Understanding and diagnosing musculoskeletal issues requires a thorough assessment including functional movements, active range of motion (AROM), passive range of motion (PROM), muscle testing, palpation and special tests. This guide details functional physical assessment tests that identify restrictions, pain points, and potential injuries, helping you determine when it's necessary to consult a physiotherapist.
1. Knee to Wall Test
Use:
Assessing ankle stiffness – if having issues with squat depth, knee to wall will help identify if the ankle is the limiting joint.
Checking ankle mobility.
Checking tightness of calf muscles and the muscles in front of the shin.
Information:
Measures ankle dorsiflexion AROM
Average result: approximately 8 cm from foot to wall, with the front foot's heel on the floor.
Each cm equals approximately 3.6 degrees of ROM.
Demonstration:
The individual stands facing a wall, places their foot 8 cm away, and attempts to touch the wall with their knee without lifting the heel.
2. Single Leg Squat
Use:
Assessing the knee, hip, and ankle
Information:
Identifies muscular compensations such as knee valgus, hip drop, foot external rotation, and pronation.
Note the point in the movement where pain occurs (on the way down or up).
Individuals that run or play sports should be able to perform 20 single leg squats on each leg.
Demonstration:
The individual performs a squat on one leg to a standard chair, touches bottom to chair and then stands up whilst maintaining balance.
3. Duck Walk
Use:
Assessing the knee, hip, and ankle ROM
Information:
A provocative movement that varies in norms by age.
Identifies the location and type of pain - tightness, stiffness, or pain in the ankle, knee, hip, joints or muscles.
Demonstration:
The individual performs a deep squat. Whilst at the bottom of the movement, the individual is to walk forward in that position.
4. AROM of the Spine
Use:
Assessing how much movement is available and identifying any structural restrictions.
Information:
Can assess flexion, extension, rotation, and side flexion in the cervical, thoracic, and lumbar spine.
Norm values differ by region and decrease with age.
Comparing AROM with Passive ROM (PROM):
If PROM > AROM, contractile tissue is likely the issue.
If PROM = AROM, non-contractile tissue is likely the issue.
Demonstration:
The individual performs various spine movements to assess the range of motion.
5. Slump Test
Use:
Assessing neural tension.
Information:
A provocative test used to reproduce neural symptoms.
Demonstration:
The individual sits and slumps forward, extending one leg and flexing the neck.
6. Median Nerve Glide
Use:
Assessing neural tension - can also be used as an exercise.
Information:
Used as a provocative screen to reproduce neural symptoms.
Demonstration:
The individual performs specific arm movements to stretch and mobilise the median nerve.
7. Overhead Movement:
Use:
Assessing shoulder mobility and stability.
Evaluating the functional range of motion.
Identifying potential impingement or movement restrictions in the shoulders and shoulder blades.
Information:
Helps determine the flexibility, strength and coordination of the shoulder girdle.
A normal range of motion allows the arms to reach fully overhead without compensatory movements in the spine or shoulder blades.
Demonstration: Standing facing the wall, start with palms on the wall at shoulder height and move them upwards until they are directly vertical above your head.
Notes:
Always aim to reproduce the pain the patient feels, as this ensures the relevance of the test.
Compare results between the left and right sides to identify asymmetries.
If the test results indicate pain or dysfunction refer to a physiotherapist and avoid aggravating activities until physiotherapist indicates otherwise.
Active Movements of Shoulder | Range of motion |
Flexion | 180 |
Extension | 45-60 |
Abduction | 180 |
Adduction | 30-50 |
External rotation | 90 |
Internal rotation | 70-90 |
Active Movements of Hip | Range of motion |
Flexion | 110-120 |
Extension | 10-15 |
Abduction | 30-50 |
Adduction | 30 |
External rotation | 40-60 |
Internal rotation | 30-40 |
Active Movements of Knee | Range of movement |
Flexion | 0 - 135 |
Extension | 0 - 15 |
Internal rotation (of tibia on femur) | 20 - 30 |
External rotation (of tibia on femur) | 30 - 40 |
Active Movements of Ankle and Foot | Range of movement |
Plantarflexion | 0-50 |
Dorsiflexion | 0-20 |
Supination | 45-60 |
Pronation | 15-30 |
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