Neural Tension and Muscle Length Tests

Question 1

Straight leg test

Answer 1

How to:
-Hip is neutral rotation; knee extended. Leg is raised until patient reports pain in leg or back.
- Can be made more sensitive by dorsiflexing ankle, raising head, or adducting thigh.

Results:
- Positive: Pain below the knee at 35-70° hip flexion.
- Back pain only: possible central disc prolapse
- Leg pain only: lateral disc herniation
- Back and leg pain: posterior or p/l disc herniation

Question 2

Crossed Straight leg test

Answer 2

• Raising the non-involved leg causes pain on the opposite side.
• High specificity for disc herniation.
• positive in cases of disc herniation with nerve root involvement

Question 3

Slump Test

Answer 3

• Involves thoracic/lumbar flexion, neck flexion, knee extension, and ankle dorsiflexion.
• Positive: Symptom reduces with neck extension or if there is asymmetry between sides
• High sensitivity for neuropathic pain.

Question 4

Prone Knee Bending Test

Answer 4

• Tests femoral nerve irritation (L2-L4).
• examiner flexes the patients knee
• pain in the anterior thigh(as opposed to a stretch) constitutes positive test

Question 5

Babinski Test

Answer 5

• should be performed when an upper motor neuron lesion is suspected
• examiner strokes plantar aspect of foot with a reflex hammer
• positive: great toe dorsiflexion with fanning of toes).
• test is usually positive in infants younger than 1

Question 6

Upper limb neuro tension

Answer 6

• Scapular depression
• Shoulder abduction
• Forearm supination, wrist and finger extension
• Shoulder lateral rotation
• Elbow extension
• Contralateral / ipsilateral cervical sidebending.
• This test is positive if symptoms are produced, if there is a side-to-side,difference in elbow extension of > than 10 degrees, or if contralateral neck flexion increases symptoms, or ipsilateral neck flexion decreases symptoms.
• This test has shown to have high sensitivity and low specificity in the detection of cervical radiculopathy.

Question 7

90/90 Hamstring Length test

Answer 7

• Purpose: To assess the flexibility of the hamstring muscles.
• Procedure:
  
  • Patient lies supine with hips flexed to 90° and knees bent at 90°.
  • Patient actively extends the knee as far as possible.
  • Clinician measures the angle of knee flexion.
• Normal Range: ≤10° of knee flexion (knee should be nearly straight).
• Positive Test: Limited knee extension (>10°), indicating tight hamstrings.

Question 8

Ely Test

Answer 8

• Purpose: To test the length of the rectus femoris muscle.
• Procedure:
  
  • Patient lies prone.
  • Clinician passively flexes the patient’s knee.
  • Observe for heel reaching buttocks and pelvic motion.
• Positive Test:
  
  • Heel cannot touch the buttocks.
  • Early anterior pelvic tilt during knee
    flexion indicates tightness in rec fem

Question 9

Modified Thomas test

Answer 9

Purpose: To evaluate tightness in the iliopsoas and rectus femoris muscles.
- Procedure:
- Patient sits at the edge of the table and lies back while holding one knee to the chest.
- The opposite leg hangs off the table.
- Observe the position of the thigh and knee.
- Findings:
- Iliopsoas Tightness: Thigh remains above horizontal.
- Rectus Femoris Tightness: Knee remains extended or cannot flex to 90°.
- Ensure lumbar lordosis is eliminated during testing.
-

Question 10

Ober test

Answer 10

• Purpose: To assess tightness of the Tensor Fasciae Latae (TFL) and Iliotibial Band (ITB).
• Procedure:
  
  • Patient lies on their side with the lower leg bent for stability.
  • Clinician abducts and slightly extends the upper leg while stabilizing the pelvis.
  • The clinician then allows the leg to drop towards the table.
• Positive Test:
  
  • The thigh does not drop below horizontal (remains elevated).
  • Indicates tightness in TFL/ITB.