Healthy Back Test

PURPOSE

The purpose of this laboratory session is to determine if you have some muscle imbalance and potential for back problems.

PROCEDURE

1. Secure a partner and administer the Healthy Back Tests to each other. (Details appear in chart 16.1, next page.) Record results of tests in the Results section of this laboratory. If you failed a test, indicate the muscles involved.
2. Determine your ratings by referring to charge 16.2 below.

RESULTS

These tests are among the ones used by physicians and therapists to make differential diagnoses of back problems. You and your partner can use them to determine if you have muscle tightness that may make you "at risk" for back problems. Discontinue any of these tests if they produce pain or numbness, or tingling sensations in the back, hips, or legs. Experiencing any of these sensations may be an indication that you have a low back problem that requires diagnosis by your physician. Partners should use great caution in applying force. Be gentle and listen to your partner's feedback.

Test 1 - Back to Wall

Stand with your back against a wall, with head, heels, shoulders, and calves of legs touching the wall. Try to flatten your neck and the hollow of your back by pressing your buttocks down against the wall. Your partner should just be able to place a hand in the space between the wall and the small of your back.

If this space is greater than the thickness of his/her hand, you probably have lordosis with shortened lumbar and hip flexor muscles.

Test 2 - Straight-leg Lift

Lie on your back with hands behind your neck. The partner on your left should stabilizeyour righ leg by placing his/her right hand on the knee. With the left hand, your partner should grasp the left ankle and raise your left leg as near to a right angle as possible. In this position, your lower back should be in contact with the floors. Your right leg should remain straight and on the floor throughout the test.

If your left leg bends at the knee, short hamstring muscles are indicated. If your back arches and/or your right leg does not remain flat on the floor, short lumbar muscles or hip flexor muscles (or both) are indicated. Repeat the test on the opposite side. (Both sides must pass in order to pass the test.)

Test 3 - Thomas Test

Lie on your back on a table or bench with your right leg extended beyond the edge of the table(approximately one-third of the thigh off the table). Bring your left knee to your chest and pull the thigh down tightly with your hands. Your lower back should remain flat against the table. Your right thigh should remain on the table.

If your right thigh lifts off the table while the left knee is hugged to the chest, a tight hip flexor iliopsoas) on that side is indicated. Repeat on the opposite side. (Both sides must pass in order to pass the test.)

Test 4 - Ely's Test

Lie prone; flex right knee. Partner gently pushes right heel toward the buttocks. Stop when resistance is felt or when partner expresses discomfort.

If pelvis leaves the floor or hip flexes or knee fails to bend freely (135 degrees) or heel fails to touch buttocks, there is tightness in the quadriceps muscles. Repeat with left leg. (Both sides must pass to pass the test.)

Test 5 - Ober's Test

Lie on left side with left leg flexed 90 degrees at the hip and 90 degrees at the knee. Partner places right hip in neutral position (no flexion) and right knee in 90-degree flexion; partner then allows the weight of the leg to lower it toward the floor.

If there is no tightness in the iliotibial band (fascia and muscles on lateral side of leg), the knee touches the floor without pain and the test is passed. Repeat on the other side. (Both sides must pass in order to pass the test.)

Test 6 - Press-Up (Straight Arm)

Perform the press-up.

If you can press to a straight-arm position, keeping your pubis in contact with the floor, and if your partner determines that the arch in your back is a continuous curve (not just a sharp angle at the lumbosacral joint), then there is adequate flexibility in spinal extension.

Test 7 - Knee Roll

Lie supine with both knees and hips flexed 90 degrees, arms extended to the sides at shoulder level. Keep the knees and hips in that position and lower them to the floor on the right and then on the left.

If you can accomplish this and still keep your shoulders in contact with the floor, then you have adequate rotation in the spine, especially at the lumbar and thoracic junction. (You must pass both.)