Muscle Length Assessment

Question 1

What is a positive assessment

Answer 1

• when motion is limited during a muscle length assessment

Question 2

Describe hamstring muscle length assessment

Answer 2

• patient is supine
• passive flexion of the hip with full knee extension
• take the hip flexion goniometric angle
• opposite hip must remain extended
• normal ROM: 70-80 degrees hip flexion

Question 3

Describe hamstring muscle length 90/90 assessment

Answer 3

• patient is supine
• flex hip to 90 degrees and then passively extend the knee
• take the knee extension goniometric
• avoid dorsiflexion of the ankle
• normal ROM: no more than 20 degrees from full knee extension

Question 4

Straight leg test and sciatic nerve tension

Answer 4

• cause pain before 30 degrees - think disc issue
• cause pain before 75 degrees - think sciatic nerve tension
• cause pain over 75 degrees - note it if it is not symmetrical

Question 5

Describe the sciatic nerve tension slump testing position

Answer 5

• full trunk flexion
• hip flexion in seated position
• full knee extension
• ankle dorsiflexion

Question 6

Describe sciatic nerve tension slump testing results

Answer 6

• dorsiflex ankle & get to the same spot as hamstring test it suggests hamstring burn
• dorsiflex ankle & get to less ROM than hamstring test it suggests sciatic nerve

Question 7

Describe piriformis muscle length assessment

Answer 7

• patient is supine
• hip flexion greater than 90 degrees, hip external rotation, hip horizontal adduction
• compare side to side

Question 8

Describe Thomas test (iliopsoas & rectus femoris)

Answer 8

• patient is supine with legs over end of table
• patient begins seated, is assisted to supine w/both knees to chest, then release affected leg
• take hip flexion (iliopsoas) or knee flexion (rectus femoris) goniometric
• don’t allow anterior tilt of the pelvis
• normal ROM: posterior thigh flat on table & knee flexed at least 80 degrees

Question 9

Describe iliopsoas muscle length assessment alternative

Answer 9

• patient is prone
• flex knee to 70 degrees while stabilizing the pelvis & passively extend the hip
• avoid lumbar extension

Question 10

Describe Ely’s test (rectus femoris)

Answer 10

• patient is prone
• passively flex the knee
• take knee flexion goniometric
• don’t allow elevation of the pelvis or flexion of the hip
• normal ROM: full knee flexion

Question 11

Describe the position for the femoral nerve tension slump test

Answer 11

• side lying
• full trunk flexion
• hip & knee flexion
• passively pull top leg into hip extension

Question 12

Describe Ober test (IT band)

Answer 12

• patient is sidling on unaffected side
• knee flexed to 90 degrees, examiner passively abducts & extends the hip
• stabilize the pelvis in the frontal plane and allow the leg to lower towards the table
• don’t allow pelvis rotation
• normal ROM: upper leg parallel to table

Question 13

Describe weight bearing gastrocnemius muscle length assessment

Answer 13

• patient is standing with affected leg in slight hip extension, heel flat on floor
• patient shifts forward towards wall
• take ankle dorsiflexion goniometric or inclinometer
• don’t allow the heel to rise
• normal ROM: comparison to unaffected side

Question 14

Describe pectoralis major sternal fibers assessment

Answer 14

• patient is supine
• abduct shoulder to 135 degrees & externally rotate with elbow extended
• measure lateral epicondyle to table with tape measure
• normal ROM: arm flat on table

Question 15

Describe pectoralis major clavicular fibers assessment

Answer 15

• patient is supine
• abduct shoulder to 90 degrees, externally rotate, & extend elbow
• measure lateral epicondyle to table with tape measure
• normal ROM: arm flat on table

Question 16

Describe pectoralis minor assessment

Answer 16

• patient is supine
• shoulders are relaxed at side, elbows should be slightly flexed & elevated from table with small towel
• measure posterior acromion to table with tape measure

Question 17

Describe latissimus dorsi assessment

Answer 17

• patient is supine with knees flexed & lumbar spine flat
• flex shoulders with arms close to head & elbows fully extended
• take shoulder flexion goniometric
• don’t allow lumbar spine to extend
• normal ORM: arm flat on table