POSTURE, JOINT R.O.M.

& MUSCLE FUNCTION

POSTURE, JOINT R.O.M.

& MUSCLE FUNCTION
MANUAL

© Copyright – Mark McKean 2008 – mark@markmckean.com

 POSTURE, JOINT R.O.M. & MUSCLE FUNCTION
PROTOCOLS FOR JOINT RANGE OF MOTION and BEHAVIOUR TESTS

Muscles Tested / Start Position Indications

Test Name
Hip Flexors – Lying on bench, back/sacrum flat, Short 1 joint – if thigh is off the bench but knee is bent 900
Thomas Test bent knee to chest, other leg Short 2 joint – if knee is bent less than 800
relaxed down Short Sartorius – if any of three of these actions present – abd,
flex, ext rot, flex knee
Short TFL – (indications only) abduction, lateral deviation of
patella, ext of knee if thigh prevented from abducting
Forward bending test Seated with hips flexed and knees Upper back – excessive length if curve is hinge like
for posterior muscles extended Lower back – excessive if hinge like with poor hamstring length
Gastrocnemius – short if foot cannot be dorsi flexed
Hamstring muscles – Lying on bench, back/sacrum flat, 1 joint knee flexors – tight if knee cannot be extended in this start
Straight leg raise hip extended, knee extended, foot position
relaxed 2 joint hamstrings – if hip can flex less than 800 with knee straight
* Modify test for hip flexor shortness by padding up knees with
pillow
Forward bending test
for hamstrings Seated with hips flexed, knees Hamstrings short- if sacrum angle doesn’t reach 800 same as for
extended, avoid dorsi flexion straight leg raise
Prone Leg Curl Prone on the floor with leg Normal – can flex knee to 1200 whilst hips remain still
straight Weak Obliques – if hips move before 1200
Tight quads – if knee cannot reach 1200
TFL / ITB – OBER Lying on side with hips and Short – if leg fails to drop below horizontal in adducted direction
test shoulder at right angles to table, + slight pressure may be needed to insure abductors are not
top knee straight and pelvis contracted
stabilised in neutral, leg kept from
rotating in/out

© Copyright – Mark McKean 2008 – mark@markmckean.com

 POSTURE, JOINT R.O.M. & MUSCLE FUNCTION
Back Extensors / Prone on floor with hands together in
Hip Extensors middle of lower back, with
1. legs held down to floor by trainer
2. legs remain free
* low back muscles are
seldom weak
Trunk Flexion Supine with arms crossed over
chest and legs out straight
Bent Knee Fall out Supine with knees bent and feet
flat
Lower Abdominals Supine with arms across chest, back
held flat to floor, legs straight up in
the air
Lower Abdominals Supine on the floor with legs held
at 90 degrees to the floor and
straight
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Strong
1. raise trunk in extension
2. raising the leg with anterior pelvic tilt and increased curve in
lumbar spine
Strong back extensors/weak hip extensors
1. lumbar spine hyper extended, but trunk cannot be lifted
2. hip lifts off bench, increased hip flexion, hyperextension of
lumbar spine, leg cannot lift of floor
Strong hip extensors/weak back extensors
1. pelvis tilts, lumbar spine flattens up, and trunk stays flat
2. glutes contract to pull into posterior tilt, back remain flat, leg
cannot be lifted
Normal – achieves full sit up with trunk flexion followed by hips
flexion in smooth manner
Trunk – weak abdominals if trunk remains semi straight and lift
occurs at hips only
Hips – weak hips if trunk flexes but cannot achieve full sit up
Normal – one knee can fall out to the side reaching 600 without the
pelvis rolling to the same side
Short adductors – if knee cannot reach 600
Weak Obliques – if hips cannot remain still
Normal – lower legs to floor with back held flat on the floor
Good – legs lowered to 300 off the floor
Average – legs lowered to 600 off the floor
* Weak abs will cause back to hyperextend off the floor during this
movement
Normal – legs can be lowered all the way to the floor without lower
back arching off the floor
Weak - legs cannot reach the floor
 POSTURE, JOINT R.O.M. & MUSCLE FUNCTION
Pec Major Supine, low back flat, knees bent,
Lower fibres – arm held at 450 above horizontal
adduction
Upper fibres – arm held at horizontal
abduction, with external rotation
Pec Minor Passive test - Supine on the floor,
back flat, arms by side, palms up
Active Test – subject raises hand
off the floor, wrist extended and
fingers pointing at ceiling whilst
tester holds shoulder to floor
Teres Major, Lat Supine, knees bent, back flat,
Dorsi, Rhomboids straight arms by side. Raise arms
to touch floor overhead keeping
elbows straight
Shoulder Rotators Supine, back flat, knees bent,
Internal shoulder and elbow flexed 900,
forearm at right angles to table
External
Scapula Control Standing with tester behind with
hands on scapula
Pelvic Control Standing and lift one leg off floor
© Copyright – Mark McKean 2008 – mark@markmckean.com
Normal - if arm flat on table
Normal - if arm is flat on table
Normal – if AC joint is less than 5cm off the floor
Short – if shoulder is raised of the floor
Normal – if subject can place wrist back on the floor
Short – if subject cannot return wrist to the floor
Short – if unable to place straight arms on floor above head
* short abs, kyphosis, tight Pec minor will all influence the results of
this test
Short – if unable to place back of hand and wrist flat on table
without keeping back flat
Normal – reaching a 200 angle with the table and the palm facing
down with shoulder girdle held down on table
Normal abduction – if subject can raise arm in abduction to 600
and flexion 30% without scapula following
Normal – hips remain almost level and trunk vertical with one foot
raised
Weak Glute med – hip drops on same side as leg lifted and
opposite hips moves to outside
 POSTURE, JOINT R.O.M. & MUSCLE FUNCTION
Lateral Flexion Stand with hands by side and lean Normal – pelvis remains still as trunk leans to one side
to one side Weak Glute med – hips move away from the side subject leans
towards
Weak obliques – hip drops on same side as subject leans towards

