PTHA 2301 Muscle Length Testing

Stabilization will occur at the proximal joint.

Where does stabilization occur during muscle length testing?

It allows the determination of whether the muscle length is normal, limited, or excessive.

What can muscle length testing determine?

Muscle Length Testing

A clinical assessment procedure that involves passively stretching a muscle.

To determine a muscle's flexibility.

What is the purpose of muscle length testing?

passively stretching a muscle in the opposite direction of its action.

How is muscle length testing performed?

Flexibility

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

Dynamic and passive.

What are the two main types of flexibility?

- soft tissue

- osseous properties

- muscular properties

What joint properties does flexibility depend on?

muscle length

A measure of how much a muscle can stretch or elongate.

By fully lengthening the muscle across all joints it crosses.

How is muscle length assessed?

It identifies tight muscles that may lead to various issues.

Why is muscle length testing important?

Reduced joint range of motion

What can abnormal muscle length result in?

Abnormal movement patterns

What can abnormal muscle length lead to in terms of movement?

Compensatory postures or motions

What is a potential consequence of abnormal muscle length related to posture?

Pain

What is a possible outcome of tight muscles identified through muscle length testing?

passive insufficiency

A condition where a two-joint muscle is lengthened to its fullest extent at both joints.

The full range of motion of each joint that the muscle crosses.

What does passive insufficiency prevent?

active insufficiency

A condition where a two-joint muscle is maximally shortened across both joints.

It limits the muscle's ability to generate force.

What happens to a two-joint muscle when it is fully contracted across both joints?

Hook lying position

What is the starting position for muscle length testing of the Latissimus dorsi?

Ipsilateral ribs and pelvis

What areas should be stabilized during the Latissimus dorsi muscle length test?

Passively flex the arm overhead with the shoulder externally rotated

What is the test movement for the Latissimus dorsi muscle length test?

- trunk rotation

- anterior pelvic tilt

- lumbar extension

What compensations may occur during the Latissimus dorsi muscle length test?

Humerus is not flat on the table

What indicates a positive test result for the Latissimus dorsi muscle length test?

Humerus is flat on the table

What indicates a negative test result for the Latissimus dorsi muscle length test?

- Hooklying

- arms at the side or across the abdomen

- elbows supported with a towel roll

What is the starting position for muscle length testing of the pectoralis minor?

- press over the coracoid processes

- release and measure distance from the posterior acromion to the table surface

What is the test movement for pectoralis minor length testing?

- thoracic extension

- increased thoracic kyphosis

What compensations may occur during the pectoralis minor length test?

Posterior acromion to plinth is more than 2.54cm (1 inch)

What indicates a positive test for pectoralis minor length?

Posterior acromion to plinth is less than 2.54cm

What indicates a negative test for pectoralis minor length?

Hands behind head

What is the general procedure for muscle length testing of the pectoralis major?

Arm abduction at 90°

What is the procedure for testing the clavicular part of the pectoralis major?

Arm abduction at 135°

What is the procedure for testing the sternal part of the pectoralis major?

- low back extension

- anterior pelvic tilt

- trunk rotation

What compensations might occur during muscle length testing for pectoralis major?

Arms do not rest on the plinth

What indicates a positive test in muscle length testing for pectoralis major?

Arms rest on the plinth

What indicates a negative test in muscle length testing for pectoralis major?

Prone with the knee cradled in your arm and the hips neutral

What is the starting position for muscle length testing of the iliopsoas in prone extension?

The ipsilateral pelvis

What is the stabilization point during the iliopsoas muscle length test?

Passively extend the patient's hip while cradling the knee with your arm

What is the test movement for iliopsoas muscle length testing?

Anterior pelvic tilt, lumbar extension

What compensations may occur during the iliopsoas muscle length test?

Less than 10° of hip extension

What indicates a positive test result in iliopsoas muscle length testing?

Greater than 10° of hip extension

What indicates a negative test result in iliopsoas muscle length testing?

Prone, knees extended

What is the starting position for the Ely Test?

Ipsilateral pelvis

What is the stabilization point during the Ely Test?

Passively flex the knee until tension is felt

What is the test movement in the Ely Test?

Hip flexion, anterior pelvic tilt

What is a compensation observed during the Ely Test?

Less than 90° knee flexion; if the heel does not touch the glutes

What indicates a positive Ely Test?

