Stretching in pediatrics

a) Thomas test:
 Aimed to detect if there is shortening in iliopsoas or
rectus femoris and iliotibial band.
 Child position: supine falling position with untested leg
should be completely flexed (hip and knee) and external
rotation of the hip joint to prevent an anterior tilt of the
pelvis.
 Therapist grasp as follow: one hand stabilize the untested
leg while the other hand placed above the knee of the
tested leg with index on lateral aspect above the thigh,
thumb on anterior aspect of thigh and other fingers on
posterior surface of thigh to put it in mid position.
 There are three possibilities appear in sever contracture
and palpable in mild one:
1- Forward flexion mean iliopsoas contracture.
2- Forward flexion with abduction and external rotation
mean iliotibial band contracture.
3- Forward flexion with knee extension mean rectus
femoris contracture.

Prone position

b) Ober's test:
 Aimed to detect if there is shortening in hip abductor including
iliotibial band.
  Child position is side lying with tested hip up and flex the
bottom hip and knee to stabilize patient.
 Therapist stabilizes the pelvis at iliac crest.
 If there is shortening, the limb placed in abduction, flexion of
hip with knee flexion.

c) Test for knee flexion contracture:

 Child is prone lying position
 Therapist press on pelvis and buttocks
 If there is shortening the knee is flexed.

Another test:

 Child is supine lying

 Therapist one hand above knee and other hand below knee
with index under popliteal fossa to prevent knee hyper
extension.
 Pull the leg and move it up while pressing by other hand down
ward.

d) Test & stretching for adductors:

The child crook lying Abduct either both limbs (ring shape) or only
one limb

e) Test for tendoachillis shortening:

 Child position supine lying with slight knee flexion to test
soleus then apply the same test with tapping on quadriceps to
test gastrocnemius.
 Therapist grasp child leg with cigarette grasp index on anterior
aspect of leg and middle finger on posterior aspect of leg other
lateral fingers on calcanoues and thumb on sole of the foot.
 Apply dorsiflexion if thee is resistance mean shortening in
tendoachillis.
 f) Test for subscapularis muscle shortening:

Child position is supine lying position

Therapist is standing in front of him and grasping both upper limbs

with thumb introduced in the palm and other fingers make fixation to
the wrist joint. Put the upper limbs in complete adduction shoulder
and elbow flexion.

Then apply external rotation, if there is resistance and there is gap

between the dorsum of affected hand and the plinth mean
subscapularis shortening

N.B: the test can be applied unilateral or bilateral (preferable). If

unilateral, fixation of the upper body to prevent compensatory and
trick movement. If bilateral aimed for comparing both sides and
fixation of scapula.

g) Test for pronator ms shortening:

Child is supine lying position with elbow flexed right angle

Therapist grasps around forearm and move in supination.

h) Test for wrist flexors shortening:

Child is supine lying position with one hand, while other hand grasp
above the wrist joint.

Therapist move the hand in extension and radial deviation, observe if

there is tightness or not.