Three finger test for hernia

Three Finger Test For Hernia

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Hernia is a condition where an organ or tissue structure pushes through a weak or defective muscle wall around it. It is more common in the abdominal or groin areas, where the muscle walls are more susceptible to weakening.

There are many tests, instrumental and manual, that can be done to diagnose a hernia. One such test is the three finger test. In this article, we will discuss the test in detail, understand how it is performed, and learn what types of hernias it helps diagnose.

What is three finger test for a hernia?

The three finger test, or Zieman’s Test, is a simple diagnostic procedure that your hernia doctor will perform to identify if you have hernias. This simple procedure doesn’t require any instruments and can be done by placing three fingers on your lower abdomen.

This procedure helps your doctor identify direct inguinal, indirect inguinal, and femoral hernias.

Procedure for three finger test

Your hernia doctor will place three fingers (index, middle, and ring fingers) of their hands on each side of your body (one side at a time).

The finger won’t be placed on any random spot in your body. Each finger has a purpose and will be placed on a spot where hernia is most prevalent.

Here are the spots where each of their fingers will be placed on your body.

  • The index finger will be placed on the deep inguinal ring.
  • The middle finger will be placed on the superficial inguinal ring (this ring is located about 2.5 cm above the pubic tubercle).
  • The ring finger will be placed over the saphenous opening (this opening is located about 4 cm below and lateral to the pubic tubercle).

Once these three fingers are placed on both sides of your body, you will be asked to cough or blow while holding your nose. If the doctor feels any impulse or bulge in any of these fingers, it indicates you have a hernia.


Uses of the three finger test

The three finger test can be used by professionals to identify different types of hernias. It is best used to identify the Inguinal Hernia and femoral hernias.

  • If the impulse is felt on the index finger, you have an indirect inguinal hernia.
  • If the impulse is felt on the middle finger, you have a direct inguinal hernia.
  • If the impulse is felt on the ring finger, you have a femoral hernia.

The impulse mentioned above is the bulging or moving sensation the doctor will feel when you cough. The sensations will be due to the gliding of the hernia sac walls or the viscus (organ) protrusion into the sac.

The three-finger test can also be done to examine the tone of the abdominal muscles. It can be done in two ways:

  • Raising the shoulders against resistance and
  • Lifting both legs straight off the bed.

These two activities will put pressure on your abdomen, allowing doctors to test for divarication of recti, a condition where the rectal abdominal muscles are no longer located next to each other.

Rules of hernia examination

If you visit your hernia Specialist for a hernia examination, ensure they do all these tests while performing the three finger test.

  • Both sides of the abdomen should be checked (left and right).
  • The urethra should be properly examined.
  • A per rectal examination should be done.
  • The examination should be performed in an appropriate manner and conditions.
  • The abdominal muscular tone should be checked.

What are the symptoms of Hernia?

Some common symptoms of hernia include

  • A visible bulge at the hernia site that enlarges when you cough or do some physical activity,
  • Pain and discomfort at the hernia site,
  • Nausea and vomiting (in case of incarceration or strangulation).
  • Difficulty with bowel movements.
  • Bloating and fever.


A three finger test is one of the best ways to identify inguinal and femoral hernias. It doesn’t require any instruments and can be done easily in minutes. So, there is no need to worry about pain during the procedure. Hernia is a common disease and there are different types of Hernias 

If you feel like you have a hernia or experience symptoms that might indicate a hernia, do not delay and visit a hernia surgeon immediately. Hernia can become a serious issue if left untreated for a long period. So, it is best to treat it as early as possible.

Dr. K. Amilthan MBBS., MS., FMAS., FALS.

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