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Ely's Test (Rectus Femoris Flexibility Assessment)
Ely's Test is a commonly used method for assessing the flexibility of the Rectus Femoris, a major muscle of the thigh. During the test, the patient is asked to lie flat with the knee bent at 90° angle, and then to extend the leg, keeping the hips on the surface. The therapist then evaluates how far the leg can straighten. A decreased flexibility of the Rectus Femoris may indicate a certain degree of impairment of the knee joint, and other muscle
Transcript
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This is Brent, and I'm excited to go
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we're going to do the Ely test, but first let me explain how I personally would
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use this a test like this.
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This is a specific flexibility test for a specific muscle group.
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This becomes important after I've done a dynamic movement assessment, something
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like the overhead squad. The limit of something like an overhead squat, is it
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implies joint actions. That is, we are determining what joint action occurred
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to get somebody outside of optimal posture. If we have a joint action to
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look at, it then only implies a group of muscles. In the Ely test,
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what I'm trying to determine is which of my hip flexors are tight. So like, let's
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say, I have something like an excessive forward lean. Excessive forward lean is
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excessive hip flexion. Excessive hip flexion would imply that my psoas,
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iliacus, rectus femoris, or TFL could be tight.
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Now I'm going to go to something like my Ely test, Thomas test, or Ober's test, to
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determine which of those structures are tight, and which need to be included in
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my exercise program.
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So here we go. We're starting with the Ely test. I'm going to have my friend Yvette
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come out and I'll show you guys how to perform this very simple, very easy, test.
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Now first things first, they lie prone. Make sure they're in a comfortable
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position. You have your kinetic chain checkpoints lined up.
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You don't want to start your assessment already out of alignment.
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Next thing I'm going to do, is I'm going to find her PSIS, alright, her posterior
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superior iliac spine, and you guys can do that if you haven't done that before, you
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can kind of google some pictures and see where those are located.
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If you guys have ever seen somebody with their pants hanging a little low in the back,
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and they get those two little dimples in the back right here.
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Those are pretty close to the PSIS. You can also just feel the ilium, until you
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get to these two bony notches, just lateral to the spine.
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So what I'm going to do is I'm going to take my index finger and my thumb,
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and put those on her PSIS. Next thing I'm going to do, since this is a rectus
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femoris test, is I'm going to go ahead and take her foot in neutral position
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here, and just try to push it towards her backside.
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Now for the most part, I use this as a pass/fail test.
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You should be able to get to the heel within a couple inches of the back side,
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or actually touching the back side, without any compensation, and with a
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fairly soft end feel.
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Now, Yvette's not really terribly tight, but she is a little tight, and here is how I can
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tell. As I push her towards her backside, I actually feel the pressure of
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her PSIS pushing in to my thumb.
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So what does that mean? It means she's going into an anterior pelvic tilt. Her
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rectus femoris, a hip flexor, is pulling her pelvis this way. So we got
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just a little bit of tightness in her rectus femoris. And if I test the
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other leg,
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I actually already feel, feel some pressure here, and then you guys will get
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to see another compensation start to happen.
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She does a couple things here, and I don't know if you guys can see it, but
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she actually starts to rotate up this way, as she tries to, as this rectus femoris
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tries to pull this side of her pelvis into an anterior pelvic tilt. She
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also starts to deflect into abduction a little bit. So I start
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feeling pressure in my index finger here, at her PSIS. She starts to rotate up
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towards me, and I'm actually seeing just a little bit of deflection this way.
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So those are all signs that her rectus femoris is tight. Now, she's not terribly
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tight, and I'm pushing pretty hard.
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You'll be surprised. You'll find some people and it's like, stuck right here.
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Now if I had somebody where I thought the rectus femoris was not only tight, but
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a key structure in their dysfunction, something I really wanted to keep track
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of,
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I do think this test is simple enough, and reliable enough, that I may take a
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goniometer to this test.
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And all I would do is go through my same exact steps, and when I feel that first
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resistance barrier,
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all right Yvette, can you hold that for me? Good. I would have her hold that
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position.
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My stability arm goes through the center of my knee joint and I can palpate her
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joint line here, and then through her greater trochanter, and then the movement
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arm,
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we line up with the lateral malleolus. And I'm going to make this up, because
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this is actually not her end range, but that's 62 degrees. Now, what I would
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do is, I would then implement my corrective programming and either, at the
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end of every session, or maybe at the end of every week, or at the end of every two
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weeks, I would go ahead and reassess to make sure that we are getting gains. Of
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course, if I'm not getting gains,
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there's something wrong with my program and I need to change what I'm doing with
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her.
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I hope you guys enjoy the simple test. I hope it helps refine your exercise
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selection and exercise program. I look forward to talking to you guys again
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