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Dr. Brent Brookbush performing ankle dorsiflextion goniometric assessment with a client.

Lower Body Goniometric Assessment: Technique and potential restricting structures

Goniometry of the lower body, including ankle dorsiflexion, knee extension, knee flexion, hip internal rotation, hip external rotation, hip abduction, hip flexion and hip extension goniometric assessments. A list of potential muscles, fascia, and neural structures that may restrict motion at the hip, knee, and ankle joints.

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Course Description: Goniometry: Lower Body

Why Assessment? All fitness, performance, and rehabilitation programs should start with an assessment. The goal of assessment is to refine technique selection, with the intent of improving client and patient outcomes. This course describes the reliable goniometric assessments used to assess range of motion (ROM) of the lower extremity (Note, reliable = ankle dorsiflexion goniometry is included, and ankle inversion goniometry is not).

  • Goniometry - "refers to the measurement of angles, in particular, the measurement of angles created at human joints by the bones of the body (1)"

Why Goniometry? Most often, goniometric assessments highlight osteokinematic hypomobility (loss of joint ROM), aiding in the selection of release, mobilization, and stretching techniques. Less often, goniometry will highlight hypermobility (excessive joint ROM) and imply a need for activation, stabilization, and conditioning techniques. For an introduction to specific terminology, defining "good assessments," defining what goniometry measures, and best use, please check out:

Why Add Goniometry to Movement Assessment? Goniometry adds an assessment with continuous interval measures to movement assessments that only provide binary or discrete values. Assessments that only provide binary values include the Overhead Squat Assessment (OHSA) , the gastroc/soleus length test , the Functional Movement Screen, static postural assessments, the L.E.F.T. Test, and mobility-dependent special tests such as the FABER (Patrick's) Test  and FADDIR Test .

The Brookbush Institute recommends that these assessments are added to the repertoire of all sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.).

Goniometric Assessments Covered in this Course

Each goniometric assessment in this course includes a list of potentially affected structures, and those structures are hyperlinked to courses that cover specific interventions for those structures. Predictive Models of Postural Dysfunction were used to aid in considering all muscular, articular, fascial, and neural structures that may restrict each motion.

Printable PDF of the Movement Assessment Template:

Pre-approved credits for:

Pre-approved for Continuing Education Credits for:

This Course Includes:

  • AI Tutor
  • Text and Illustrations
  • Audio Voice-over
  • Technique Videos
  • Practice Exam
  • Pre-approved Final Exam

Course Study Guide: Lower Body Goniometric Assessment

Introduction

Hip Internal Rotation at 90 degrees of Flexion (90/90 Hip IR)

Hip External Rotation at 90 degrees of Flexion (90/90 Hip ER)

Hip Internal Rotation in Prone

Hip External Rotation in Prone

Hip Extension (Thomas Test Position)

Hip Flexion Goniometry

Hip Abduction Goniometry

Knee Flexion Goniometry

Knee Extension with Hip Flexion Goniometry (Hamstring Length Test)

