Joint mobility and muscle flexibility can be assessed by performing passive range of movement exercises. In this type of assessment, the subject exerts no effort and the therapist or trainer moves and measures the amount of movement that is possible at a particular joint. In addition to assessing individual joints, pairs of joints should be compared to see whether there is a difference between the range of movement in the left and right sides. Reduced range of movement and left to right imbalances might indicate a current injury or an increased risk of future injury.
Passive Knee Flexion
Lie the subject face down on the floor or a massage couch with her head resting on her folded arms. Position her legs so that her knees are together. Gently but firmly bend the subject's left leg as far as comfortably possible. Note the distance between the heel and butt. Place the leg back down and repeat the exercise on the subject's right leg, again noting the distance between the heel and butt. Finally, bend both legs at the same time and compare the left side with the right. This exercise measures quadriceps flexibility and the subsequent range of movement of the knee. Ideally, the heel should touch or be very close to touching the butt.
Passive Hip Flexion
Passive hip flexion tests hamstring flexibility and knee joint mobility. Lie your subject on his back on the floor or a massage couch. Extend both legs, making sure the knees are level. Stand to the side of your subject and then, with the knee held straight, lift one leg up as high as is comfortable. Stop when you feel the hamstrings come to the end of their range of movement. The opposite leg should remain perfectly still while you perform this exercise. Lower the leg back down and repeat the assessment on the other leg. ideally, the angle for both legs should be between 80 and 90 degrees. Hip flexion of less then 80 degrees indicates tight hamstrings. Very tight hamstrings might result in hip flexion of 45 degrees or less.
Passive Hip Abduction
This exercise assesses adductor or inner thigh muscle flexibility. Lie your subject on the floor with her legs together and body perfectly straight. Standing to the side of your subject, grasp one leg by placing your hand behind the knee and around the ankle. Slide the leg outward as far as is comfortable. Ideally, the hip should travel outward to 45 degrees of abduction. Place the leg back to the center position and repeat the exercise on the other leg. Make sure you keep the leg close to the floor when performing this assessment to isolate the adductors and avoid stretching the hamstrings. Lifting the leg off the ground might cause a false positive result.
Passive Ankle Dorsiflexion
Passive ankle dorsiflexion assesses the flexibility of the gastrocnemius and soleus muscles, which make up the calf. Lie your subject on the floor or on a massage couch. Place his legs together so that the inner ankle bones are aligned. Press on the bottom of your subject's feet so that the foot moves toward the shin bone. Note the angle of flexion. Perform the test on the opposite ankle and then on both together so that you can compare. This test assesses the gastrocnemius, the larger calf muscle. To assess soleus flexibility, repeat the test but with the knees bent. The gastrocnemius and soleus are very strong muscles, so you might have to push quite hard to get a usable result from this exercise.
References
- "Sports Injuries: Diagnosis and Management"; Christopher M. Norris; 2004
- "Sports Injury Handbook: Professional Advice for Amateur Athletes"; Allan M. Levy and Mark L. Fuerst; 1993
- "Sports Injuries: Their Prevention and Treatment - 3rd Edition"; Lars Peterson and Per Renström; 2000
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