FLEXIBILITY TESTS

Lect. Gizem Ergezen

Department of Physiotherapy and
Rehabilitation
 Flexibility
•Flexibility is the ability of a joint or series of
joints to move through an unrestricted, pain
free range of motion. Although flexibility
varies widely from person to person,
minimum ranges are necessary for
maintaining joint and total body health.
 Flexibility
•Many variables affect the loss of normal joint
flexibility including injury, inactivity or a lack
of stretching. The range of motion will be
influenced by the mobility of the soft tissues
that surround the joint. These soft tissues
include: muscles, ligaments, tendons, joint
capsules, and skin.
 Why Flexibility is Important?
• Physical fitness=
➢ endurance training + muscle
strength
• Range of motion
• Specific to each joint
• May improves athletic ability
• Inadequate flexibility increases
the risk of ınjury
• Excessive flexibility increases the
risk of injury by decreasing the
stability
 Factors Affecting The Flexibility
• Gender Woman > Male
• Age Children > Adult
• Body type
• Hereditary joint structure
• The elasticity of the
connective tissue
• Muscle viscosity
• Reciprocal muscle coordination

In addition; it can be effected and therefore

limited by Muscles, ligaments, tendons or bone
structure.
 Classification of Flexibility
• Static flexibility: Regardless of the SPEED of the
transaction, is based on the flexibility of the
joint mobility
• Dynamic flexibility: flexibility with SPEED factor
(Hall gymnasts)
Our assessment area is static flexibility.
 Evaluation of Flexibility
1. Method: evaluation of Single joint
2. Method: evaluation of more than one joint

Tape measure, ruler, goniometer is also used

as simple measuring devices.
The assessment must be slow and endpoint
maneuvers should be hold for at least 5 sec.
 Trunk Flexion and Hamstring Flexibility
• The block 15 cm height
• Standing
• Fingertip is reached without
allowing knee flexion
• Block surface is measured from
the tip of the finger
• Values measured passing the
surface are (+) and values not
reaching the surface of the block
are marked as (-)

Lumbar region + hamstring + gastrocnemius

 Long Sitting Position
• Feet are against a fixed object in 90 degrees.
• The person extends forward.
• The last point reached with the fingertips is
recorded.
• The values befor the surface of the object are
recorded as negative.
 Trunk Hyperextension
• Standing or prone position
• The person is standing facing the
wall, pelvis and the trunk are in
contact with the wall
• Space between wall/floor with
sternal notch
• The height difference between
the start and end point values
are recorded
 Trunk Lateral Flexion
• Anatomical position
• The changes of the distance
between the tip of the middle
finger is recorded with trunk
lateral flexion
• Right and left sides should be
evaluated separately

• Compensated movements!!!
 Trunk Rotation
• Standing and facing towards the wall, keep
pelvis in contact with wall.
• Coracoid process-wall distance is measured
• While maintaining the contact of one side, the
distance between the other shoulder and the
wall is recorded
• Two sides are evaluated separately
 Horizantal Movement of Arms
• Start position: arms are in horizontal Abd
• Arms are requested to be crossed in the front
• The angle of the shoulder joint is recorded
 Hamstring

• Can be evaluated Supine or

in a sitting position on a
Chair
• While in supine position;
Straight Leg Raise (SLR) ➔
hip angle will be recorded.
 Hamstring Length

• While sitting; the leg which

is not tested is at 90
degrees of hip and knee

• The other leg will be asked

to full extension and the
knee flexion angle is
recorded.
 Hip Hyperextension
• Prone position, pelvis
contacting the table
• Hyperextension is asked to leg
without hip moving.
• Knee extension is preserved
during evaluation.
• Both sides are tested
separately.
 Ankle Dorsi and Plantar Flexion

➔ Can be evaluated with Goniometer

 Ankle Dorsi and Plantar Flexion
• Feet are shoulder wide open,
hands against the wall and
standing off the wall
approximately 1 m away
• Getting near to the wall with
elbow flexion
• Back is straight !
• Heels fixed on the floor!!
• Clavikular notch-Wall distance
 Hip abduction
• The hip joint abduction, flexion
and External Rotation,
• Knees flexed
• Soles adjacent
• The person is asked to push the
knees towards the floor with
elbows while holding the Abd.
• Lateral condyle of the knee-
ground distance
 M. Quadriceps Femoris and Hip Flexors

• Prone with knee

flexed 90 degrees
• Stabilize the pelvis
• Asked to bring the leg
up without disturbing
the position
• The knee-ground
distance
SHORTNESS TESTS

Medipol University
Department of Physical Therapy and
Rehabilitation
 MUSCLES
For a normal mobility, they need to have.

-Supports the skeletal structure

-Provides mobility
-Provides functionality and skill

• Contraction (supporting skeletal

construction) for an effective stabilization
• And stretching at a sufficient capacity
 The Purpose of Shortness Tests
The muscle length determines the normal
Range of motion of the joints.

Evaluation
• Normal
• Short (Limit)
• Extreme

There is a different evaluation position and

procedure for each muscle group.
 Shortness Test Applied Muscle
Groups
1. Lumbar Extensors, Hamstrings and Gastro-soleus
2. Straight Leg Raise Test for Hamstrings
3. Tensor Fasciae Latae Test
4. Hip Flexors Shortness Test
5. Shoulder Adductor and Internal Rotator Muscles
1. Lumbar Extansors, Hamstrings and
Gastrosoleus Shortness Test

Patient position: Long sitting position (with

knees in extension)

In practice: Patients are asked to reach

their toes and fingers.
Lumbar Extansors, Hamstrings and Gastrosoleus
are normal
Lumbar Extansors, Hamstrings are normal
Gastrosoleus is short.
• Lumbar Extansors and Gastrosoleus are
normal
• Hamstrings are short
• Pelvis is in PPT (more than normal)
• Thoracal Extansors, Hamstrings and
Gastrosoleus are normal
• Lumbar Extansors are short
 Lumbar Extansors Supine Position
Position: arms in reverse T, legs in extension,
supine position.

