BOX 2: FLEXIBILITY TESTS

Sit and reach test for hamstring and lower back flexibility Method 1: Procedure with a sit and reach box: This test involves sitting on the floor with the legs out straight ahead. Feet (shoes off) are placed with the soles flat against the sit and reach box, shoulder-width apart. Both knees are held flat against the floor by the tester. With hands on top of each other and palms facing down, the subject reaches forward along the measuring line as far as possible. After three practice reaches, the fourth reach is held for at least two seconds while the distance is recorded. Make sure there are no jerky movements, and that the fingertips remain level and the legs flat.

Method 2: Procedure without sit and reach box: This test can also be done without a sit and reach box. Try placing your client in the position in the picture. If they are not flexible enough to reach the wall then you can record how far down the tibial bone they are able to reach and use this as a comparitor. If they are flexible enough to reach the wall you will need to find a block which they can reach over and past their toes but which is positioned against their feet in dorsi-flexion. Record how far down the box they can reach and use this to compare with future tests or with the uninjured leg.

Figure 6: Sit and reach test without box

BOX 3: MANUAL MUSCLE TESTING

1) Hip flexors Iliopsoas - patient is supine with their knee bent to 90o to 60o

and then to 30o

and hip flexed first –40o

flexion at the knee. The first position tests psoas major and minor, whilst the second isolates iliacus.

2) Abductors . Resist hip

The gluteus minimus muscle abducts, internally rotates and may act as a weak flexor of the hip. The gluteus medius abducts the hip joint. Figure 10 demonstrates a strength test of the posterior fibres of gluteus medius where the examiner resists hip abduction, lateral rotation and extension while stabilising the pelvis.

Figure 8a: Psoas major muscle test Figure 10: Gluteus muscle test 3) External rotators Figure 8b: Iliacus muscle test

Sartorius - flexes, abducts and externally rotates the hip joint. To test, the patient should be supine with leg to be tested in “figure 4” position with foot resting on other thigh. Ask the patient to hold on to side of couch and flex, abduct and externally rotate against resistance.

Iliotibial band test This test measures the flexibility of the iliotibial band. With the unaffected leg in full extension, the affected leg flexed at the hip and knee, adducted hip and foot on couch on lateral side of straight leg. Stabilise hip laterally and see how far you can passively stretch the ITB.

Figure 7: Iliotibial band test

Figure 11: External rotator muscle test Figure 9: Sartorius muscle test

Rectus femoris is tested as part of the quadriceps group.

The piriformis, obturator and gemelli muscle groups externally rotate the hip. They can be tested in sitting as in figure 11. The examiner resists hip joint lateral rotation by applying pressure on the inside of the ankle and the outside of the thigh. Alternatively the external rotators can be tests in a prone position with the hip in extension as shown in figure 12. The examiner stabilises the pelvis and resists lateral rotation via pressure on the medial malleolus.

Figure 12: Piriformis muscle test

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sportEX dynamics 2008:17(Jul):18-21