Slump test Tests for nerve root compression due to a disc herniation in the lumbar region. The client should be seated on the edge of the massage table, spine erect with their feet hanging freely. They will be asked to put the back of their hands on their lower back before slumping their entire spine into flexion. The massage therapist may either place Quadratus lumborum (QL) length test Tests for hypertonicity of the QL. The client may be seated or standing. The massage therapist stands behind the client and notes the position of the bilateral hips. The client then laterally flexes their trunk to one side and then the other
their forearm at the base of the neck and direct pressure inferiorly or tilt the client’s head forward so that their chin is toward their chest. Then the client will extend the knee on the affected side. The therapist may also reach and dorsiflex the client’s foot. A positive result is indicated by pain in the lower back at any time during the test. while the therapist notes which side has a reduced ROM. A reduced ROM in combination with and elevated hip free of pain indicates a shortened QL. All massage strokes are indicated.
ORTHOPEDIC TESTS FOR THE HIPS
Iliopsoas strength test Tests for weakness of the iliopsoas muscles. The client should be lying on the table in the supine position with their knees in full extension; no bolster is placed underneath them. The client is asked to actively raise one of their thighs off the table with a slight lateral rotation while flexing their Iliopsoas length test I Tests for hypertonicity of the iliopsoas muscles. The client should be on the table in the supine position, again, with no bolster. The massage therapist places the foot of the side Iliopsoas length test II Tests for hypertonicity of the Iliopsoas muscles. The client should be on the table in the supine position near the edge of the table on the side being tested. Again, no bolster. The massage therapist drapes the thigh being tested off Thigh adductor length test Tests for hypertonicity of the adductor group of muscles. The client should be on the table in the supine position. On the thigh that is being tested, the client will place the plantar (bottom) surface of their foot on the medial portion of the opposite knee. (The client should be in a “figure-4” position.) From this position, the massage therapist will push the thigh on the side of the adductors that are being tested into flexion – most easily done by the therapist pushing Hip range of motion test Tests for hypertonic muscles or a dysfunction of the hip joint. The client should be in the supine position and their knees may be bolstered for comfort. The client’s thigh is brought into flexion at the hip while keeping the knee flexed. The massage therapist will perform circumduction of the hip joint at approximately 45 degrees of flexion. Limited ROM or pain around the femur’s greater trochanter may indicate hypotonic muscles depending upon where ROM is Ober’s test Tests for hypertonicity of the iliotibial band aka IT band and the tensor fasciae latae aka TFL muscle. The client should be placed in the side-lying position. Their bottom leg, the leg not being tested, is flexed to 90 degrees at the hip and knee. The leg being tested is kept straight. The client abducts their entire leg while attempting extension to 45 Pace abduction test Tests for a dysfunction of piriformis. The client should be in the supine position with both legs flexed to 90 degrees at the hip and knee. With the massage therapist’s hands on the lateral aspect of the client’s knees, the client is asked to abduct their knees away from each other. Weakness of the piriformis muscle is indicated if the client is unable to abduct their legs against the therapist’s light resistance. Pain in the
knee to 30 degrees. The client is asked to maintain this position. If they cannot, the iliopsoas group is considered weak. Active-resisted exercises may be employed to strengthen the iliopsoas.
being tested on the opposite knee (in a “figure-4” position). Hypertonic iliopsoas muscles are indicated if the hip of the side being tested rises above the opposite knee.
the edge of the table. Hypertonic iliopsoas muscles are indicated if the client’s thigh does not drop below tabletop level.
with their own hip – while applying posterior pressure on the knee of the side being tested. (The therapist may want to place a hand on the opposite thigh’s quadricep muscles just above the knee for stabilization purposes.) Shortened adductors or hypertension of the adductor muscles is indicated if the knee is unable to touch the table top or flexion under 90 degrees. limited. Pain deep in the joint or crepitus (crackling) at any point through the ROM may indicate a dysfunction between the acetabulum and the head of the femur. The head of the femur can be pressed into the acetabulum to elicit pain to confirm the result. Stretches may lengthen hypertensive muscles that may be limiting ROM but the therapist should avoid performing ROM movements and stretches if crepitus is present. degrees. Then the client is asked to slowly lower their leg to the starting position. If the client is unable to lower their leg smoothly, this indicates hypertonicity of the IT band or TFL. Myofascial release along the IT band from knee to hip may by beneficial. area of the piriformis may indicate a dysfunction or injury of the piriformis muscle or other lateral rotators in the inferior gluteal region. Pain, numbness, tingling or burning that radiates to the lateral thigh or knee may indicate sciatica/ piriformis syndrome. The therapist should apply cold therapy to reduce pain and inflammation. The therapist may then use PNF stretches to lengthen the piriformis muscle
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Book Code: MNJ0524
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