Practice: Both hips and

knees are brought to the
flexion and evaluated
according to the distance
between knee and chest.
 Gastrocnemius Shortness Test
Position: Supine lying

Practice: Hold the knee being tested with one

hand in the extension.

• The base of the foot and the heel are grabbed by

hand, and the foot is brought to the dorsiflexion.
• The neutral position of the foot must pass 90
degrees.
Gastrocnemius Shortness Test
 2. Hamstring Shortness Test
Position: Arms inverse T, legs in supine position

Practice: Keeps the heel of the

leg being tested with one hand
while maintaining the
extension with the other hand
and performs hip flexion
Right Hamstring, Lumbar
Extensors and Left Hip Flexors are
normal
85-90 degree in young people / 70 degree hip flexion in the elderly
Right Hamstings are short,
Lumbar extensors and Left Hip
Flexors are normal
Right Hamstings are normal,
Lumbar extensors and Left
Hip Flexors are short (due to
pelvis anterior pelvic tilt)
 3. Tensor Fasciae Latae TFL Modified
OBER Test (a)
Position: Side lying, Leg being tested on top,
lower leg support surface - slight flex for balance.

Practice: Stabilizes the pelvis with one hand. The

other hand will bring the upper leg to
hyperextension and release it. Falls or not?

!! Stabilisation of the pelvis; It is important to

prevent Anterior pelvic tilt, that is, hip flexion.
Normal
TFL

Short TFL
 3. Tensor Fasciae Latae TFL Modified
OBER Test (b)
Position: Lower extremity in extension and supine
position

Practice: Untested leg is brought to abduction, the

other leg is brought to hyperadduction.

In short TFL, leg will not come to hyperadduction.

Untested leg is in abduction
 OBER Test (TFL/ITB)
Position: Side lying, lower leg in semi-flex

Practice: PT stand at the back of the patient with

one hand on the upper Trochanter Major

• Grasps the knee with other hand under the

knee to provide 90 knee flexion, bringing the
upper leg to Abduction and hyperextension
• Extend and abduct the hip joint.
• Slowly lower the leg toward the table -adduct
hip- until motion is restricted.
• If the ITB is normal, the leg will adduct with the
thigh dropping down slightly below the
horizontal and the patient won't experience any
pain; in this case, the test is called negative.
• If the ITB is tight, the leg would remain in the
abducted position and the patient would
experience lateral knee pain, in this case, the
test is called positive.
 4. Hip Flexors
Position: The patient lies in a supine position,
with the legs hanging from the edge of the table
or with the hip and knees in extension.

Practice: When one leg is pushed to the chest

with the knee and leg flexion, the other leg that
is tested should not rise and the hip extension
should be protected.
Left hip flexors are normal.
Left hip flexors are short.
 Quadriceps Femoris Shortness
Test
Position: The patient
lies in a prone
position.

Practice: The leg

being tested is
brought to the
flexion.
 5. Shoulder Adductor and Internal
Rotator Muscle Shortness Tests
Position: To test the shortness of the
pectoral muscles, the patient lies in supine
position and the knees in the semiflex pos.
Practice: During the test, the lumbar area
should contact the bed and protect its
smoothness.
5. Shoulder Adductor and Internal
Rotator Muscles Shortness Tests
• The patient clamps his hands in the
nape region.

• The elbows must be in contact with the

bearing freely without being forced.

• If the elbows do not touch the bed, the

pectoral muscles are short.
 Shortness Test of Pectoralis Major
Sternal Part
Position:
• The patient in supine position
• Shoulder in external rotation and 135 degrees
abduction
• Elbow in extension.

Practice: The arm is expected to fall freely if not,

shortness is noted and recorded by measuring the
distance between the lateral epicondyle of the
Humerus and the table.
(or mild, moderate, clearly marked)
Pectoralis Major-Sternal is normal
Pectoralis Major-Sternal is short
 Shortness Test of Pectoralis Major
Clavicular Part
Position:
• Patient in the supine position
• Elbow extension
• Shoulder external rotation and 90 degree
abduction.

Practice: When the arm is released from above,

the arm should fall freely into the bed.
Pectoralis Clavicular is normal
Pectoralis Major-Clavicular is short
Pectoralis Major-Clavicular is excessively long
 Pectoralis Minor Shortness Test
Position: The test is applied on a hard bed.
• Patient's knees are flexed
• Lumbar area is flat
• Palms facing down, next to the trunk.

Practice: Therapist;
stays behind the head of the patient,
observes the shoulder girdle,
applies pressure down the shoulders to
make sure it is short or not.
 Pectoralis Minor Shortness Test
• Shortness; light,
moderate, clear

Or

• It can be measured
as the distance of
Acromion and bed.
 An alternative Shortness Test for
Adductor and Internal Rotators

This test is also

used to evaluate
the flexibility of
the shoulder
region.
• The dorsal face of the lower hand and the
palmar face of the upper hand are placed on
the back to perform shortness test on
✔ The lower arm External Rotator muscles
✔ and the upper arm on the Internal Rotator
muscles.

• The distance between the hands is measured

and noted.