Enhance Your Spinal Assessment With The MAT

assessment Feb 16, 2018
 

Our spine is made up of 3 sections (Cervical, Thoracic and Lumbar vertebrae) with the sacrum and coccyx forming part of the tailbone. Each area is individualised in the way it moves, for example, the Lumbars prefer to flex and Extend, whereas the Thoracics prefer to rotate.

Each segment throughout all 3 areas rotates/flexes/extends and laterally flexes a few degrees, but as a total, there is a great deal of range of motion available through the spine. Along with these movements occurring at the spine, we also have rotational movements below and above the spine that directly affect the range of motion available, an example of this is the hips.

“Range-of-motion deficits in the lead hip rotation and lumbar spine extension correlated with a history of low back pain in golfers” (Vad. V,  Bhat. A,  Basrai. D, Gebeh. A, Aspergren. D and  Andrews. J,  2004). Along with golfers having lower back pain we also see athletes involved in throwing sports needing to...

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Strength Testing With Hip Extension Raises

assessment Feb 15, 2018
 

 The single leg hip extension (also commonly referred to as a hip thruster) exercise is performed with the foot placed on a bench/chair. The role of this exercise it to emphasis the use of our Gluteus Maximus “Gluteal muscle in the human body is one of the largest and strongest muscles” (Raj. S, 2016).

The gluteus Muscles are also apart of posterior chain (muscles that run along the back of our legs and back). “explosive hip extensor strength may be crucial in the primary prevention and rehabilitation of a variety of lower extremity injuries” (Cronin. B, Johnson. S and Chang.E, 2016).

The single leg hip extension is a very beneficial exercise to perform in a clinical setting because by having the leg at 90 degrees it shortens the hamstrings and places more emphasis on the contraction of the glutes (which is what we are aiming for). Along with that we also see that “hip thrust activates the gluteus maximus and biceps femoris to a greater degree than...

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Strength Testing with the Single Leg Wall Hold Test

assessment Feb 15, 2018
 

A single leg wall hold is a functional performance test that looks at the capacity of our knee’s to bear load as well as the strength of the surrounding musculature (quadriceps/hamstrings/glutes).

They are very similar to a single leg squat but the main difference is that you’re leaning against the wall and that your knee/hip is bent to 90 deg and maintaining this position for as long as possible. “One leg squat and wall squat exercises are used in both athletic training and during knee rehabilitation programs” (Escamilla. R , Zheng. N , Hreljac. A ,Imamura. R , MacLeod. T , Edwards. W , Fleisig. G and Wilk. K, 2009).  

The Single Leg wall hold/squat is a very useful clinical exercise and along with other weight-bearing exercises that are similar because it has been shown in patients suffering from Patellofemoral pain syndrome (PFPS) that is has helped “patients to recover faster and return to function earlier” (Escamilla. R , Zheng. N ,...

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Strength Testing with Planks

assessment Feb 15, 2018
 

The Single Leg Plank is an intermediate core exercise which is a progression from the basic plank. By having a single leg in the air we lose a point of contact with the ground which increases instability and makes the drill more challenging.

The ability to recruit our core muscles is really important with multiple research papers showing that evidence exists that “core muscle recruitment alterations in low back pain (LBP) patients compared with healthy controls” (Bliven.K and Anderson. B, 2013). Along with improving outcomes for patients with back pain, research has also shown that  “preexisting core deficiency may increase the risk of lower extremity injury” (Wilson. J, Dougherty. C, Ireland. M and Davis. I, 2015).

This test is important to perform in a clinical setting because it can demonstrate (with minimal equipment) to us as clinicians how well someone’s trunk musculature is working. Doing this test as an assessment aids in the following:

  • ...
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Single Leg Hop Test

assessment Feb 15, 2018
 

The Single Leg Hop Test (SLHT) is a series of tests that are done at a high intensity to determine if you as an individual are ready to return to sport. They are commonly used in the later stages of ACL rehabilitation and the test results will determine if you are ready to return to play or not. The types of single leg hops we can do to assess:

Single leg hop test
Single leg triple hop test
Single diagonal hop test (crossing over a line with every jump).
Timed single leg hop over 6m

In a clinical setting hop tests are extremely useful for identifying “isokinetic flexion strength deficits and flexion-to-extension ratios” ( Sueyoshi T, Nakahata A, Emoto G, Yuasa T, 2017) for individuals looking to return to their chosen sport. They also found that “hop tests are useful tools for a bilateral comparison of knee strength and function when returning athletes to their sport” (Sueyoshi et al.).

The Hop tests are used in conjunction with the Limb Symmetry Index (LSI)...

