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Goniometric Assessment. Joints . NASM only chose a select number of joints to be measured Foot Dorisflexion Hip Flexion (Bent knee and 90/90 position) Internal Rotation External Rotation Extension Abduction Shoulder Flexion External Rotation Internal Rotation

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joints
Joints
  • NASM only chose a select number of joints to be measured
  • Foot
    • Dorisflexion
  • Hip
    • Flexion (Bent knee and 90/90 position)
    • Internal Rotation
    • External Rotation
    • Extension
    • Abduction
  • Shoulder
    • Flexion
    • External Rotation
    • Internal Rotation
  • Measurements were selected because of their overall importance to optimum human movement as well as their ability to correlate to the overhead squat and single movement assessment.
the foot
The Foot
  • Joint motion being assessed
    • Dorsiflexion of talocrural joint
  • Muscles being assessed
    • Gastrocnemius and soleus
    • Posterior tibialis, peroneus longus, flexor hallicus longus, and flexor digitorum longus.
  • Antagonists potentially underactive if ROM is limited
    • Anterior tibialis
    • Extensor digitorum longus, extensor digitorum brevis, extensor hallicus longus and peroneus tertius.
  • Normal Value- 20o
  • Client Positioning
    • Supine with Knee extended
    • Ankle is subtalar neutral
slide4
Placement of Goniometer
    • Axis (A)- Directly below the lateral mallelous near the base
    • Stationary Arm (SA) – Lateral aspect of fibula
    • Movement Arm- (MA) Midline of 5th metatarsal.
  • Pressure
    • Hold planter surface of foot right below MTP joints
    • Client/Patient actively DF while you are passively assisting the glide of motion
  • Compensation during Goniometer Assessment
    • Everson of the ankle
    • Flexing of the knee
  • Over Head Squat/ Single Leg Squat
    • Foot compensations ( feet going outward

Flattening and/or heels rising)

    • Excessive forward leaning
  • A lack of DF in the ankle has been know

to lead to knee injuries.