OTHER MUCSLE STRENGTH TESTS

Muscles Tested Position/key points Indications

Lateral Trunk Flexors / Side lying, body in a Strong
Hip Abductors straight line, 1. trunk can flex of the floor
1. top arm along body, 2. hip can be abducted with hip remaining still and aligned vertically
bottom arm crossed Strong later trunk flexors/weak hip abductors
over chest 1. head will flex laterally, trunk can flex but shoulder will not lift far off floor
2. hips kept in vertical and pelvis will be hitched upwards to trunk
alignment 2. hip will be hitched to trunk but leg will not be raised
Strong abductors/Weak trunk lateral flexors
1. hip abductors will attempt to lift trunk if can be held firm
2. pelvis will tilt downwards and leg can be lifted, but not very high

Upper Abdominals Supine with legs Normal – hands behind head, can raise trunk through full curve to sit up position
extended Good – With arms folded, can raise trunk through full curve to sit up position
Average – with arms extended forward, can raise trunk through full curve to sit up
position
* Weak abs will cause back to hyperextend off the floor before trunk curls off
** Knees can bent or trunk raised in start position to assist correct movement
Soleus Observation – in standing people with weak Soleus will flex at the knee and dorsi flex at
the ankle
Gastrocnemius/ Standing on one foot, Normal – body is raised in a straight line
Plantaris shoes off Weak – body is raised but may bend forwards or flex at the knee
Observation – when standing person will hyper extend the knee and foot plantar flexes

© Copyright – Mark McKean 2008 – mark@markmckean.com

 POSTURE, JOINT R.O.M. & MUSCLE FUNCTION
Medial Hamstrings – Prone with thigh flat and Normal – resists strong pressure
Semitendinosus, knee bent to 500-700 and Good – can hold against firm pressure
Semimembranosus internally rotated Average – can hold against gravity only
Weak – cannot hold leg against gravity
Lateral Hamstrings Prone with thigh flat and Normal – resists strong pressure
knee bent to 500-700 and Good – can hold against firm pressure
externally rotated Average – can hold against gravity only
Weak – cannot hold leg against gravity
Popliteus Seated with knee bent at Normal – lower limb can be internally rotated on the femur
900 and lower limb Weak – lower limb cannot be rotated
externally rotated, foot
flat
Quads Seated with knee bent at Normal – can extend knee against strong pressure
900 Good – can extend knee against firm pressure
Average – can extend knee against gravity only
Weak – cannot extend knee against gravity
Observations
– if TFL is dominant knee flexor it will internally rotate the thigh
- if Rectus femoris is dominant, person may lean backwards

Iliopsoas group – Supine with straight leg Normal – resists strong pressure
mainly Psoas Major slightly abducted and Good – can hold against firm pressure
external rotation, trainer Average – can hold against gravity only
holds down opposite side Weak – cannot hold leg against gravity
of pelvis. Apply pressure Observation – Psoas major weak on one side will indicate lumbar scoliosis, weak on
in an extension, slight both sides will indicate sway back and lumbar kyphosis
abducted direction

© Copyright – Mark McKean 2008 – mark@markmckean.com

 POSTURE, JOINT R.O.M. & MUSCLE FUNCTION
Hip Flexors Seated with knees bent
1. As a group and resistance applied in 1. thigh is raised from table in upward direction
2. Iliopsoas downward direction to 2. thigh is held in full hip flexed position
lifted knee Normal – resists strong pressure
Good – can hold against firm pressure
Average – can hold against gravity only
Weak – cannot hold leg against gravity
Observation
1. externally rotating and abducting the thigh as pressure is applied can indicate
Sartorius strength or that TFL is weak acting as an antagonist to Sartorius.
2. Internal rotation shows TFL is stronger than Sartorius
3. If adductors are strong then the thigh will adduct as pressure is applied
TFL Supine with hip abducted, Normal – resists strong pressure
flexed and internally Good – can hold against firm pressure
rotated. Apply resistance Average – can hold against mild pressure
in extension adduction Weak – cannot resist any pressure
direction Observation
1. if weak, then legs will bow out
2. if strong, then hips will flex and push knees in knock knee position and pelvis
tilted anteriorly
Internal Hip Rotators Seated with knees bent Normal – resists strong pressure
over edge of bench and Good – can hold against firm pressure
thigh internally rotated. Average – can hold against mild pressure
Pressure is applied in Weak – cannot resist any pressure
external rotation direction Short – if unable to sit in cross legged position
Observation – if weak person will externally rotate limb during walking and standing
External Hip Rotators Seated with knees bent Normal – resists strong pressure
over edge of bench and Good – can hold against firm pressure
thigh externally rotated. Average – can hold against mild pressure
Pressure is applied in Weak – cannot resist any pressure
internal rotation direction Observation – if weak person will internally rotate limb and pronate feet in a knock
knee direction