Greater than 90° knee flexion; if the heel does touch the glutes

What indicates a negative Ely Test?

Iliopsoas tightness

What is the Thomas Test used to assess?

Sit on the end of the plinth with half of the thigh off the plinth.

What is the first step in the Thomas Test procedure?

Hold both knees and lie back on the plinth.

What should you do after sitting on the plinth in the Thomas Test?

Continue holding the non-test limb and let the other drop.

What is done with the non-test limb during the Thomas Test?

The thigh lifts off the table with the same knee flexed.

What indicates a positive Thomas Test?

The thigh stays flat on the table with the same knee flexed.

What indicates a negative Thomas Test?

- sit on the end of the plinth with ½ to ¾ of the thigh of the plinth

- hold onto the non-test knee and lie back on the plinth

- let the other leg stay on the plinth or hang loose.

What is the procedure for the Modified Thomas Test?

The knee flexes < 80° with the thigh flat on the table (knee becomes MORE extended).

What indicates a positive result in the Modified Thomas Test?

The knee flexes ≥ 80° with the thigh flat on the table (knee becomes MORE flexed).

What indicates a negative result in the Modified Thomas Test?

- tensor Fascia Latae

- Iliotibial Band

What does the OBER TEST assess?

Side lying on the flexed non-test limb to flatten the lumbar curve and stabilize

What is the starting position for the OBER TEST?

Anterior and upward pressure just below the pelvic crest

How is stabilization achieved during the OBER TEST?

Passively flex knee to 90 degrees, flex, abduct, and extend the hip, then slowly lower thigh into adduction

What is the test movement in the OBER TEST?

Trunk rotation, anterior/lateral pelvic tilt, hip flexion/internal rotation

What compensations may occur during the OBER TEST?

Thigh above horizontal (10° of adduction)

What indicates a positive test result in the OBER TEST?

Thigh below horizontal (10° of adduction)

What indicates a negative test result in the OBER TEST?

To assess hip abductor tightness.

What is the Modified Ober Test used for?

Extend the leg being tested.

What is the first step in the Modified Ober Test procedure?

The hip should be extended and abducted.

What position should the hip be in during the Modified Ober Test?

The thigh is above horizontal.

What indicates a positive result in the Modified Ober Test?

The thigh is below horizontal.

What indicates a negative result in the Modified Ober Test?

Supine, legs extended, low back flat on the table

What is the starting position for the Straight Leg Raising Test for hamstrings?

Contralateral thigh

What is the stabilization method used in the Straight Leg Raising Test for hamstrings?

Passively flex the hip by lifting the leg

What is the test movement in the Straight Leg Raising Test for hamstrings?

Knee flexion, PPT

What compensation might occur during the Straight Leg Raising Test for hamstrings?

Hip flexion is LESS than 68°

What indicates a positive test result in the Straight Leg Raising Test for hamstrings?

Hip flexion is between 68° and 80°

What indicates a negative test result in the Straight Leg Raising Test for hamstrings?

Supine, test leg in 90° hip and knee flexion and the non-test leg extended on the table.

What is the starting position for the Distal Hamstring (90/90) Length Test?

Ipsilateral femur

What is the stabilization method used in the Distal Hamstring (90/90) Length Test?

Extend the knee of the test leg until tension is felt in the hamstrings or the hip begins to move into extension.

What is the test movement in the Distal Hamstring (90/90) Length Test?

Greater than 20° of knee flexion

What indicates a positive test result in the Distal Hamstring (90/90) Length Test?

Less than 20° of knee flexion

What indicates a negative test result in the Distal Hamstring (90/90) Length Test?

Ensure pelvis aligned with the trunk and legs, possibly starting with a bridge exercise.

What is the first step in ensuring true or actual leg length?

Measure from the ASIS to the umbilicus on each side.

How do you measure leg length from the ASIS?

Adjust the pelvis until the measurements are equal.

What should you do if the measurements from ASIS to umbilicus are not equal?

Measure from the ASIS to the ipsilateral medial malleolus.

What is the second step in leg length measurement?

Keep legs close together.

How should the legs be positioned during leg length measurement?

Have the patient perform a bridge.

What is the first step in the procedure for measuring apparent leg length?

Measure from the umbilicus to the ipsilateral medial malleolus.

How do you measure leg length for apparent leg length?