Why does pain diminish with external rotation in a positive Bonnet's Test?

• A. Because the hamstrings are stretched
• B. Because the piriformis is an external rotator
• C. Because the hip capsule is released
• D. Because the adductors are relaxed

Answer: (B)

In the context of Bonnet's Test, which is used to assess for issues associated with the sciatic nerve and its relationship to the piriformis muscle, the chosen answer highlights the role of the piriformis as an external rotator of the hip. When the leg is externally rotated, it alleviates the pressure or tension on the sciatic nerve, particularly when the nerve runs close to or under the piriformis muscle.

When the hip is externally rotated, the piriformis muscle may relax or elongate, potentially reducing any compression it places on the sciatic nerve. As a result, patients may experience diminished pain during this movement, indicating a positive response in the context of the test. The pain reduction suggests that the discomfort in the hip or down the leg may be related to the relationship between the piriformis and the sciatic nerve rather than other muscle groups like the hamstrings or adductors.

Understanding this relationship is critical in assessing hip and lower extremity pain, particularly in cases of sciatica or piriformis syndrome. The joints, ligaments, and other soft tissues play their roles, but the specific action of the piriformis as an external rotator is a key factor in the mechanics