# 2 MMT Positions

Knee extention

AG: Shortsit, towel for neutral hip

GE: Contralateral sidelying, pillow between legs

palpating: Distal quad tendon

Knee flexion

AG: Prone, towel under distal thigh to ease the patella

GE: Contralateral sidelying, pillow between legs

palpation: Semitendinosus

Hip IR/ER

AG: Short sit, towel under distal thigh

GE: Supine, other knee has to be bent or straight if there is no room

palpating: TFL, ASIS-3 centimeters distal-2 centimeters lateral or posterior.

*WE HAVE TO FIND PIRIFORMIS*

Hip Abduction

AG: Contralateral sidelying, hip has to be in extention and push on distal thigh, hand is a launch pad

GE: Supine

palpating: Glute med

Hip Flexion

AG: short sit, bring thigh down to fist, stabilize on hip

GE: Contralateral sidelying, at 90 degrees, we start in extention

palpating: Anterior inferior iliac spine, find ASIS, go medial, go distal, further down then ASIS

Hip Extention

AG: prone, TWO PILLOWS UNDER HIPS, ONE under chest, outside cradle leg and keep it straight, stabilize on PSIS

GE: Contralateral sidelying, at 90 degrees, we start in flexion

palpating: Glute Max

Inversion with Dorsiflexion

AG: short sit, towel under test leg, we hold their leg in our hand and pus diagonally down

GE: SAFETY BRIEFING patient has to be center of the table, IPSILATERAL sidelying, knee forward on pillows,

palpating: Tibialis anterior

Eversion with Plantar flexion

AG: Contralateral sidelying, pillows and towels under test leg and foot, foot off towel stack, hold under shin, move to front of foot to push down, fingers underneath foot not thumb

GE: Supine,  feet off table, 4 fingers on posterior edge of tibia MORE VERBAL CUES

palpation: Fibularis brevis or longus—Lateral

Inversion with Plantar flexion

AG: SAFETY BRIEFING IPSILATERAL sidelying, non-test leg forward on pillow stack, stand in front of foot, stabilize under shin while palpating

GE: Supine, feet off table, 4 fingers on posterior edge of tibia MORE VERBAL CUES

palpating: Posterior tibialis

Weight bearing Plantar flexion

AG: Heel raises, demo with patient seated, watch for substitutions, we only do it one time

Grades: 6 or more=5/5 3 to 5=4/5 1 to 2= just 3

Non-weight bearing Plantar flexion

AG: Prone, feet hanging off table, other leg on pillow stack, pull on calcaneous in C shape, long arm stabilizing underneath, don’t get kicked

*AG, one or the other, if its balance or weakness we go to non weightbearing*

Plantar flexion

GE: IPSILATERAL sidelying, feet off table, other leg on pillow stack, two hand stabilize

palpating: Achilles tendon

Shoulder Flexion

AG: Chair, arm comes down to 90 degrees, stabilize on top of shoulder-traps, resistance at distal femur, stand beside for more force, behind for less force

GE: Sidelying, pillows between legs, cradle and palpate, pass off motion

palpating: Anterior deltoids

Shoulder Scaption

AG: Chair, arm comes down to 90 degrees, stabilize on top of shoulder-traps, resistance at distal femur, stand beside for more force, behind for less force

GE: Supine, cradle in outside arm, palpate with inside arm

palpation: Middle deltoids

Shoulder Internal/External

AG: Prone, feet off table, good amount of arm on table, towel under arm, stabilize, for strong stabilizing put hand under arm WE SIT

GE: Chair, angle towel up and out of way of forearm

palpating: IR-Infraspinatus— right below spine of scapula, finger width

ER-Pectoralis major

Scapular Adduction

AG: Diagonal on table, arm is lifted at 90 degrees to patient not table, DEMO from hand side-we stand up and push through humerus and hand on scapula the driver… TEST from foot side stabilizing at opposite PSIS

