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Gastrocnemius and Soleus Muscle Length Test

The Gastrocnemius and Soleus Muscle Length Test is a physical examination used to assess the muscle length and flexibility of the calf muscles and their tendons. The examiner can use this test to check for calf tightness, muscle imbalance, or flexibility issues. This test involves the use of a goniometer to measure the length of the gastrocnemius and soleus muscles when the patient is either standing on their toes or performing a single leg calf raise. The results can

Transcript

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This is Brent of the Brookbush Institute
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...blank
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bringing you guys a muscle length test.
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In this video we're going to go over the
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gastroc soleus length test. I'm going to
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show you guys how to take that maybe one
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step further, and maybe determine whether
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the peroneal and fibularis muscles or
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the posterior tib is restricting plantar
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flexion. We're also going to talk about
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the strengths and weaknesses of this
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particular muscle length test. I'm going
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to have my friend Melissa come out, she's
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going to help me demonstrate. Now the
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idea behind this test is just our
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knowledge of anatomy. So if let's say I
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did the overhead squat assessment, I
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determined that the lower extremity was
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the cause of my issues. I did goniometry
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for dorsiflexion I got a
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restriction, and now I'm trying to figure
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out which muscle is restricting
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dorsiflexion, so I can target my
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intervention there. If my knee is in
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extension I have lengthened the one
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plantar flexor that actually crosses the
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knee, which is the gastrocnemius. So the idea
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here is if i push into dorsiflexion and
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it's restricted knee extension, there's a
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good chance the gastrocnemius is involved. I'm
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then going to compare that to putting
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Melissa here in knee flexion, did I gain
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dorsiflexion, was dorsiflexion the same.
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If dorsiflexion is still restricted then
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maybe it's one of the dorsi flexors that
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does not cross the knee, like the soleus.
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If I gained a bunch of dorsiflexion back
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with knee flexion, then I have a pretty
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good idea that the one muscle that
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restricts plantar flexion that i
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shortened is actually responsible, which
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in this case is the gastrocnemius. Now I might
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be able to even take this a step further.
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If i push somebody into dorsiflexion,
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actually let's put them back in this
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position, since neither your posterior
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tib nor your fibularis / peroneal
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muscles cross the knee we can leave it
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in this position. If I pull into
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dorsiflexion this way and I evert the
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ankle, that would shorten the peroneal
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muscles. If I shorten the peroneal
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muscles a little bit i would have more
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slack, which means i might be able to
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gain dorsiflexion. If that were the case
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if i push you into eversion and i
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gained some dorsiflexion, then I know her
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peroneals are contributing to this
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restriction in plantar flexion. Now I
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can do the same thing with the posterior
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tib, although the posterior tib is rarely
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a restrictor of plantar flexion because
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it's rarely short and overactive. I could
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go into inversion and see if that gained
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me dorsiflexion, in Melissa's case
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that does not. Alright so we could take
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the gastroc soleus length test up a
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notch and add fibularis and posterior
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tib, but there is one glaring flaw to
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this test and we need to discuss it. The
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truth of the matter is, in this position
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regardless of the fact that my gastroc
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is now lengthened, my soleus as well as
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my other plantar flexors do not cross
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the knee, so they could care less whether
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my knee was extended or flexed. What this
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means is is let's say for an example my
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soleus is tight, my soleus is short and
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overactive, i'm going to be restricted in
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this position and i'm also going to be
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restricted in this position. I'm going to
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be restricted if i evert, i'm going to be
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restricted if I invert. If my soleus is
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restricted you will get no other
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information from this test, all you will
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know is that the soleus and potentially
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all of the other plantar flexors are
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contributing to Melissa's lack of dorsiflexion.
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In fact the only results that
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give us any information from this
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particular exam is if I get more range
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of motion when I get into knee flexion,
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meaning my gastroc is the primary
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culprit restricting dorsiflexion. If my
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soleus is not the primary culprit then I
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also may get that differentiation
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between the peroneal and posterior tib. I
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know that was a lot to take in, that's a
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lot of if's, then's. So let's take it all the
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way back down to the simplest part of
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this exam, this is supposed to be gastrocnemius,
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this is supposed to be soleus. The truth
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of the matter is, is this is all plantar
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flexors, this is all plantar flexors
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minus the gastrocnemius. If you get a change
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from here to here, then there's a good
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chance that your gastroc is the primary
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restrictor. If your gastroc and soleus
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are out of the equation right, they don't
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seem to be the ones restricting
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dorsiflexion, because you gain a
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dorsiflexion in this position, you can
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then try the eversion-inversion thing
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to see where some of that other
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restriction might be coming from. Alright
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guys so that's a fairly complicated way
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of getting through this muscle length
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test, but I think if you give it some
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practice, you give it some thought, you'll
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start to see how you can use this test
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to potentially differentiate some of the
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structures that are restricting
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dorsiflexion, after you've done your
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goniometric assessment so that you can
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narrow down your corrective exercise
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intervention, or if obviously if you're a
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therapist or licensed professional, what
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manual techniques you're going to use to
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help gain dorsiflexion back. I look
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forward to talking to
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you guys more. I hope this test adds a
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little more accuracy to your