Muscle Length Testing Exam Review

What is muscle length testing?

-procedure that involves PASSIVELY stretching a muscle in the opposite direction of its action

-Stabilization occurs proximally

-Watch for any compensations

Passive Insufficiency

A two-joint muscle is lengthened to its fullest extent at both joint thus preventing the full range of motion of each joint it crosses.

Active Insufficiency

A two-joint muscle is maximally shortened across both joints simultaneously limiting the ability to produce force

Flexibility

the ability of muscles, joints and tissues to move through an unrestricted, pain free range of motion

Compensation for gastroc/soleus testing

inversion/eversion

Compensations for straight leg raise testing

-Posterior Pelvic Tilt

-Knee Flexion

-Elevation of the non-test limb off the table

Compensations for pec major testing

-Low back extension (APT)

-Trunk Rotation

Compensations for obers/modified obers

-Trunk/pelvic rotation

-Anterior or lateral pelvic tilt

-Hip flexion or internal rotation

Stabilization for Ober's/Modified Ober's

-pt is lying on flexed non-test limb to STABILIZE body

-anterior/upward pressure to pelvis to prevent pelvic tilt or rotation

Compenastion for the lats

-Anterior Pelvic Tilt

-Thoracic/lumbar extension

Does APT increase or decrease the apparent hamstring length?

Decrease

Does PPT increase or decrease the apparent hamstring length?

Increase

Straight Leg Raise (SLR) Procedure

-Pt is in supine with both legs extended

-SPTA passively flexes the test hip with knee in full extension

Soleus Testing Procedure

-Pt is in supine

-Tested hip and knee is flexed

-SPTA will passively dorsiflex the left ankle

Pec Major General Muscle Length Testing Procedure

-Patient is supine hook lying with arms interlaced behind head

-Arms are passively dropped, elbows toward table

Pec Major Clavicular Head Muscle Length Testing Procedure

-Patient is supine hook lying, arms resting at the sides, elbows extended and palms upward

-SPTA will bring the arm into 90° of flexion with shoulder in external rotation and the elbow extended.Then, slowly abduct the arm to 90°

Pec Major Sternal Head Muscle Length Testing Procedure

-Patient is supine hook lying, arms resting at the sides, elbows extended and palms upward

-SPTA will bring the arm into 90° of flexion with shoulder in external rotation and the elbow extended. Then, slowly abduct the arm to 135°

Pec minor muscle length testing starting position/stabilization

- Pt is in supine, with arms resting on the abdomen or to the side and elbows supported with a towel roll

-Hooklying to ensure back is flat on the table

What muscle is Ely's test for?

Rectus Femoris

What muscle is Ober's Test for?

TFL

What muscle is the prone extension test for?

Iliopsoas

Which muscles can Thomas/Modified Thomas test for?

Rectus Femoris

Illiopsoas

TFL

Sartorius

What is the difference between Thomas Test and Modified Thomas Test?

Thomas Test- Both knees are brought to the chest when lying supine on the plinth

Modified Thomas Test- One knee is brought down when lying supine on the plinth

What muscle is straight leg raise test for?

Hamstring

What portion of the hamstring does straight leg raise vs. 90/90 test for?

SLR- proximal

90/90- Distal

Ober's Vs. Modified Ober's

Ober's- the test knee is bent to 90 degrees

Modified Ober's- the test knee is extended

Soleus Positive/Negative Muscle Length Test Values

Positive test- less than 20 degrees of dorsiflexion

Negative test- 20 degrees or greater (≥20) of dorsiflexion

Gastroc Positive/Negative Muscle Length Test Values

Positive Test- less than 10 degrees of dorsiflexion

Negative test- 10 degrees or greater (≥10) of dorsiflexion

What part of the hamstring is straight leg raise test for?

Proximal

What part of the hamstring does 90/90 hamstring test for?

Distal

Thomas Test/Modified Thomas Test: Positive/Negative results for Iliopsoas

Positive: thigh lifts off the table (hip flexion)

Negative: thigh stays flat on the table

Thomas Test: Positive Test for TFL

abducted hip and hip IR

Thomas Test: Positive Test for Sartorius

abducted hip and hip ER

Thomas Test: Positive/Negative Test Results for Rectus Femoris

Positive Test: less than 80 degrees of knee flexion with the thigh flat on the table (knee becomes more extended;less flexed)

Negative test: 80 degrees or greater of knee flexion with the thigh flat on the table (knee is more flexed; less extension)

Give an example of where you can infer that rectus femoris AND iliopsoas might be tight when performing the Thomas/Modified Thomas Test

- If the thigh is off the table (hip is flexed) and knee flexion is LESS than 80 degrees

How can an SPTA confirm whether rectus femoris or iliopsoas is responsible for hip flexion during the thomas test?

If you extend the knee (rectus femoris is on slack), and the thigh drops down to the plinth, rectus femoris is tight.

Which muscle is most likely tight with rounded shoulders posture?

Pec minor

To test for pec minor tightness, you are measuring the distance from the ________ to the _________

posterior acromion to the plinth

Line of Gravity Posterior to the Axis of Rotation @ Knee

-If the line of gravity falls posterior to the axis of rotation at the knee, the QUADRICEPS must activate to prevent KNEE FLEXION

Line of Gravity Anterior to the Axis of Rotation @ Knee

-If the line of gravity falls anterior to the axis of rotation at the knee, the HAMSTRINGS must activate to prevent KNEE EXTENSION

Swayback Posture

-flattened lumbar curve and trunk angled posteriorly

Military Posture

-increased lumbar lordosis (tight low back extensors and hip flexors)

Flatback Posture

-decreased lumbar curve

-increased posterior pelvic tilt & hip flexion

Validity

how ACCURATE a tool is

Reliability

how CONSISTENT a tool is

Kyphotic/Lordotic Posture

increased thoracic kyphosis, increased lumbar lordosis (tight low back extensors)

Cross-Sectional Study

data is collected from different participants at a single point in time to assess the prevalence

Longitudinal Study

Tracks the same participants over time to observe changes

Experimental Study

used to establish cause and effect

Non-Experimental Study

the researcher collects data without introducing an intervention

Actual Leg Length Vs. Apparent Leg Length

True/actual leg length: This measures the physical bone length of your legs. It tells you if your legs are genuinely different in length.

Apparent leg length: This measures how your legs look from the outside. Sometimes, one leg can appear shorter due to things like pelvic tilt, muscle imbalances, posture etc.

Procedure for Measuring True Leg Length

-Pt lies in supine

-Measure from the ASIS to the umbilicus to ensure the pelvis is aligned

-If it is not aligned, the pelvis alignment should be corrected with a bridge

-THEN, measure from ASIS to ipsilateral medial malleolus

Procedure for Apparent Leg Length

-Ensure pelvis is aligned like above

-Measure from umbilicus to ipsilateral medial malleolus

How does a bridge work to bring the pelvis to neutral?

Activates the abdominals and hip extensors which work in a muscle synergy