Knee Extension Goniometry

Dorsiflexion Goniometry

Bibliography

  1. Cynthia C. Norkin, D. Joyce White. Measurement of Joint Motion: A Guide to Goniometry 3rd Edition. Copyright (C) 2003 by F.A. Davis Company
  2. Dr. Mike Clark & Scott Lucette, “NASM Essentials of Corrective Exercise Training” © 2011 Lippincott Williams & Wilkins
  3. Donald A. Neumann. Kinesiology of the Musculoskeletal System: Foundations of Rehabilitation – 2nd Edition © 2012 Mosby, Inc.
  4. Cynthia C. Norkin, Pamela K. Levangie, Joint Structure and Function: A Comprehensive Analysis: Fifth Edition © 2011 F.A. Davis Company
  5. David G. Simons, Janet Travell, Lois S. Simons, Travell & Simmons’ Myofascial Pain and Dysfunction, The Trigger Point Manual, Volume 1. Upper Half of Body: Second Edition,© 1999 Williams and Wilken
  6. Tom Myers, Anatomy Trains: Second Edition. © 2009 Elsevier Limited
  7. David Butler. The Sensitive Nervous System © 2000 NOI Group
  8. Michael Shacklock. Clinical Neurodynamics: A New System of Musculoskeletal Treatment © 2005 Elsevier Limited
  9. Miller, P. J. (1985). Assessment of joint motion. Measurement in physical therapy, 103-136.
  10. Lea, R. D., & Gerhardt, J. J. (1995). Range-of-motion measurements. J Bone Joint Surg Am, 77(5), 784-798.
  11. Ekstrand, J., Wiktorsson, M., Oberg, B., & Gillquist, J. (1982). Lower extremity goniometric measurements: a study to determine their reliability. Archives of physical medicine and rehabilitation, 63(4), 171-175.
  12. Gajdosik, R. L., & Bohannon, R. W. (1987). Clinical measurement of range of motion. Physical Therapy, 67(12), 1867-1872.
  13. Bovens, A. M., van Baak, M. A., Vrencken, J. G., Wijnen, J. A., & Verstappen, F. T. (1990). Variability and reliability of joint measurements. The American Journal of Sports Medicine, 18(1), 58-63.
    • Both Upper and Lower
  14. Boone, D. C., Azen, S. P., Lin, C. M., Spence, C., Baron, C., & Lee, L. (1978). Reliability of goniometric measurements. Physical Therapy, 58(11), 1355-1360.
  15. Rothstein, J. M., Miller, P. J., & Roettger, R. F. (1983). Goniometric reliability in a clinical setting. Physical Therapy, 63(10), 1611-1615.
    • Lower Body
  16. Prather H, Harris-Hayes M, Hunt D, Steger-May K, Mathew V, Clohisy JC. Hip range of motion and provocative physical examination tests reliability and agreement in asymptomatic volunteers. PM R. 2010, 2(10): 888-895.
  17. Poulsen E, Christensen HW, Penny JO, Overgaard S, Vach W, Hartvigsen J. Reproducibility of range of motion and muscle strength measurements in patients with hip osteoarthritis – an inter-rater study. BMC Musculoskeletal Disorders. 2012, 13:242
  18. Konor MM, Morton S, Eckerson JM, Grindstaff TL. Reliability of three measures of ankle dorsiflexion range of motion. Int J Sports Phys Ther. 2012, 7(3): 279-287.
  19. Powden CJ, Hoch JM, Hoch MC. Reliability and minimal detectable change of the weight-bearing lunge test: a systematic review. Man Ther. 2015, 20(4): 524-532. (lunge test)
  20. Gogia, P. P., Braatz, J. H., Rose, S. J., & Norton, B. J. (1987). Reliability and validity of goniometric measurements at the knee. Physical therapy, 67(2), 192-195.
    • Small Joint Reliability
  21. Hellebrandt, F. A., Duvall, E. N., & Moore, M. L. (1949). The measurement of joint motion. Part III: Reliability of goniometry. Phys Ther Rev, 29(6), 302-7.
    • Additional Research
  22. Vigotosky AD, Lehman GJ, Beardsley C, et al. (2016). The modified Thomas test is not a valid measure of hip extension unless pelvic tilt is controlled. PeerJ. 4:e2325; DOI 10.7717/peerj.2325
  23. Fahrer, H., Rentsch, H. U., Gerber, N. J., Beyeler, C., Hess, C. W., & Grunig, B. (1988). Knee effusion and reflex inhibition of the quadriceps. A bar to effective retraining. Bone & Joint Journal, 70(4), 635-638.
  24. Torry, M. R., Decker, M. J., Viola, R. W., D O’Connor, D., & Steadman, J. R. (2000). Intra-articular knee joint effusion induces quadriceps avoidance gait patterns. Clinical Biomechanics, 15(3), 147-159.
  25. Hopkins, J. T., Ingersoll, C. D., Krause, B. A., Edwards, J. E., & Cordova, M. L. (2001). Effect of knee joint effusion on quadriceps and soleus motoneuron pool excitability. Medicine and Science in Sports and Exercise, 33(1), 123-126.
  26. Jensen, K., & Graf, B. K. (1993). The effects of knee effusion on quadriceps strength and knee intraarticular pressure. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 9(1), 52-56.

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