Muscle Extensibility Testing for the Lower Extremity – A Review for the Personal Trainer
by Dr Scott Cheatham, DPT, PhD, ATC, CSCS, NSCA-CPT
Personal Training Quarterly
June 2020
Vol 7, Issue 1
The purpose of this article is to provide personal trainers with a review of common muscle extensibility tests of the lower extremity.
Lower extremity muscle extensibility deficits can affect joint mobility and be a problem in the active population by increasing injury risk (6). Researchers have reported a correlation between muscle extensibility deficits and injuries to the hamstrings (17), quadriceps (8,27), and Achilles tendon (15,18). The personal trainer may need to address muscle extensibility deficits with their clients in order to decrease the likelihood of injury (4,6).
One way personal trainers can determine if a client has muscle extensibility deficits is through muscle extensibility tests. These tests are often used to screen clients and confirm the presence of extensibility deficits prior to prescribing a flexibility and mobility program (6,7). Understanding specific tests may help the personal trainer to better identify deficits and focus the intervention programs to address those issues. The purpose of this article is to provide a review of common muscle extensibility tests of the lower extremity.
This article originally appeared in Personal Training Quarterly (PTQ)—a quarterly publication for NSCA Members designed specifically for the personal trainer. Discover easy-to-read, research-based articles that take your training knowledge further with Nutrition, Programming, and Personal Business Development columns in each quarterly, electronic issue. Read more articles from PTQ »
Related Reading
References
1. Baggett, BD and Young, G. Ankle joint dorsiflexion. Establishment of a normal range. Journal American Podiatric Medical Association 83: 251-254, 1993.
2. Baumbach, SF, Braunstein, M, Seeliger, F, Borgmann, L, Bocker, W, and Polzer, H. Ankle dorsiflexion: what is normal? Development of a decision pathway for diagnosing impaired ankle dorsiflexion and M. gastrocnemius tightness. Archives of Orthopaedic and Trauma Surgery 136: 1203-1211, 2016.
3. Baumbach, SF, Brumann, M, Binder, J, Mutschler, W, Regauer, M, and Polzer, H. The influence of knee position on ankle dorsiflexion - a biometric study. BMC Musculoskeletal Disorders 15: 246, 2014.
4. Baxter, C, Mc Naughton, LR, Sparks, A, Norton, L, and Bentley, D. Impact of stretching on the performance and injury risk of long-distance runners. Research in Sports Medicine 25: 78-90, 2017.
5. Behara, B and Jacobson, BH. Acute effects of deep tissue foam rolling and dynamic stretching on muscular strength, power, and flexibility in Division I linemen. Journal of Strength and Conditioning Research 31: 888-892, 2017.
6. Behm, DG, Blazevich, AJ, Kay, AD, and McHugh, M. Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review. Applied Physiology, Nutrition, and Metabolism 41: 1-11, 2016.
7. Bonser, RJ, Hancock, CL, Hansberger, BL, Loutsch, RA, Stanford, EK, Zeigel, AK, Baker, RT, May, J, Nasypany, A, and Cheatham, S. Changes in hamstring range of motion after neurodynamic sciatic sliders: A critically appraised topic. Journal of Sport Rehabilitation 26: 311-315, 2017.
8. Bradley, PS, and Portas, MD. The relationship between preseason range of motion and muscle strain injury in elite soccer players. Journal of Strength and Conditioning Research 21: 1155-1159, 2007.
9. Cejudo, A, Ayala, F, De Baranda, PS, and Santonja, F. Reliability of two methods of clinical examination of the flexibility of the hip adductor muscles. International Journal of Sports Physical Therapy 10: 976-983, 2015.
10. Cejudo, A, Sainz de Baranda, P, Ayala, F, and Santonja, F. Testretest reliability of seven common clinical tests for assessing lower extremity muscle flexibility in futsal and handball players. Physical Therapy and Sport 16: 107-113, 2015.
