PTA 226

Muscle Length Testing

General Instruction & CONCEPT

Muscle length measurements are often taken in comparison to PROM measurements to check the influence of muscles that cross more than one joint. Take the biceps brachii as an example.

We know that the biceps brachii performs shoulder flexion and elbow flexion.
Therefore, it is lengthened when the shoulder is positioned in shoulder extension and elbow extension.

With all muscle length tests, we will place one joint at its maximum end range and then document the position of the other joint that the muscle crosses.

For example with the biceps brachii, the shoulder is placed in maximal extension, and we measure the elbow extension in this position.
To measure the length of the biceps:
1. Check the patient's PROM of the shoulder and elbow as individual joints.
2. Place the shoulder in maximal extension while the elbow is flexion.
3. While maintaining maximal shoulder extension, the patient's elbow is extended.
4. Note if there is a difference in elbow ROM when the shoulder was in neutral vs. now (with the shoulder in maximal extension).
5. Document the measurement of elbow extension. If the measurement of elbow extension was -10 degree (10 degrees short of achieving extension), then the documentation should read: (L) biceps length: -10 degrees.

lower extremity

Hamstring Length - Straight Leg Raise (SLR) Test (goni)

Compare measurement to: hip flexion (goni)

SLR test uses the same goni landmarks as hip flexion.
Standard hip flexion ROM is measured with the knee flexed to remove the influence of the hamstrings. SLR test is measured with the knee extended, as shown in the video.
Hamstrings is a 2-joint muscle, lengthened with knee extension and hip flexion.
Example documentation: (L) SLR test: 80 degrees

Hamstring Length - 90/90 Test (goni)

Compare measurement to: knee extension (goni)

90/90 test uses the same goni landmarks as knee extension.
Standard knee extension ROM is measured with the hip extended to remove the influence of the hamstrings. 90/90 test is measured with the hip flexed, as shown in the video.
Hamstrings is a 2-joint muscle, lengthened with knee extension and hip flexion.
Example documentation: (L) 90/90 test: -10 degrees

Iliopsoas (or Psoas Major) Length - Thomas Test (goni)

Compare measurement to: hip extension (goni)

Thomas test uses the same goni landmarks as hip extension.
Standard hip extension ROM is measured with the pelvis in neutral or anterior tilt (which is the pelvis position when hip extension is measured in prone) to remove the influence of the psoas major. Thomas test is measured with the pelvis in a posterior tilt, accomplished by flexing the opposite hip.
Psoas major is a 2-joint muscle, lengthened with posterior pelvic tilt and hip extension.
Example documentation: (L) Thomas test: -10 degrees

Rectus Femoris Length - Ely Test (goni)

Compare measurement to: knee flexion (goni)

Ely test uses the same goni landmarks as knee flexion.
Standard knee flexion ROM is measured with the hip flexed to remove the influence of the rectus femoris. Ely test is measured with the hip extended.
Rectus femoris is a 2-joint muscle, lengthened with knee flexion and hip extension.
Example documentation: (L) Ely test: 90 degrees

Gastrocnemius Length (goni)

Compare measurement to: ankle dorsiflexion (goni)

Gastroc length test uses the same goni landmarks as ankle DF.
Standard ankle dorsiflexion ROM is measured with the knee flexed to remove the influence of the gastrocnemius. Gastroc length test is measured with the knee extended.
Gastrocnemius is a 2-joint muscle, lengthened with knee extension and ankle dorsiflexion.
Example documentation:

Note: Gastroc length can be measured in supine or prone. Gravity does a better job of maintaining knee extension in prone.

upper extremity

Upper Trapezius Length (goni or tape)

Compare measurement to: neck lateral flexion (goni or tape)

UT length test uses the same landmarks as neck lateral flexion.
Standard neck lateral flexion ROM is measured allowing scapular elevation (scapular hiking) on the opposite side. UT length test does not allow scapular elevation to occur; the scapula should remain depressed.
UT is a 2-joint muscle, lengthened with cervical lateral flexion and scapular depression on the opposite side.
Example documentation: (L) UT length: 20 degrees

Latissimus Dorsi Length (goni)

Compare measurement to: shoulder flexion (goni)

Lat dorsi length test uses the same landmarks as shoulder flexion.
Standard shoulder flexion ROM is measured allowing arching of the lower back (thoracolumbar extension). Lat dorsi length test does not allow thoracolumbar extension.
Lat dorsi is a 2-joint muscle, lengthened with thoracolumbar flexion and shoulder flexion.
Example documentation: (L) lat dorsi length: 150 degrees

Pectoralis Major Length (goni)

Compare measurement to: shoulder horizontal abduction (goni)

Pec major length test uses similar landmarks to shoulder HAB.
Standard shoulder HAB ROM is measured with the elbow flexed to remove the influence of the pec major. Pec Major length is measured with the elbow extended.
Pec major is technically a 1-joint muscle, but due to the multi-joint anatomy of the shoulder complex, it functions similar to a 2-joint muscle. Pec major is lengthened with elbow extension and shoulder HAB.

Note: Pec major is a fan-shaped muscle, so 2 measurements are commonly taken.

Sternal pec major length at 135 degrees of shoulder ABD.
Clavicular pec major length at 90 degrees of shoulder ABD.

Other measures can be taken, but the position of shoulder ABD should be noted.

Ex. doc.: (L) Pec major length (120 degrees ABD): -10 degrees

Biceps Brachii Length (goni)

Compare measurement to: elbow extension (goni)

Biceps brachii length test uses the same landmarks as elbow extension.
Standard elbow extension ROM is measured with the shoulder in neutral to remove the influence of the biceps brachii. Biceps length is measured with the shoulder extended.
Biceps brachii is a 2-joint muscle, lengthened with shoulder extension and elbow extension.
Example documentation: (L) biceps length: -20 degrees

Triceps Brachii Length (goni)

Compare measurement to: elbow flexion (goni)

Triceps brachii length test uses the same landmarks as elbow flexion.
Standard elbow flexion ROM is measured with the shoulder in neutral to remove the influence of triceps brachii. Triceps test is measured with the shoulder flexed.
Triceps brachii is a 2-joint muscle, lengthened with shoulder flexion and elbow flexion.
Example documentation: (L) triceps length: 120 degrees

(Extrinsic) Finger Flexors Length (goni)

Compare measurement to: wrist extension (goni)

Finger flexors length test uses the same landmarks as wrist extension.
Standard wrist extension ROM is measured with the fingers flexed to remove the influence of the finger flexors. Finger flexor length is measured with the fingers extended.
Extrinsic finger flexors are multi-joint muscles, lengthened with wrist extension and extension of MCPs and all IPs.
Example documentation: (L) finger flexors length: 50 degrees

(Extrinsic) Finger Extensors Length (goni)

Compare measurement to: wrist flexion (goni)

Finger extensors length test uses the same landmarks as wrist flexion.
Standard wrist flexion ROM is measured with the fingers extended to remove the influence of the finger extensors. Finger extensor length is measured with the fingers flexed.
Extrinsic finger extensors are multi-joint muscles, lengthened with wrist flexion and flexion of MCPs and all IPs.
Example documentation: (L) finger extensors length: 60 degrees

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