Functional Assessment

Kinetic Chain Assessment

Hip Range of Motion

 Movement fpnotebook  wikipedia  mit.edu  tutplus  nail ebraheim 
 External Rotation  40-60  45 45  45  45 
 Internal Rotation  30-40   40  40  40  30 
 ABduction  20-30  45  45-50  45-50  45 
 ADduction  30-50  30  20-30  20-30  30 
 Extension  10-15  10-40  30  30  10-15 
 Flexion  110-120  125 110-130 110-130  125 

Knee Hyperextension
High extension moment at initial contact can lead to knee problems.

Standing
Genu recurvatum is a posture where the knees appear to bend bacwards in standing due to the knees being placed in a hyperextended position.

Lateral view - curved alignement of legs
Anterior view - can make the knee caps appear to point inwards

Supine
Fix femur just above knee, support ankle and raise lower leg.
If >5° extension - abnormal

Resources


Hip Mobility - Internal / External Rotation


Thomas Test & Modified Thomas Test






 






Image Source: http://www.blogcdn.com/www.thatsfit.com/media/2010/06/thomas-test-tight-hip-flexor240wy060110-1275415846.jpg


Thomas Test - Iliopsoas (hip flexor & external rotator
Check lumbar spine stay in contact with bed
Subtle signs: knee rising or foot flopping out

Modified Thomas Test - Iliopsoas & Rectus Femoris
<0° hip extension - restricted iliopsoas
>90° knee flexion - restricted Rectus Femoris

Short iliopsoas
reduce hip flexion - low knee lift
contribute to anterior pelvic tilt & excessive forward lean
can't do self administered release

Short Rectus Femoris
Knee extensions / Reduced knee flexion
Reduced heel lift during swing phase


Prone Leg Lift
Theory: activation of muscles during a prone leg extension (PLE) simulates the muscle recruitment pattern of hip extension during gait.

Theory suggests that the temporal activation of the posterior muscle groups should occur in the following order (right PLE exercise): right gluteus maximus, right hamstring, left lumbar erector spinae, right lumbar erector spinae, left thoracolumbar erector spinae and lastly right thoracolumbar erector spinae.


Knee to Wall Test
Weight bearing dorsiflexion

Tibial angle from vertical
Restricted <35°
External dorsiflexion moment - internal plantar flexion - early heel lift - tight soleus / achilles



Standing Thoracic Extension & Rotation
  • Standing, back and shoulders against the wall
  • Tilt pelvis posteriorly, flatten lower back against the wall
  • Attempt to extend mid/upper back and flatten against wall
  • No more than 2-4cm between the spinos process of C7 (sticks out the most) /T1
  • Posterior Chain – spring mechanism
  • Cross Extensor reflex
  • Rotate maximally to the left and right 
  • Maintain fixed foot position
  • 1 – Allow pelvic rotation
  • 2 – Pelvic rotation manually resisted
  • Observe available rrange of motion 
  • Observe for asymmetries

Overhead Squat Assessment




Single Leg Squat Assessement





Hop Down Test (Klatt Test)
Predictor of how ground reaction forces may alter running kinematics, screening for movement patterns that prospectively predict injury.


Methodology
  • Barefoot
  • Platform 20cm (as low as 2cm)
  • Both arms extended in front
  • One leg extended at 15° angle
  • Athlete hops of platform
  • Use injured or non-dominant limb first
  • Look at knee, hip and trunk on landing
  • Perform barefoot, in shorts and ideally with the spine visible



 Fault  Muscle Weakness   Auxillary Exercise 
 Knees Buckle  VMO   High Step Ups
 Hop Medially   ADductors  Lunges
 Hop Laterally  ABductors  Glute-Ham Raises
 Hop Forward  Hamstrings  Leg Curls
 Lean Forward  Gluteus Maximus  Reverse Back Extensions
 Lean Sideways  Quadratus Lumborum  Sidebends