red flags are present
the assessment question is return-to-sport clearance
Record:
test name: Bragard Sign Test
side tested: left or right
result: positive, negative, unclear or unable to test
Straight Leg Raise symptom onset angle
angle where leg was lowered before dorsiflexion
ankle position before sensitisation
ankle dorsiflexion response
pain score during SLR
pain score during ankle dorsiflexion
symptom location
symptom quality:
pain
burning
tingling
numbness
pulling
stretch
whether symptoms were familiar
whether symptoms travelled below the knee
comparison side
neurological findings:
dermatomes
myotomes
reflexes
neural symptoms
related tests:
Straight Leg Raise
Slump Test
Bowstring Sign
lumbar movement assessment
femoral nerve tension test if relevant
irritability
compensations or guarding
reason for stopping, if relevant
confidence in result
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 Bragard Sign Test is reproduction or increase of the client’s familiar neural-type leg symptoms when ankle dorsiflexion is added after lowering the leg slightly below the Straight Leg Raise symptom threshold.
No. Bragard is usually performed after the Straight Leg Raise by adding ankle dorsiflexion as a sensitising movement.
No. It may support suspicion of sciatic nerve or lumbosacral nerve-root mechanosensitivity, but it does not diagnose sciatica on its own.
A negative test means ankle dorsiflexion does not reproduce or increase familiar neural-type symptoms. This may reduce suspicion in some contexts, but it does not fully exclude radiculopathy or low-back-related leg pain.
Evidence exists for modified Bragard and for Bragard combined with Straight Leg Raise. One MRI-based study found SLR and Bragard used in parallel had high sensitivity and a low negative likelihood ratio for helping rule out lumbar or lumbosacral radiculopathy, but this does not mean Bragard alone confirms diagnosis.
Not by itself. The most meaningful positive finding is reproduction of the client’s familiar neural-type symptoms, especially symptoms matching their usual posterior thigh, calf or foot complaint.
It should be interpreted alongside Straight Leg Raise, Slump Test, neurological screen, symptom distribution, lumbar movement findings, pain behaviour and history.
The Bragard Sign Test is a neurodynamic test based on Straight Leg Raise plus ankle dorsiflexion.
A positive finding is reproduction or increase of familiar neural-type leg symptoms.
It may support suspicion of sciatic nerve or lumbosacral nerve-root mechanosensitivity.
It does not diagnose lumbar disc herniation, radiculopathy or sciatica on its own.
Diagnostic accuracy is stronger when interpreted as part of a test cluster.
Reliability depends on standardised SLR angle, lowering point, ankle dorsiflexion and symptom criteria.
Measurz should record side, SLR angle, dorsiflexion response, symptom quality, symptom location, neurological findings and related tests.
Cochrane. (2026). Physical examination for the diagnosis of lumbar radiculopathy due to disc herniation in patients with low-back pain and sciatica. https://www.cochrane.org/evidence/CD007431_physical-examination-diagnosis-lumbar-radiculopathy-due-disc-herniation-patients-low-back-pain-and
González Espinosa de los Monteros, F. J., Gonzalez-Medina, G., Garrido Ardila, E. M., Rodríguez Mansilla, J., Paz Expósito, J., & Oliva Ruiz, P. (2020). Use of neurodynamic or orthopedic tension tests for the diagnosis of lumbar and lumbosacral radiculopathies: Study of the diagnostic validity. International Journal of Environmental Research and Public Health, 17(19), 7046. https://doi.org/10.3390/ijerph17197046
Homayouni, K., Jafari, S. H., & Yari, H. (2018). Sensitivity and specificity of Modified Bragard Test in patients with lumbosacral radiculopathy using electrodiagnosis as a reference standard. Journal of Chiropractic Medicine, 17(1), 36–43. https://doi.org/10.1016/j.jcm.2017.10.004
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Scaia, V., Baxter, D., & Cook, C. (2012). The pain provocation-based straight leg raise test for diagnosis of lumbar disc herniation, lumbar radiculopathy, and/or sciatica: A systematic review of clinical utility. Journal of Back and Musculoskeletal Rehabilitation, 25(4), 215–223. https://doi.org/10.3233/BMR-2012-0333
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