© Copyright – Mark McKean 2008 – mark@markmckean.com

 POSTURE, JOINT R.O.M. & MUSCLE FUNCTION
Gluteus Minimus Lying on side, holding
pelvis stable
Gluteus Medius Lying on side with
bottom leg flexed at hip
and knee and hips rotated
slightly forwards
Gluteus Maximus Prone with knee flexed
fully and thigh raised of
the floor. Pressure is
applied downward on the
thigh
Sartorius Supine with hip flexion,
abduction and external
rotation and knee slightly
flexed
Hip Adductors Side lying with legs
raised sideways off the
floor. On right side to test
right leg Adductors in
downward direction
Supraspinatus/ Middle Standing/sitting with neck
Deltoid extended and laterally
flexed to same side and
head rotated to opposite
side
© Copyright – Mark McKean 2008 – mark@markmckean.com
Normal – resists strong pressure
Good – can hold against firm pressure
Average – can hold against gravity only
Weak – cannot hold leg against gravity
Person pushes in an abducted, slight extension with slight external rotation direction
Normal – resists strong pressure
Good – can hold against firm pressure
Average – can hold against gravity only
Weak – cannot hold leg against gravity
Normal – resists strong pressure
Good – can hold against firm pressure
Average – can hold against gravity only
Weak – cannot hold leg against gravity
Pressure is applied in a hip extension, adduction and internal rotation direction and
knee extension with second hand
Normal – resists strong pressure
Good – can hold against firm pressure
Average – can hold against mild pressure
Weak – cannot resist any pressure
Normal – resists strong pressure
Good – can hold against firm pressure
Average – can hold against gravity only
Weak – cannot hold leg against gravity
Resistance is applied against shoulder abduction
Normal – resists strong pressure
Good – can hold against firm pressure
Average – can hold against mild pressure
Weak – cannot resist any pressure
 POSTURE, JOINT R.O.M. & MUSCLE FUNCTION
Teres Major Prone with bent arm and Pressure applied downwards on bent elbow
back of hand across lower Normal – resists strong pressure
back Good – can hold against firm pressure
Average – can hold against mild pressure
Weak – cannot resist any pressure
Latissimus Dorsi Prone with shoulder Resistance is applied in adduction and slight flexion direction
extended, internally Normal – resists strong pressure
rotated and abducted Good – can hold against firm pressure
slightly Average – can hold against mild pressure
Weak – cannot resist any pressure
External Shoulder Prone with shoulder Pressure is applied in internal rotation direction
Rotators (Infraspinatus, abducted 900 and elbow Normal – resists strong pressure
teres Minor) flexed 900 over edge of Good – can hold against firm pressure
bench palm down Average – can hold against mild pressure
Weak – cannot resist any pressure
Internal Shoulder Prone with shoulder Pressure is applied in external rotation direction
Rotators (subscapularis, abducted 900 and elbow Normal – resists strong pressure
Lats, Pec Major, Teres flexed 900 over edge of Good – can hold against firm pressure
Major) bench palm up Average – can hold against mild pressure
Weak – cannot resist any pressure
Middle Trapezius Prone with shoulder Pressure is applied in downward direction to the floor
abducted 900 and Normal – resists strong pressure
externally rotated. Good – can hold against firm pressure
Average – can hold against mild pressure
Weak – cannot resist any pressure
Lower Trapezius Prone with shoulder Pressure is applied in downward direction to the floor
abducted 1350 and Normal – resists strong pressure
externally rotated. Good – can hold against firm pressure
Average – can hold against mild pressure
Weak – cannot resist any pressure

© Copyright – Mark McKean 2008 – mark@markmckean.com

 POSTURE, JOINT R.O.M. & MUSCLE FUNCTION
Upper Trapezius Seated with neck slightly
extended and laterally
flexed to testing shoulder,
Distal end of clavicle
elevated towards head
Serratus Anterior Standing facing the wall
with hands extended into
a wall push up position,
palms level with
shoulders
Pressure is applied against head in flexion to opposite side and front and against
shoulder in direction of depression
Normal – resists strong pressure
Good – can hold against firm pressure
Average – can hold against mild pressure
Weak – cannot resist any pressure
Let chest sag to towards the wall and scapula adduct. Keep arms extended.
Strong – Scapula will remain in flattened position relative to rib cage
Weak – scapula will wing during the push as they try to move into abduction

© Copyright – Mark McKean 2008 – mark@markmckean.com