Figure 1: The slump test The slump test involves the use of neck position to detect the role of neural tissue in the restriction of knee extension. The subject is asked to “slump”; flex the lumbar and thoracic spines and fully dorsi-flex the foot. Then in either a position of neck extension or flexion the subject is asked to extend the knee and the angle achieved is noted. When undertaking the slump test, if there is a significant difference in knee extension range between the neck in a flexed compared to an extended position (as shown) the test is said to be positive and it is likely that the neural structures are involved in the restriction of range of movement.

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Figure 2: Assessment of extension disassociation between movements of the hip and lumbar spine This test assesses the ability of the hip to move into extension in isolation from the lumbar spine. The subject is asked to lift their thigh off the bed aiming to achieve 20-30° of hip extension. The picture on the left shows a subject performing the test correctly on the right the subject fails the test. Note the anterior pelvic rotation and lumbar extension of the subject on the right, indicating poor dissociation of hip extension from lumbar extension.

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Figure 3: Assessment of control of lumbo-pelvic motion using leg slide exercise

This test assesses the ability to maintain a stable pelvis and lumbar spine whilst the leg is moving from the bed to 90° hip flexion and back. The subject is asked to draw in the lower abdominal muscles and hold that contraction while flexing the hip to 90° and returning it to the bed. The test is failed if the pelvis moves, indicating an inability to control the pelvis and spine under limb loading conditions.

Figure 4: Assessment of preferential recruitment of gluteal muscle during hip extension During active hip extension the gluteal muscle should show equitable activity in terms of strength of contraction and timing of contraction to the hamstring muscles. Whilst palpating gluteus maximus and the hamstring muscles the subject is asked to actively extend the hip. Failure is indicated by an inability to recruit the gluteal muscles or a poor level of contraction compared to that of the hamstrings.

THE AUTHOR

Lee is a chartered physiotherapist and certified strength and conditioning

specialist and a senior lecturer in sports rehabilitation at the University of Salford.

Lee has worked with elite sports people for the last seventeen years including time with the Great Britain Rugby League and Wigan Warriors Rugby League Club. He currently with the Great Britain Women’s Basketball team. Lee also has worked as a consultant for a number of professional football clubs and individual elite level sports people from a multitude of sports including archery, athletics, swimming, triathlon, sailing, boxing and martial arts.

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