hip flexion
Hip Flexion
  • Joint motion being assessed
    • Extension of the tibiofemoral joint
    • Flexion of iliofemoral joint
  • Muscles being assessed
    • Hamstrings, Gastrocnemius, neural tissue (sciatic nerve)
  • Antagonists potentially underactive if ROM is limited
    • Hip flexor complex
    • Quadriceps complex
  • Normal Value- 20o
  • Client Positioning
    • Supine with Hip flexed and knee flexed to 90o
    • Hip is in neutral (0o rotation, abduction and adduction)
slide6
Placement of Goniometer
    • Axis (A)- lateral joint line of the tibiofemoral joint
    • Stationary Arm (SA) – Lateral midline of femur
    • Movement Arm (MA)- lateral midline of fibula
  • Pressure
    • Hold lower leg and thigh of client
    • Passively extend the knee until first compensations
  • Compensation during Goniometer Assessment
    • Posterior tilting of the pelvis
    • Hip extension
  • Over Head Squat/ Single Leg Squat
    • Feet turned out (External rotated)
    • Feet flattening
    • Knee moving inward or outward
    • Low back rounding
hip flexion bent knee
Hip Flexion (Bent Knee)
  • Joint motion being assessed
    • Flexion of iliofemoral joint
  • Muscles being assessed
    • Gluteus maximus, adductor magnus, upper portion of hamstrings
    • Psoas, rectus femoris, hip capsule.
  • Antagonists potentially underactive if ROM is limited
    • Hip flexor complex
    • Hip extensor complex (gluteus maximus)
  • Normal Value- 120o
  • Client Positioning
    • Supine with knee flexed
    • Hip is in neutral (0o rotation, abduction and adduction)
slide8
Placement of Goniometer
    • Axis (A)- Great trochanter
    • Stationary Arm (SA) – Lateral midline of pelvis
    • Movement Arm (MA)- lateral midline of femur
  • Pressure
    • Hold clients knee
    • Passively flex the hip until first compensation.
  • Compensation during Goniometer Assessment
    • Posterior tilting of the pelvis
    • Adbuction of the femur
  • Over Head Squat/ Single Leg Squat
    • Rounding of the lower back
hip internal rotation
Hip (Internal Rotation)
  • Joint motion being assessed
    • Internal rotation of iliofemoral joint
  • Muscles being assessed
    • Piriformis and hip external rotators and adductor magnus, ischiofemoral ligaments
    • Gluteus medius, gluteus maximus
  • Antagonists potentially underactive if ROM is limited
    • Adductor magnus, TFL, gluteus minimus, glutues medius, adductor longus, adductor brevis, pectineus, gracilis, medial hamstrings.
  • Normal Value- 45o
  • Client Positioning
    • Supine with Hip flexed and knee flexed to 90o
    • 0o of abduction and adduction
slide10
Placement of Goniometer
    • Axis (A)- Anterior aspect of patella
    • Stationary Arm (SA) – parallel to imaginary line down the center of the body
    • Movement Arm (MA)- Anterior midline of the lower leg (referencing the tibial tuberosity).
  • Pressure
    • Hold lower leg and thigh of client
    • Passively rotate the femur internally until first compensation
  • Compensation during Goniometer Assessment
    • Hip hike ( lateral flexion of spine) on side of measurement
  • Over Head Squat/ Single Leg Squat
    • Knee moving inward or outward
    • Asymmetrical weight shift
the hip external rotation
The Hip (External Rotation)
  • Joint motion being assessed
    • External rotation of iliofemoral joint
  • Muscles being assessed
    • Adductor magnus, iliofemoral ligament, and pubofemoral ligament
    • TFL, gluteus minimus, and gluteus medius
  • Antagonists potentially underactive if ROM is limited
    • Piriformis and hip external rotators and adductor magnus
    • Gluteus medius and gluteus maximus.
  • Normal Value- 45o
  • Client Positioning
    • Supine with hip and knee flexed to 90o
slide12
\
  • Placement of Goniometer
    • Axis (A)- Anterior aspect of patella
    • Stationary Arm (SA) – parallel to imaginary line down the center of the body
    • Movement Arm (MA)- Anterior midline of the lower leg (referencing the tibial tuberosity).
  • Pressure
    • Hold lower leg and thigh of client
    • Passively rotate the femur externally until first compensation
  • Compensation during Goniometer Assessment
    • Motion of ASIS
  • Over Head Squat/ Single Leg Squat
    • Knee moving inward or outward
    • Asymmetrical weight shift
hip extension
Hip (Extension)
  • Joint motion being assessed
    • Extension of iliofemoral joint
  • Muscles being assessed
    • Psoas, iliacus, rectus femoris, tensor fascia latae and sartorius
    • Adductor complex and anterior hip capsule
  • Antagonists potentially underactive if ROM is limited
    • Gluteus maximus, glutues medius
    • Hamstring complex, adductor magnus