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Strength Testing with Side Planks

assessment Feb 15, 2018
 


The side plank test is typically a measure of core endurance and dictates that the subject brace themselves in a neutral and extended side lying position on the forearm with the shoulder directly above the elbow, whilst the top leg and trunk is raised and held for as long as possible.

However, performing this test with a leg lift also allows assessment of hip abductor endurance (Youdas et al., 2014). Functionally, core and hip control and endurance serves as the foundation for force transference between upper and lower body and is relevant across patient and sporting populations (Van Der Merwe, Burden, & Maulder, 2017).

Studies looking at core and hip abductor endurance have shown:

  • Poor core stability and endurance to be linked to increased rates of low back pain and lower extremity injuries (Leetun, Ireland, Willson, Ballantyne, & Davis, 2004)
    Improving core hip, trunk and abdominal strength and endurance may improve athletic performance (Youdas et al., 2004)
  • The side plank...
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Strength Testing with Single Leg Squats

assessment Feb 15, 2018
 

The single leg squat (SLS) is a test used to assess dynamic hip control and lower limb function and has practical relevance to any sport involving landing, cutting, or running (Stickler, Finley, & Gulgin, 2015).

The patient performs a unilateral squat as many times as possible from a standardised height, such as a plinth or bench, with comparison in repetitions and movement-control between sides noted.

The non-tested leg is held freely in space with no contact between the ground or testing leg permitted (Alenezi, Herrington, Jones, & Jones, 2014). During the SLS, the hip abductor muscles serve to limit pelvic drop and hip adduction, reducing abnormal forces on lower limb joints (Hollman et al., 2009).

Research on this test has revealed the following:

  • Patellofemoral pain is linked to the presence of increased hip adduction in female athletes during the SLS, suggesting hip control and/or strength deficits (Noehren, Hamill, & Davis, 2013)
  • Links between poor hip abductor...
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Strength Testing with Calf Raises

assessment Feb 15, 2018
 

The calves play a significant role in daily life, as well as in many sporting endeavours. As a result, injury to the gastrocnemius, soleus, Achilles tendon, and triceps surae muscle-tendon unit is common, with the calf raise test (CRT) often employed clinically for diagnosis and monitoring purposes (Hebert-Losier, Schneiders, Newsham-West, & Sullivan, 2009).

This can be accomplished either by bodyweight or using a calf raise machine. Importantly, differentiation between the gastrocnemius and soleus muscles should be considered for more accurate identification of contributing muscles, with the gastrocnemius playing a dominant role in full knee extension due to its biarticular nature, whilst in contrast, the soleus is favoured during varying degrees of knee flexion (Hebert-Losier, Newsham-West, Schneiders, & Sullivan, 2009).


From the research we find that:

  • Six months following ACL reconstruction, an average unilateral calf strength deficit of 8% was present, as measured by...
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Strength Testing with the Leg Curl

assessment Feb 15, 2018
 

The hamstrings are a group of muscles comprising the biceps femoris (long and short heads), semitendinosus, and semimembranosus. Together, these assist in various combinations to extend the hip, and flex and rotate the knee.

They are also especially important in walking, running, and participating in many forms of sport and exercise. Testing the hamstrings group can be achieved via the prone leg curl, whereby the patient lies face down and flexes the knees against a pad, ensuring full range of motion with the movement being taken through full knee extension and flexion.

As the hamstrings cross both the hip and knee joints (except for the short head of biceps femoris), they may be subject to higher rates of injury due to the increased joint interactions such as in athletic events requiring great degrees of acceleration, deceleration and lower limb strength (Wright, Delong, & Gehlsen, 1999).

Hamstring injuries are the most common non-contact injury throughout soccer, Australian...

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Strength Testing with the Leg Extension

assessment Feb 15, 2018
 

Assessing the muscular strength of the lower limbs generally involves compound movements which is an excellent method to determine global lower limb strength.

However, it is often important to more finely identify deficits in individual muscle groups for injury risk analysis and the development of appropriate treatment techniques.

The leg extension, involving the subject extending the knee joint in a seated position against a shin pad, preferentially tests the quadriceps and can be conducted in either a bilateral or unilateral manner.

From the research we know that:

  • Less than 85% via the Limb Symmetry Index (LSI) in knee extension strength is considered poor and warrants further rehabilitation (Lepley, 2015)
  • Leg extension strength is a critical component of many daily activities such as rising from a chair and climbing stairs, movements that are required for maintaining independence and mobility throughout the lifespan (Paasuke, Ereline, Gapeyeva, Joost, Mottus, & Taba, 2004)
...
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