Strength Testing with Hip Abduction Holds/Raises

assessment Feb 17, 2018

Hip abduction is a movement where our leg moves away from the midline of body or the opposing leg, this movement is produced by our Gluteal muscles (Maximus, Medius and Minimus).

This movement is extremely important in a sporting or dynamic context as knee adduction “associated with increased knee valgus angles during athletic movements” (Cronin. B, Johnson. S, Chang.E, Pollard. C and Norcross. M,  2016).

Decreased Hip Abduction strength or excessive hip adduction has been a cause of issue for people with patellofemoral pain (PFP). With research being perfromed by Ramskov. D et al (2015) they found that “eccentric hip abduction strength that is higher than normal may reduce the risk of PFP” (Ramskov. D, Barton.C, Neilsen. R and Rasmussen. S, 2015).

The single leg abduction exercise when used correctly in a clinical setting can decrease our risk of associated lower limb injuries to the hip, knee or ankle. By performing the activity in a controlled way we...

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Strength Testing with Hip Adduction Holds/Raises

assessment Feb 17, 2018

Hip Adduction is the movement of where we bring our leg closer to the midline of the body or closer to the other leg. It is largely performed by our adductor group (adductor magnus, longus and brevis). Hip adductor weakness has been related to pain in through the groin in sports that require repetitive change of direction ( “Large eccentric hip adduction strength deficits were found in soccer players with adductor-related groin pain compared with asymptomatic soccer players” (Thorborg K, Branci S, Nielsen MP, Tang L, Nielsen MB and Hölmich P, 2014). Another article found that “decreased hip adduction strength is a risk factor for developing groin injuries” (Harøy.J, Thorborg. K, Serner. A, Bjørkheim. A,Rolstad.L, Hölmich.P, Bahr. R and Andersen.T, 2017).

The single leg adduction exercise when used correctly in a clinical setting can decrease our risk of associated groin injuries and performance detriments. The Copenhagen...

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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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