11. Fasen, JM, O’Connor, AM, Schwartz, SL, Watson, JO, Plastaras, CT, Garvan, CW, et al. A randomized controlled trial of hamstring stretching: Comparison of four techniques. Journal of Strength Conditioning Research 23: 660-667, 2009.
12. Gajdosik, RL, Sandler, MM, and Marr, HL. Influence of knee positions and gender on the Ober test for length of the iliotibial band. Clinical Biomechanics 18: 77-79, 2003.
13. Hall, EA and Docherty, CL. Validity of clinical outcome measures to evaluate ankle range of motion during the weight-bearing lunge test. Journal Science Medicine and Sport 20: 618-621, 2017.
14. Herrington, L. The effect of pelvic position on popliteal angle achieved during 90:90 hamstring-length test. Journal of Sport Rehabilitation 22: 254-256, 2013.
15. Kaufman, KR, Brodine, SK, Shaffer, RA, Johnson, CW, and Cullison, TR. The effect of foot structure and range of motion on musculoskeletal overuse injuries. The American Journal of Sports Medicine 27: 585-593, 1999.
16. Lee, SY, Sung, KH, Chung, CY, Lee, KM, Kwon, SS, Kim, TG, Lee, SH, Lee, IH, and Park, MS. Reliability and validity of the Duncan-Ely test for assessing rectus femoris spasticity in patients with cerebral palsy. Developmental Medicine and Child Neurology 57(10): 963-968, 2015.
17. Liu, H, Garrett, WE, Moorman, CT, and Yu, B. Injury rate, mechanism, and risk factors of hamstring strain injuries in sports: A review of the literature. Journal of Sport and Health Science 1: 92-101, 2012.
18. Mahieu, NN, Witvrouw, E, Stevens, V, Van Tiggelen, D, and Roget, P. Intrinsic risk factors for the development of Achilles tendon overuse injury: A prospective study. The American Journal of Sports Medicine 34: 226-235, 2006.
19. Page, P. Current concepts in muscle stretching for exercise and rehabilitation. International Journal of Sports Physical Therapy 7: 109-119, 2012.
20. Park, JH, Kang, SY, Choung, SD, Jeon, HS, and Kwon, OY. Effects of tibial rotation on Ober’s test and patellar tracking. The Knee 23: 600-603, 2016.
21. Peeler, J, and Anderson, JE. Reliability of the Ely’s test for assessing rectus femoris muscle flexibility and joint range of motion. Journal of Orthopedic Research 26: 793-799, 2008.
22. Peeler, JD, and Anderson, JE. Reliability limits of the modified Thomas test for assessing rectus femoris muscle flexibility about the knee joint. Journal of Athletic Training 43: 470-476, 2008.
23. Powden, CJ, Hoch, JM, and Hoch, MC. Reliability and minimal detectable change of the weight-bearing lunge test: A systematic review. Manual Therapy 20: 524-532, 2015.
24. Reese, NB, and Bandy, WD. Use of an inclinometer to measure flexibility of the iliotibial band using the Ober test and the modified Ober test: differences in magnitude and reliability of measurements. Journal of Orthopedic and Sports Physical Therapy 33: 326-330, 2003.
25. Su, H, Chang, NJ, Wu, WL, Guo, LY, and Chu, IH. Acute effects of foam rolling, static stretching, and dynamic stretching during warm-ups on muscular flexibility and strength in young adults. Journal of Sport Rehabilitation 26: 469-477, 2017.
26. Weppler, CH, and Magnusson, SP. Increasing muscle extensibility: A matter of increasing length or modifying sensation? Physical Therapy 90: 438-449, 2010.
27. Witvrouw, E, Danneels, L, Asselman, P, D’Have, T, and Cambier, D. Muscle flexibility as a risk factor for developing muscle injuries in male professional soccer players. A prospective study. The American Journal of Sports Medicine 31: 41-46, 2003.
