The FABER test is one of the most commonly used physical examination maneuvers to help pinpoint the source of hip, groin, or low back pain. Whether you’re a patient trying to understand your doctor’s exam or a clinician wanting a concise refresher, this quick guide walks through what the FABER test is, what it can (and can’t) tell you, and how it fits into diagnosis and treatment of hip-related pain.
What Is the FABER Test?
FABER is an acronym for:
- Flexion
- ABduction
- ER (External Rotation)
It’s also called the Patrick’s test. The FABER test is a passive movement where the examiner positions your hip in a figure‑four posture to stress specific joints and soft tissues in and around the hip and pelvis.
Clinicians use it mainly to:
- Differentiate hip joint pathology from sacroiliac (SI) joint or lumbar spine problems
- Reproduce a patient’s characteristic pain in a controlled way
- Screen athletes and active individuals for hip or groin issues
How the FABER Test Is Performed
Understanding the step‑by‑step process helps you know what to expect during an exam.
- Starting position
- You lie on your back (supine) on an exam table.
- Leg placement
- The examiner bends your hip and knee on the side being tested.
- The ankle is placed just above the opposite knee, so your leg forms a figure‑four position (hip flexion, abduction, and external rotation).
- Stabilization
- One hand stabilizes the opposite pelvis (the anterior superior iliac spine, or ASIS).
- Downward pressure
- The examiner gently pushes the bent knee toward the table.
- Observation and feedback
- The clinician watches how far the knee drops compared to the opposite side.
- You’re asked if and where you feel pain or tightness.
The result is considered positive if:
- It reproduces your typical pain (in the groin, lateral hip, or buttock), and/or
- There is asymmetry compared to the other side (e.g., the knee stays higher off the table).
What a Positive FABER Test Can Indicate
A single test cannot provide a complete diagnosis, but the FABER test offers valuable clues based on where you feel pain.
1. Groin Pain: Intra‑Articular Hip Pathology
Pain deep in the groin during the FABER maneuver often points toward problems inside the hip joint, such as:
- Hip osteoarthritis
- Femoroacetabular impingement (FAI)
- Labral tear
- Synovitis or inflammatory arthropathy
- Loose bodies or cartilage injury
Intra‑articular issues frequently produce a deep, sharp, or aching groin pain, sometimes with catching or clicking sensations.
2. Lateral Hip Pain: Soft Tissue or Bursal Issues
Pain along the side of the hip (lateral pain) may suggest:
- Greater trochanteric pain syndrome
- Gluteus medius or minimus tendinopathy
- Trochanteric bursitis
- Iliotibial (IT) band tightness or friction
These conditions often worsen with lying on the affected side, climbing stairs, or prolonged walking.
3. Posterior Buttock or Low Back Pain: SI Joint or Lumbar Spine
If FABER reproduces pain in the buttock or low back rather than the groin, the likely sources include:
- Sacroiliac (SI) joint dysfunction or inflammation
- Referred pain from the lumbar spine (e.g., facet joint arthropathy)
- Posterior hip capsule or deep gluteal tension
In these cases, clinicians usually combine the FABER test with other SI joint or lumbar tests to refine the diagnosis.
Accuracy and Limitations of the FABER Test
The FABER test is a screening maneuver, not a stand‑alone diagnostic tool.
- Sensitivity and specificity vary widely across studies, depending on the condition and patient population.
- It’s particularly helpful as part of a cluster of tests for hip pathology and SI joint disorders.
- The test may be positive in multiple conditions—for example, an older adult with hip arthritis and a runner with a labral tear can both have a positive FABER.
A 2017 review noted that while the FABER test can indicate intra‑articular hip pathology or SI joint involvement, imaging and additional clinical tests are often needed to confirm the cause of pain (source: National Center for Biotechnology Information).
Because of these limitations, clinicians interpret the FABER test in the context of:
- History: onset, aggravating activities, previous injury
- Physical exam: range of motion, strength, gait, neurological signs
- Imaging: X‑ray, MRI, CT, or ultrasound if indicated
Other Tests Commonly Used With FABER
To refine diagnosis, providers often pair the FABER test with:
- FADIR test (Flexion, ADduction, Internal Rotation) – stresses the anterior hip, commonly positive in FAI and labral tears.
- Straight Leg Raise – screens for lumbar radiculopathy and nerve root irritation.
- SI Joint Provocation Tests – such as thigh thrust, Gaenslen’s, and compression tests.
- Ober’s Test – assesses IT band tightness and lateral hip structures.
No single maneuver is definitive; the pattern across multiple tests is what guides diagnosis.
What Happens After a Positive FABER Test?
If your FABER test is positive, the next steps typically include:
-
Detailed clinical history
- Onset, mechanism of injury, sports or job demands
- Night pain, stiffness, or instability
- Previous imaging or treatments
-
Full physical exam
- Active and passive range of motion in the hip
- Strength testing of hip flexors, extensors, abductors, rotators
- Gait analysis and functional tests (squats, single‑leg stance)
- Lumbar and SI joint screen
-
Imaging when indicated
- X‑ray: osteoarthritis, dysplasia, bony impingement patterns
- MRI: labral tears, cartilage damage, stress fractures, soft tissue injuries
- Ultrasound: bursitis or tendon pathology, often dynamic
- CT or CT‑arthrogram: complex bony morphology or pre‑surgical planning
-
Diagnostic injections (in some cases)
- Anesthetic injections into the hip joint or SI joint may help localize the primary pain source.