GE: Chair by back edge of table, towels for support surface, arm is at 90 degrees in plane of scapula, we cradle the arm facing the scapula patient back

palpation: Middle traps—spine of scapula, above it and then medial

Scapular Depression with Adduction

AG: Diagonal?? on table, arm is lifted at 90 degrees to patient not table, DEMO from hand side-we stand up and push through humerus and hand on scapula the driver….bring shoulder blade to opposite back pocket- give patient a target…

GE: Prone, arms by side horizontal, lift from underneath patient shoulder on table, cradling arm

palpating: Lower traps—end of scapula and go medial

Elbow extention

AG: Supine, bringing forearm towards head, have them straighten it and then come down all the way

GE: Chair, UE at 90° scaption on table, full elbow flexion, forearm in neutral

palpating: Over distal triceps tendon proximal to olecranon or muscle bell… WHAT I WROTE palpating triceps-thumb is on it

Elbow Flexion in Supination

AG: Chair, elbow at side with towel, forearm in supination

GE: Seated on chair, UE at 90° scaption on table, full elbow extension, folded towel under UE, forearm in full supination. Plane of scapula, crease of armpit. Towards chest.

palpating: Biceps brachii

Elbow Flexion in Neutral

AG: Seated on chair, elbow at side, forearm in neutral, folded towel under UE

GE: Seated on chair, UE at 90° scaption on table, full elbow extension, forearm in neutral. Plane of scapula, crease of armpit. Towards chest.

palpating: Brachioradialis

Elbow Flexion in Pronation

AG: Seated on chair, elbow at side, folded towel under UE, forearm in full supination

GE: Seated on chair, UE at 90° scaption on table, full elbow extension, forearm in full pronation. Plane of scapula, crease of armpit. Towards chest.

palpating: Brachialis

Forearm Pronation/Supination

AG: Chair, elbows at side, 90 degrees with towel under armpit, if pronation we start in supination and vice versa, we always push. We demo with hand we dont push with and we bring it back half way

GE: Chair, towel stack at high low table, arm forward and standing up, in front of pt. At diagonal angle kind of, we start in opposite

palpating: Pronation=pronator teres Supination= distal biceps tendon

Wrist Flexion/Extention

AG: Shortsit, feet in front of table bar, towel under test forearm, we start in opposite direction and apply resistance with 2 fingers-C shape resistance, stabilize under forearm

GE: Hand is sideways with thumb upwards, block the forearm, we start in opposite

palpating: Common extensor mass, and Common flexor mass

Cervical Flexion

AG: Supine, knees bent, arms up by head, tuck chin and lift head an inch, they hold for 30 seconds

Grade: Have to get 30 seconds, they only do it TWICE

NO PALPATION OR GE POSITION

Cervical flexion with Rotation

AG: Supine, knees bent, arms up by head, they turn head, ring it back to center for them, tuck chin and then move head up. Apply resistance in a C shape with side of hand, other hand behind head just in case-but not touching

palpating: Sternocleidomastoid, we palpate from the start

Cervical Extention

AG: Prone, horseshoe towel for face, each rep we palpate either side, apply resistance on back of head with side of hand, other hand moves after palpating…do we do it three times?

palpating: Bilateral erector spinae

Thoracolumbar flexion ONLY AG-always start in 5 position regardless

Supine, knees bent, posterior pelvic tilt-chin tuck-fingers behind ears

5/5 fingers behind ears

4/5 Wakanda forever

3/5 arms by side Frankenstein

2 doesn’t clear inferior angles etc.

1 contraction no movement etc

0 etc.

palpating: Rectus Abdominus

Thoracolumbar flexion with rotation ONLY AG-always start in 5 position regardless

POSITION IS SAME AS FLEXION/SAME GRADES TOO

They have to clear BOTH inferior angles

palpating: IPSILATERAL internal obliques-palpate medial to ASIS and CONTRALATERAL external obliques-palpate medial to the ribs

If rotation to the right = ipsilateral internal oblique and contralateral external oblique

Vice versa

Thoracolumbar extention ONLY AG-always start in 5 position

Prone, 2 pillows under hips, none under chest and feet off table, we stabilize at the distal thigh

POSITION FOR GRADES 3/5 AND 4/5 ARE THE SAME

palpating: thoracic and lumbar thoracic spinae