[citation needed] If the patient is making an honest effort, the examiner should feel the "normal" limb's heel extending (pushing down) against his or her hand as the patient tries to flex (raise) the "weak" leg's hip.
If the examiner does not feel the "normal" leg's heel pushing down as the patient flexes the hip of the "weak" limb, then this suggests functional weakness (sometimes called "conversion disorder"), i.e. that effort is not being transmitted to either leg.
[citation needed] Alternatively, if a patient reports weakness of hip extension, and appears to have weakness upon direct testing of hip extension, Hoover's test can also be applied.
If an examiner places one hand behind the heel of the patient's weak leg and asks her or him to push against it, no movement will be felt.
[4] Efforts have been made to use the theory behind the sign to report a quantitative result.