Muscle Length Test

Question 1

Upper Trapezius

Answer 1

Muscle Action: Shoulder girdle elevation, cervical spine extension, ipsilateral cervical spine lateral flexion and contralateral axial rotation.

Patient’s Position: Supine with arms by the sides and elbows flexed, rested against lateral wall of abdomen and hands gently rested on abdomen (Glenohumeral joint in slight internal rotation)

Test: Move the patient’s head into cervical flexion, contralateral lateral flexion and ipsilateral rotation with cradling hand, and then depresses the ipsilateral shoulder with the other hand.

Measurement by tape measure

• Distance between mastoid and acromion.
• Compare the distance at start of the test and distance after the therapist has moved the head into lengthened position.
• CAN ASK EXAMINER TO HELP YOU MEASURE.

Question 2

Hip Flexors: Thomas Test

Answer 2

Muscle Involved in hip flexion: Psoas Major (Iliopsoas), Iliacus, Rectus Femoris, Sartorius, Tensor Fascia Lata, Pectineus

Patient’s Position: Get patient to stand at the end of the plinth, adjust plinth height to slightly below the hip. Get patient to flex at hip and knee and assist patient to get into a supine position by supporting the back. Get patient to hold on to the thighs.

Ensure that the back is flat and pelvis is not in excessive posterior tilt (>10degrees). Allow knee to be flexed

Results:
• Hip (when in extension) moves into lateral rotation and abduction: Indicates tight sartorius
• Hip (when in extension) moves into medial rotation and adduction: Indicates tight TFL. Proceed to conduct Ober Test
• Hip (when in extension) moves into adduction: Indicated tight pectineus, adductor longus/brevis
• Thigh unable to lie flat on plinth: Indicates tight iliopsoas or rectus femoris.
• Thigh is unable to lie flat on plinth with knee extended: Indicates tight iliopsoas, anterior capsule, iliofemoral ligament and ischiofemoral ligament
• Thigh is able to lie flat with knees extended: Indicates tight rectus femoris

Goniometry
• Axis: Greater Trochanter
• Proximal Arm: Midline of lateral pelvis
• Distal Arm: Midline of lateral femur, aligned to lateral epicondyle

Question 3

Hamstrings Muscles (Proximal Length) – Straight leg raising test

Answer 3

Muscles Involved: Semimembranosus, Semitendinosus and Biceps Femoris Long head helps extend the hip and flex the knee

Patient’s Position: Supine, both knees extended, hips in neutral. Remove clothing to allow pelvis and lumbar spine to be observed.

Place one hand on the pelvis for stabilisation, the other guide the leg at the ankle

Test: Passively flex the hip by lifting the lower extremity off the plinth, keeping the knee in full extension. Stop the movement until you feel muscle tension/ resistance and further movement causes knee flexion, posterior pelvic tilt or lumbar flexion

Goniometry
• Axis: Greater Trochanter
• Proximal Arm: Lateral Midline of Pelvis
• Distal Arm: Lateral Midline of femur aligned to lateral epicondyle
• Normal ROM: 70 to 80 degrees
• CAN GET EXAMINER TO HELP YOU MEASURE

Question 4

Tensor Fascia Lata and Iliotibial Band – Ober Test

Answer 4

Muscle Action: Abducts, flexes and medially rotates the hip and extends the knee

Patient’s Position: Side-lying, get the patient to lie as close the edge of the plinth as possible. Both knees flexed at 90 degrees.

Place one hand on the iliac crest to stabilize the pelvis
Test: Cradles the knee, flex the hip and knee into 90degrees, abduct and extend the hip to place the TFL over the greater trochanter and lower the leg into hip adduction.
Ensure that the pelvis do not laterally tilt or hip flex. Maintain knee flexion to prevent hip medial rotation.

Goniometry
• Axis: ASIS
• Proximal Arm: Imaginary line joining both ASIS
• Distal Arm: Anterior Midline of femur, aligned to centre of patella
• Normal ROM: thigh drops slightly below horizontal (10 degrees of hip adduction)

Question 5

Rectus Femoris

Answer 5

Muscle Action: Flexes the hip and extends the knee
Patient’s Position: Prone with both feet off the plinth, knee extended and hip neutral

Place one hand on the pelvis to stabilise it and preventing in from anterior tilt.

Test: Flex the knee until resistance is felt from tension in the anterior thigh and further knee flexion causes the hip to flex. Instruct the patient to hold in that position while you measure.

Goniometry
• Axis: Lateral Epicondyle of femur
• Proximal Arm: Lateral midline of femur aligned to greater trochanter
• Distal Arm: Lateral midline of fibula aligned to lateral malleolus and fibular head
• Normal ROM: Knee flexion to 90degrees

Question 6

Hamstrings Muscles (Distal Length) – Popliteal Angle Test

Answer 6

Muscles Involved & Action: Semitendinosus, Semimembranosus and long head of biceps femoris. They extend the hip and flexes the knee.

Patient’s Position: Supine, hip in 90degrees flexion, knee flexed at 90degrees. Opposite leg is fully extended

Test: Cups the heel of the leg and extends the knee to the end of ROM. Stop the movement when tension is felt from posterior thigh and further knee extension causes hip, pelvis and/or lumbar spine to move.

Goniometry
• Axis: Lateral Epicondyle of Femur
• Proximal Arm: Lateral Midline of femur aligned to greater trochanter
• Distal Arm: Lateral Midline of Fibula aligned to lateral malleolus and fibular head
• CAN ASK EXAMINER TO HELP MEASURE