Assessment of the Muscle System

Stream A Week 2 Practical

Place thumb just in front of scapula and just before serratus anterior

When doing shoulder retraction – mostly lower and middle trapezius should be working =
good
If latissimus dorsi works more = bad

Shoulder internal and external rotation:

Anterior instability/interior dislocation – look at the patient to make sure they are not
apprehension and feel like their shoulder might dislocate

Forearm and wrist movements:

Use hand-held dynamometer and record the reading (outside numbers = kilos and inside
numbers = pounds)
Squeeze until you feel pain
Use if they have elbow pain
After the test, ask out of 10, what was your pain?
No towel underneath the hand-held dynamometer

Keep your fingers in a neutral position

-10 – 15 reps without weight
Progression -> add weight
Progression -> pronation/supination with weight
During movement ask - Are you experiencing any pain or discomfort?

To isolate other muscles

Learning Activity 3:

Scenario 1:
Latissimus dorsi, pectoralis, subscapularis, teres minor
Muscle length test of lats and pecs
Twist arm outwards and keep it straight and perform shoulder flexion. Place one hand on
top of shoulder to stabilize

To measure pec major -> drop shoulder off the plinth

To measure pec minor -> Measure from coracoid process to sternal end of the 4 th rib (most
accurate) OR measure from coracoid process to the plinth
Rounded shoulders – pec minor
Your patient had restricted elbow active range of ect - To measure triceps muscle, go to mid
inner range (like a hug) and extend elbow

Patient Is experiencing weakness of hand and thumb - Pinch test

Stream B Week 2 Practical

Isometric Muscle Testing for Ankle & Foot

- We are going to do some muscle testing of the muscles around your ankle & foot.
- With these tests I want you to meet my resistance and tell me if it reproduces any of
your symptoms.
- The movement that I want you to do is:
o Dorsiflexion – lift your toes up towards yourself

Isometric Muscle Testing for Hip & Knee

Gluteus maximus = extension,

Hip Extension Motor Control

Hip Abduction Motor Control

Foot doesn’t have to be off the bed if not doing full ROM (it’s ok for isometric muscle
testing)

Isometric muscle test:

- not maximal force – match my force
- we do it to see if they can activate their muscles

Assessment of muscle recruitment (motor control):

- Palpation
- to feel the muscles activating
- to check for evenness of muscle mass contraction
- when doing knee extension and a straight leg raise, check for lack or lag

Lack = when we attempt to straighten the leg and the patient’s norm stays flexed
Lag = when we attempt to do a straight leg raise and the patient starts to flex their leg

It is possible to have both a lag and lack

MMT:

When doing dorsiflexion, there is always some degree of inversion that comes with it.
Therefore, dorsiflexion + inversion activates tibialis anterior.