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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Strength Testing with the Leg Press

assessment Feb 15, 2018

Muscle strength is the foundation of human movement and of vital importance regardless of age or activity level. Lower limb strength is especially important in providing a stable base from which to move, with the gluteals, quadriceps, hamstrings, and calves playing pivotal roles. The leg press is a compound exercise designed to target each of these muscle groups and can be used in the assessment of lower limb strength.

The subject is typically seated, either horizontally or at a fixed angle, and is required to push a foot plate loaded with additional weight using their lower limbs for a given number of repetitions. Collecting such data allows clinicians to determine whether an athlete is ready to return to sport, whether an individual has the physical capacity to withstand forces greater than bodyweight such as when running, and in the assessment and efficacy of clinical intervention methods and risk of injury or re-injury.

Following adequate warm-up, leg press strength testing may...

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Quarter Past the Upper Quarter Y-Balance Test

assessment Feb 15, 2018

The Upper Quarter Y Balance Test (UQYBT) was developed as a clinical test for upper extremity function. It involves the patient setting themselves in the push-up position and reaching in three different directions - medial, supero-lateral, and infero-lateral. 

The subject is required to stabilise through the other upper limb (Amasay, Hall, Shapiro, & Ludwig, 2016) use this stability to allow mobility. It can be used to assess the dynamic stability of the upper extremity and the thoracic spine, including any differences between sides, and can assist in the prediction of shoulder injury risk and whether an athlete is ready to return to play (Amasay et al., 2016).

Additional research has revealed interesting implications when using the UQYBT including:

  • Limited data exists in the literature to date

  • Two studies found there was no difference in UQYBT performance between dominant and non-dominant limbs. This indicates that UQYBT performance may serve as a good measure in...

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Say It's Fast Three Times! - The Closed Kinetic Chain Upper Extremity Test - More Than Just a Tongue Twister

assessment Feb 14, 2018

The Closed Kinetic Chain Upper Extremity Test (CKCUET) is a simple, easy-to-implement, and easy method to measures your patient or clients strength, power, endurance and closed chain kinetic chain stability of the upper extremities. It can be used in the assessment of risk of injury to the shoulder and the upper extremity. 

It involves the patient adopting a push-up position and alternately tapping a pre-determined distance lateral to the stabilising hand as many times as possible within 15 seconds (Dong-Rour, & Laurentius, 2015).  

Research has shown that the CKCUET is particularly useful in the following:

  • Assessment of baseball players’ readiness for return to play following shoulder injury (Roush, Kitamura, & Waits, 2007)

  • Examination of the effects of shoulder impingement syndrome in athletes and the general population (Tucci, Martins, Sposito, Camarini, and de Oliveira, 2014)

  • Prediction of handgrip strength, which is important in the...

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Why You Need To Use The Limb Symmetry Index

assessment Feb 14, 2018

The Limb Symmetry Index (LSI)  is an excellent guide to objectively determine discrepancies in your patient’s upper and/or lower limb strength, function, and mobility.

The LSI is calculated by taking the average of any test scores for the affected limb, divided by the unaffected limb, multiplied by 100 to obtain a percentage difference between limbs.

Clinically, it is an easy-to-use, quick measure that can provide valuable data for baseline and progression purposes. It has been shown to be of significant importance in deciding when an athlete is ready to return to sport after anterior cruciate ligament (ACL) injury, with percentage values for knee extension and flexion strength equal to or above 90% considered to be satisfactory (Abrams et al., 2014).

Recent studies have also shown that:

  • At 1 year post-ACL injury, those with normal knee function had LSI values greater than 90% for the single-leg, cross-over, and triple hop tests - the LSI hop testing battery...
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assessment Feb 14, 2018

Unlock your athlete’s potential by assessing their ankle!

If you are trapped into only assessing that knee or hip that your patient is complaining about then we want to give you 3 reasons why you should be getting those shoes off and perform the weight-bearing lunge test (wblt).

The knee that continues to niggle and aggravate your patient may not be a knee problem at all and may be contributed to by a lack of ankle ROM. Addressing these deficits in ROM may help increase motion in more proximal joints and allow for your athlete to absorb and dissipate those large forces in order to help potentially decrease their risk of injury.

3 FOR 1: What can the WBLT tell me???

1 - Potential for altered knee and ankle kinematics with squatting 

  • One study wanted to compare non-weight bearing (NWB) dorsiflexion to the weight-bearing lunge test and their effects on an overhead squat, single leg squat, and jump landing tasks.  
    • They found that the individuals with a greater...

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Why you should be using the WBLT with your patients and clients!

assessment Feb 14, 2018

The Weight-Bearing Lunge Test (WBLT) is a quick and convenient test used to “determine dorsiflexion ROM” (Hall. E and Docherty. C, 2017) in a weight-bearing position (closed Kinetic chain). The amount of lower limb dorsiflexion is a common point interest for lower limb pathologies as this is one of the first areas of the body to interact with the ground and ground reaction force during activity.

The WBLT has been used to help potentially identify risk lower extremity injuries, which may include the risk of; ACL rupture, Ankle instability (chronic and acute) as well injuries associated with poor landing mechanics (Hall et al 2017).
- Persons with chronic ankle instability CIA) have demonstrated less dorsiflexion ROM during gait and less knee flexion during landing than persons without CIA. (Hall et al 2017).
- Persons with less dorsiflexion ROM demonstrated a less flexed landing strategy that was less efficient at attenuating GRF. (Hall et al 2017).
- A lower degree of...

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