Interpreting Lower Body Assessments

Mar 28, 2020

How to go through common lower body assessments

Movement Debrief Episode 114 is in the books. Here is a copy of the video for your viewing pleasure.

Here is the setlist:

• What is hip flexion measuring?
• How can a wide and narrow infrasternal angle (ISA) be limited in hip flexion?
• What is the straight leg raise actually measuring?
• What mechanics go into a straight leg raise?
• Is there a way to self-measure the infrapubic angle (IPA)?
• What are the pro's and con's of active vs passive testing?
• How about comparing the obers test to the Gillet/reverse gillet?

If you want to watch these live, add me on Instagram.  Enjoy!

 

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Show notes

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Kinesiology of the Hip: A Focus on Muscular Actions

Immediate effects of the suboccipital muscle inhibition technique in subjects with short hamstring syndrome.

Does the Gillet test assess sacroiliac motion or asymmetric one-legged stance strategies?

If you are just getting into practicing this stuff, try to teach someone to stack with this exercise.

Here is the debrief on the Ober's test

Hip Flexion Limitations (1:06)

Hi Zac , awesome job you are doing for making us better therapists! Here is my question How can hip flexion be limited with narrow and wide compensations? Thank you! Btw come to Europe with Human Matrix someday! :)  

 

The Straight Leg Raise (9:25)

Hey Big Z. Looking at things through more the lens of eccentric and concentric orientation, If someone is demonstrating a limited SLR, what would be the likely limiting factors.?

 

In a previous life, I would describe this to patients as being limited secondary to the anterior tilted position of the pelvis causing the hamstrings to already be lengthened prior to an attempted SLR or toe touch. 

 

In this scenario, the pelvis is concentrically orienting the hip flexors and eccentrically orienting the hamstrings, which would lead me to think they should not have a limited SLR.

 

I think the pelvic floor orientation could be a limiting factor, but I am unable to visualize how. I would appreciate any thoughts you have.

 

Self-Assessing the Infrapubic Angle (27:35)

How can I self assess my infrapubic angle (IPA)? Where should I literally look for my own IPA? I promise not to sue myself.  

 

Should I use movement-based tests or passive tests? (33:32)

What are the pros/cons of using an Obers test instead of a standing forward flexion/Gillet test to look at SI dysfunction or pelvic rotation?

Hip Extension in gait (41:27)

If hip extension and internal rotation are paired, and someone. If someone lacked internal rotation but was exhaled bias, where would you start with exercises?

Sum Up

• Regardless of infrasternal angle presentation, hip flexion limitations occur if there is a loss of sacral counternutation
• The straight leg raise assesses inhalation mechanics from approximately 0-45 degrees, then 45-90 degrees has more exhalation bias
• Self-assessment of the infrapubic angle has no supportive data and cannot accurately be performed. A better alternative is to find self-tests that look at your ability to exhibit inhalation and exhalation mechanics
• Passive tests are more accurate but have less transfer to complex tasks
• Active tests might transfer better to complex tasks, but are less accurate. Perform many to gather enough data points to make movement judgments 
• When choosing exercises, first teach "the stack," next, drive inhalation mechanics, and finish with exhalation mechanics