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Ely's Test (Rectus Femoris Flexibility Assessment)

The Ely Test, or Rectus Femoris Flexibility Assessment, is an objective measure of lower extremity flexibility. This video provides an overview of how to properly perform and interpret the Ely Test.

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Transcript

00:00 - 00:04This is Brent, and I'm excited to go after our first assessment. In this video,
00:04 - 00:07we're going to do the Ely test, but first let me explain how I personally would
00:07 - 00:09use this a test like this.
00:09 - 00:13This is a specific flexibility test for a specific muscle group.
00:13 - 00:19This becomes important after I've done a dynamic movement assessment, something
00:19 - 00:23like the overhead squad. The limit of something like an overhead squat, is it
00:23 - 00:29implies joint actions. That is, we are determining what joint action occurred
00:29 - 00:35to get somebody outside of optimal posture. If we have a joint action to
00:35 - 00:41look at, it then only implies a group of muscles. In the Ely test,
00:41 - 00:45what I'm trying to determine is which of my hip flexors are tight. So like, let's
00:45 - 00:49say, I have something like an excessive forward lean. Excessive forward lean is
00:49 - 00:55excessive hip flexion. Excessive hip flexion would imply that my psoas,
00:55 - 00:59iliacus, rectus femoris, or TFL could be tight.
00:59 - 01:05Now I'm going to go to something like my Ely test, Thomas test, or Ober's test, to
01:05 - 01:09determine which of those structures are tight, and which need to be included in
01:09 - 01:11my exercise program.
01:11 - 01:14So here we go. We're starting with the Ely test. I'm going to have my friend Yvette
01:14 - 01:19come out and I'll show you guys how to perform this very simple, very easy, test.
01:19 - 01:23Now first things first, they lie prone. Make sure they're in a comfortable
01:23 - 01:26position. You have your kinetic chain checkpoints lined up.
01:26 - 01:29You don't want to start your assessment already out of alignment.
01:30 - 01:35Next thing I'm going to do, is I'm going to find her PSIS, alright, her posterior
01:35 - 01:40superior iliac spine, and you guys can do that if you haven't done that before, you
01:40 - 01:44can kind of google some pictures and see where those are located.
01:44 - 01:47If you guys have ever seen somebody with their pants hanging a little low in the back,
01:47 - 01:51and they get those two little dimples in the back right here.
01:51 - 01:57Those are pretty close to the PSIS. You can also just feel the ilium, until you
01:57 - 02:01get to these two bony notches, just lateral to the spine.
02:01 - 02:04So what I'm going to do is I'm going to take my index finger and my thumb,
02:05 - 02:10and put those on her PSIS. Next thing I'm going to do, since this is a rectus
02:10 - 02:15femoris test, is I'm going to go ahead and take her foot in neutral position
02:15 - 02:19here, and just try to push it towards her backside.
02:19 - 02:23Now for the most part, I use this as a pass/fail test.
02:23 - 02:29You should be able to get to the heel within a couple inches of the back side,
02:29 - 02:34or actually touching the back side, without any compensation, and with a
02:34 - 02:37fairly soft end feel.
02:37 - 02:42Now, Yvette's not really terribly tight, but she is a little tight, and here is how I can
02:42 - 02:47tell. As I push her towards her backside, I actually feel the pressure of
02:47 - 02:51her PSIS pushing in to my thumb.
02:51 - 02:56So what does that mean? It means she's going into an anterior pelvic tilt. Her
02:56 - 03:02rectus femoris, a hip flexor, is pulling her pelvis this way. So we got
03:02 - 03:06just a little bit of tightness in her rectus femoris. And if I test the
03:06 - 03:09other leg,
03:10 - 03:16I actually already feel, feel some pressure here, and then you guys will get
03:16 - 03:18to see another compensation start to happen.
03:18 - 03:22She does a couple things here, and I don't know if you guys can see it, but
03:22 - 03:27she actually starts to rotate up this way, as she tries to, as this rectus femoris
03:27 - 03:32tries to pull this side of her pelvis into an anterior pelvic tilt. She
03:32 - 03:39also starts to deflect into abduction a little bit. So I start
03:39 - 03:45feeling pressure in my index finger here, at her PSIS. She starts to rotate up
03:45 - 03:50towards me, and I'm actually seeing just a little bit of deflection this way.
03:50 - 03:55So those are all signs that her rectus femoris is tight. Now, she's not terribly
03:55 - 03:57tight, and I'm pushing pretty hard.
03:57 - 04:00You'll be surprised. You'll find some people and it's like, stuck right here.
04:00 - 04:05Now if I had somebody where I thought the rectus femoris was not only tight, but
04:05 - 04:10a key structure in their dysfunction, something I really wanted to keep track
04:10 - 04:10of,
04:10 - 04:17I do think this test is simple enough, and reliable enough, that I may take a
04:17 - 04:20goniometer to this test.
04:21 - 04:30And all I would do is go through my same exact steps, and when I feel that first
04:30 - 04:31resistance barrier,
04:31 - 04:35all right Yvette, can you hold that for me? Good. I would have her hold that
04:35 - 04:36position.
04:36 - 04:41My stability arm goes through the center of my knee joint and I can palpate her
04:41 - 04:48joint line here, and then through her greater trochanter, and then the movement
04:48 - 04:49arm,
04:49 - 04:55we line up with the lateral malleolus. And I'm going to make this up, because
04:55 - 05:02this is actually not her end range, but that's 62 degrees. Now, what I would
05:02 - 05:07do is, I would then implement my corrective programming and either, at the
05:07 - 05:10end of every session, or maybe at the end of every week, or at the end of every two
05:10 - 05:15weeks, I would go ahead and reassess to make sure that we are getting gains. Of
05:15 - 05:17course, if I'm not getting gains,
05:17 - 05:22there's something wrong with my program and I need to change what I'm doing with
05:22 - 05:22her.
05:22 - 05:27I hope you guys enjoy the simple test. I hope it helps refine your exercise
05:27 - 05:30selection and exercise program. I look forward to talking to you guys again
05:30 - 05:34soon.

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