Conservative Treatment Options After a Positive FABER
Most hip and pelvic pain conditions identified through a FABER test can initially be managed without surgery.
1. Activity Modification
- Temporarily reduce or avoid motions that aggravate pain (deep squats, pivoting, long-distance running).
- Adjust sitting and sleeping positions to minimize stress on the hip.
- Cross‑train with low‑impact activities like swimming or cycling.
2. Physical Therapy
A targeted rehab program is often the cornerstone of treatment. It may include:
-
Strengthening
- Gluteus medius and maximus, hip external rotators, core stabilizers
- Focus on controlling hip position during walking, running, and squats
-
Mobility and flexibility
- Gentle stretching of hip flexors, adductors, and external rotators
- Joint mobilizations performed by a trained therapist
-
Neuromuscular training
- Balance, single‑leg control, and dynamic stability drills
- Gradual progression to sport‑specific movements
3. Medications and Modalities
- Over‑the‑counter NSAIDs (e.g., ibuprofen) or acetaminophen, if safe and recommended by your provider
- Heat for stiffness; ice or cold packs for acute flares
- Short‑term use of assistive devices (cane or crutch) if weight‑bearing is painful
4. Injections
For persistent or severe pain, your clinician may suggest:
- Corticosteroid injections into the hip joint or trochanteric bursa
- Platelet‑rich plasma (PRP) injections for some tendon or intra‑articular conditions (evidence is evolving)
These are typically combined with a solid rehab plan rather than used alone.
When Surgery May Be Considered
If symptoms continue despite several months of well‑supervised non‑operative care, or if structural abnormalities are clearly driving pain, surgery might be discussed.
Common procedures for hip problems associated with a positive FABER test include:
-
Hip arthroscopy
- Labral repair or debridement
- Removal of bone spurs causing impingement (FAI surgery)
-
Open hip preservation surgery
- For complex deformities such as severe dysplasia
-
Total hip replacement
- For advanced osteoarthritis or joint destruction, usually in older adults, but sometimes in younger patients with end‑stage disease
The choice is highly individual and depends on imaging findings, age, activity level, and goals.
How to Prepare for a FABER Test Exam Visit
If you know your provider will be evaluating hip pain, a bit of preparation can make the exam and FABER test more informative:
- Wear loose, comfortable clothing or athletic shorts.
- Be ready to describe your pain:
- Exact location (use one finger if possible)
- Timing (during vs. after activity, at rest, at night)
- Triggers (stairs, sitting, running, pivoting, lying on the side, etc.)
- Bring previous imaging reports or surgery notes, if applicable.
- Note what has helped or worsened your symptoms in the past.
Self-Management Tips While You Await Diagnosis
While waiting for an appointment or imaging results, you can often safely:
- Reduce or modify painful activities, rather than stopping all movement.
- Use short bouts of ice or heat based on what feels better.
- Perform comfortable, pain‑free range‑of‑motion exercises (avoid forcing stretches into pain).
- Maintain general fitness with low‑impact cardio that doesn’t aggravate symptoms.
Avoid “pushing through” sharp or deep joint pain, especially if it worsens with each session.
FABER Test FAQs
1. What does a positive FABER hip test really mean?
A positive FABER hip test means that the maneuver reproduced your characteristic pain or revealed a clear asymmetry compared to the other side. It does not identify a single condition on its own. Instead, it tells your clinician that something in or around the hip joint, SI joint, or lumbar region is likely involved and needs further assessment.
2. Can the FABER special test diagnose sacroiliac joint problems?
The FABER special test can suggest sacroiliac involvement when it produces posterior buttock pain rather than groin pain, especially when combined with other SI joint provocation tests. However, many structures around the pelvis can cause similar pain, so SI joint dysfunction is usually diagnosed using a combination of tests, history, and sometimes image‑guided injections.
3. Is the FABER test for hip pain always accurate?
No. The FABER test for hip pain is a helpful screening tool but not a perfectly accurate diagnostic test. Its accuracy depends on the underlying condition, the examiner’s skill, and how results are interpreted alongside other findings. That’s why most clinicians use FABER as one part of a broader evaluation rather than relying on it alone.
Take the Next Step Toward Lasting Hip Relief
If your hip, groin, or buttock pain is limiting daily life or keeping you from the activities you love, relying on guesswork or generic internet advice can delay recovery. A focused physical exam that includes the FABER test, combined with a thorough history and appropriate imaging, can quickly narrow down the real source of your symptoms and guide an effective, personalized treatment plan.
Don’t wait for pain to “just go away” if it’s been lingering for weeks or keeps coming back. Schedule an appointment with a qualified orthopedic specialist, sports medicine physician, or physical therapist who understands advanced hip assessment. With the right diagnosis and a targeted plan, you can move from uncertainty and frustration to clarity, confident treatment decisions, and a return to stronger, more comfortable movement.
