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Modified Thomas Test
The Modified Thomas Test is a clinical assessment used to evaluate flexibility in the hip flexors by testing the range of motion within the hip joint. In this test, the patient lies supine (on their back) with their hip bent and the knee folded up toward the chest. The contralateral leg is then lowered until it is perpendicular to the ground in order to assess the amount of hip flexor tightness. This test is becoming more and more popular due to its accuracy in predicting decreased
Transcript
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This is Brent coming at you with our third
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for the hip flexors. You guys been using like a dynamic overhead squat assessment,
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these are great tests to help narrow down your exercise selection after you've
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seen something like an anterior pelvic tilt, or an excessive forward lean, that implies
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short, overactive hip flexors, which there are several of, right? Which one do we
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need to target? Which ones do we need to release? Which ones do we need to stretch?
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That's what these tests are for. So in previous videos, you guys saw we did the
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Ely Test for rectus femoris, we did the Ober's test for the TFL. Now we're going
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to do a Modified Thomas Test with my friend Yvette here, to implicate the
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iliacus and psoas, or to rule them out.
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So, first things first, we want to get Yvette nice alignment here.
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She's got feet pointing up, knees are in line with her feet.
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She's hip width here, and her trunk isn't twisted.
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She's nice and straight all the way up. Now, I'm going to use one hand, palpate
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underneath her lower back and lumbar spine.
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This is the setup for this test. This test is actually fairly simple.
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Once we get here, all I need Yvette to do is pull her knee up towards her
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chest.
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I'm going to have her pull far enough that I feel her lumbar spine flatten
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out.
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That's going to force her into a posterior pelvic tilt, which is relative
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hip extension. If her iliacus and psoas
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are at optimal length, her leg should stay down on the table with foot
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pointing up.
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Remember your psoas and iliacus are not only hip flexors,
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but also external rotators, so this is actually negative.
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She has a negative Modified Thomas Test, which means I don't need to address the
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psoas and iliacus, even if she does have an anterior pelvic tilt, even if she does
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have an excessive forward lean. If you guys have been watching our assessment videos,
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Yvette did test positive for the Ober's test,
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so maybe I would target the TFL instead. I'm going to have her go ahead and do the other side
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and make sure that both sides are even, but let's go ahead and pull this side up,
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same thing just make sure she pulls up to the lumbar spine flattens out.
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I'm going to have you do that one more time Yvette. On this side, I see just a slight indication of
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tightness. Her knee
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came up just a little bit, so she's being pulled a little bit into hip flexion
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here, so we probably have slightly tighter hip flexors on her left side
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than her right side, but still this is not, this is not a big positive. A big positive
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would be where you saw somebody do this.
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That would be tight, tight, psoas and iliacus. Or maybe a subtler sign is she
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pulled this way and her foot would flop out that way. Once again, that's going to be
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psoas and iliacus.
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So there you guys go. This test kind of rounds out our three assessment videos.
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We had Ely's, Ober's, and now the Modified Thomas Test. If she had tested positive
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here,
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I know, at least my personal trainers would have a little bit of an issue
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right, we can't do any sort of self-administered release for the psoas
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and iliacus. Please don't shove a tennis ball or a softball into your abdomen.
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That's definitely not safe. There are some delicate structures in there,
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like your common iliac artery,
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for example, that would be not a good thing to rub up and down on every day. You
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could definitely create some damage there as well as there's your femoral
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nerve in there, and of course, your internal organs. We want to stay away
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from those. If you guys did think that these were implicated as tight for the
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individual you're working with, you could do a hip flexor stretch, like the kneeling
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hip flexor stretch, and see if that improves your problem. If it seems a
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little stubborn to you, that's the time to refer out to, of course, a license manual
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therapist, who has some experience addressing these structures with manual
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techniques. Of course, I know my PTs, ATC's, and some of my LMTs out
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there, if you guys see a positive on this test,
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probably the best thing to do is manual release
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first, and then your kneeling hip flexor stretch.
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I hope you guys enjoy these assessment videos. I hope it helps narrow down your
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exercise selection, giving you some very specific, targeted programs, that get you
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much better results in the long run.
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Talk to you soon.
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