Resisted Cross-Body Sit-Up Test | Core Muscle Injury Assessment

In another post, we discuss the Doha agreement on groin pain in athletes, which classified groin pain into 4 entities: adductor-related, iliopsoas-related, inguinal-related, and pubic-related groin pain. Core muscle injuries or CMIs aka. Athletic pubalgia which is traditionally known as a “sports hernia” would fall within the fourth entity – the pubic-related groin pain. They are characterized by abdominal wall weakening or tearing with no abdominal hernia and concomitant injury to the insertion of the adductor longus and rectus abdominis muscle on the pubis.

Kurowicki et al. (2020) proposed 3 tests to assess for CMIs in their diagnostic cohort study. As a stand-alone test, the resisted cross-body sit-up test had a sensitivity of 100% and low specificity of only 3% and thus has a moderate clinical value in the diagnosis of CMIs due to the rate of false positive tests and should be used in a cluster.

To conduct the test, the patient is in supine lying position. The examiner stands on the affected side and places the leg of the affected side into a figure four position.

Then one hand is placed on the patient’s contralateral shoulder, as well as the patient’s knee.

The patient is then instructed to bring the contralateral shoulder to the knee on the affected side against the examiner’s resistance so as to perform a cross-body sit-up.

Pubic or groin pain indicates a positive test.

Groin pain requires accurate differential diagnosis as other possible root causes such as femoroacetabular impingement syndrome, referred pain from the lumbar spine, or SI joint share similar symptoms. You can find out more about valid assessments for these regions on our channel as well. Again, special testing has limited value and should be integrated into a consistent history as well as positive diagnostic ultrasound findings.

Other common orthopedic tests that aim to provoke abdominal area are:

• Straight Leg Sit-Up Test
• External Rotation Stinchfield Test

21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE

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References

Kurowicki, J., Kraeutler, M. J., Dávila Castrodad, I. M., Hahn, A. K., Simone, E. S., Kelly, M. A., … & Scillia, A. J. (2020). Diagnostic accuracy of physical examination tests in core muscle injury. The American Journal of Sports Medicine, 48(8), 1983-1988.