  • Normal Value- 0-10o
  • Client Positioning
    • Supine with opposite hip flexed
    • Knee of testing leg should be flexed to ~ 90o
slide14
Placement of Goniometer
    • Axis (A)- Greater Trochanter
    • Stationary Arm (SA) – lateral midline of the trunk
    • Movement Arm (MA)- Lateral midline of the femur
  • Pressure
    • Hold thigh of client
    • Passively allow the hip to extend until first compensation.
  • Compensation during Goniometer Assessment
    • Anterior tilting
    • Low back arching
  • Over Head Squat/ Single Leg Squat
    • Arching of the lower back
    • Excessive forward lean
hip abduction
Hip (Abduction)
  • Joint motion being assessed
    • Abduction of iliofemoral joint
  • Muscles being assessed
    • Adductor complex, pubofemoral ligament, iliofemoral ligament, medial hip capsule
    • Medial Hamstrings
  • Antagonists potentially underactive if ROM is limited
    • Gluteus medius, Gluteus minimus, TFL, Satorius
    • Bicep Femoris
  • Normal Value- 40o
  • Client Positioning
    • Supine with knee extend
    • Hip is neutral
slide16
Placement of Goniometer
    • Axis (A)- ASIS
    • Stationary Arm (SA) – Imaginary line b/w ASIS’s
    • Movement Arm (MA)- Anterior midline of femur
  • Pressure
    • Holding Clients lower leg
    • Passively abduct the leg until first compensation
  • Compensation during Goniometer Assessment
    • Motion of opposite ASIS
    • Hip Hike on side of movement
  • Over Head Squat/ Single Leg Squat
    • Knees moving inward
    • Asymmetrical weight shift
shoulder flexion
Shoulder (Flexion)
  • Joint motion being assessed
    • Flexion of Shoulder complex
  • Muscles being assessed
    • Latissimus dorsi, teres major, teres minor, infraspinatus, subscapularis, pectoralis major, triceps
  • Antagonists potentially underactive if ROM is limited
    • Anterior deltoid, pectoralis major, middle deltoid
    • Lower and middle trapezius, rhomboids.
  • Normal Value- 160o
  • Client Positioning
    • Supine with should neutral
    • Knee’s in hook-lying position
    • Arm in external rotation
slide18
Placement of Goniometer
    • Axis (A)- Distal to the acromion process
    • Stationary Arm (SA) – mid-axillary line of upper thorax
    • Movement Arm (MA)- Lateral epicondyle of the humerus
  • Pressure
    • Hold arm in external rotation
    • Place thumb on the lateral border of the scapula and passively flex the shoulder until excessive scapular movement is felt or resistance is felt.
  • Over Head Squat/ Single Leg Squat
    • Arching of the lower back
    • Arms falling forward
shoulder external rotation
Shoulder (External Rotation)
  • Joint motion being assessed
    • External rotation of glenohumeral joint
  • Muscles being assessed
    • Subscapularis, latissimus dorsi, teres major, pectoralis major, anterior deltoid and anterior glenohumeral joint capsule.
  • Antagonists potentially underactive if ROM is limited
    • Infraspinatus, teres minor, posterior glenohumeral joint capsule
  • Normal Value- 90o
  • Client Positioning
    • Supine with humerus abducted to 90o
    • Elbow flexed to 90o
    • Towel is placed under humerus
slide20
Placement of Goniometer
    • Axis (A)- Olecranon process
    • Stationary Arm (SA) – Perpendicular to the arm
    • Movement Arm (MA)- Ulnar styloid
  • Pressure
    • Hold arm in external rotation till first resistance
  • Compensation during Goniometer Assessment
    • Upward migration of the humeral head into the hand over the anterior shoulder.
  • Over Head Squat/ Single Leg Squat
    • Arms falling forward
shoulder internal rotation
Shoulder (Internal Rotation)
  • Joint motion being assessed
    • Internal rotation of glenohumeral joint
  • Muscles being assessed
    • Infraspinatus, teres minor, posterior glenohumeral joint capsule
  • Antagonists potentially underactive if ROM is limited
    • Subscapularis, latissimus dorsi, teres major, pectoralis major, anterior deltoid.
  • Normal Value- 70o
  • Client Positioning
    • Supine with humerus abducted to 90o
    • Elbow flexed to 90o
    • Towel is placed under humerus
slide22
Placement of Goniometer
    • Axis (A)- Olecranon process of elbow
    • Stationary Arm (SA) – Perpendicular to the floor
    • Movement Arm (MA)- Ulnar styloid and olecranon process
  • Pressure
    • Hold arm in internal rotation until first resistance.
  • Compensation during Goniometer Assessment
    • Upward migration of the humeral head into the hand over the anterior shoulder.
  • Over Head Squat/ Single Leg Squat
    • Arms falling forward
reference
Reference
  • National Academy of Sports Medicine. Goniometric assessments. California, 2005 (1-38).