How is the Bowstring Sign test performed?

• A. After a positive SLR, flex the knee to the point where pain diminishes
• B. Patient prone, perform deep tissue massage on the hamstrings
• C. Patient seated, with legs dangling over the edge, lift both legs
• D. Lift both legs while the patient is supine

Answer: (A)

The Bowstring Sign test is assessed by evaluating the response following a straight leg raise (SLR) test. When performing this test, if the SLR results in pain, the examiner then flexes the knee to a point where the pain diminishes. This maneuver can help differentiate whether the source of pain is related to nerve root irritation, as the SLR places tension on the sciatic nerve and related structures. By flexing the knee and relieving the tension, you can observe whether the pain decreases, suggesting a positive Bowstring Sign that indicates potential nerve involvement or sensitivity within the spinal region.

The other options describe procedures that do not accurately align with the Bowstring Sign test's intended assessment of nerve root issues related to sciatic nerve tension, and therefore are not applicable for this specific test.