Practical Musculoskeletal Testing for Runners

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Top Contributors - Wanda van Niekerk, Kim Jackson, Jess Bell and Lucinda hampton  

Introduction

This is the practical part of the course. These tests I’ve found to be really helpful in identifying common imbalances for muscle strength and length. Most of these tests assess a number of areas at the same time making them effective and time saving. Try to assess your runner in one position, complete all the tests, then progress them to the next position to save moving them in and out of too many positions.

Key assessment tools to keep in mind

Know the test that you are performing

It is really important that you have a good understanding of the test, what position the runner must be in, the position you need to be in to effectively test and also what it is that you are observing. Explain to your runner what it is you want them to do and be very specific so that the test is reproducible and accurate. If the runner is not in a good position or performs the test incorrectly. Stop, re – position or explain, and then re-start rather than continuing in an incorrect manner.

Explain the test to your runner

There will be a better buy in if one understands the reason and purpose behind doing an action. In explaining what it is that you would like from your runner – and how it could help them – they will be more eager and willing to do the test properly and subsequently the exercises following your assessment. Be specific with hand, leg and body positions as well as timing. Demonstrate the exercise first so that they are able to visually see how it is done too.

Know what you are testing

Remember to continually assess the runner while they are performing the test. Make notes especially if one side is weaker than the other so that you can refer back to them immediately rather than trying to remember all the tests at the end of your assessment. I find this is really helpful.

Be prepared

Some equipment is needed for these tests. Make sure that you have everything you need in easy access so that you don’t spend time setting up or looking for the missing item. Being prepared and organised will show your professionalism as well as your efficiency with testing. It will also build more trust with your runner as they see that you know exactly what you want to do and have everything organised.

Tests:

Introduction

Single leg balance test

• Ask runner to cross arms across chest and stand on one leg
• Assess:
  • hip movement for example: has the hip dropped?
  • Time - how long can runner keep their balance, how long before runner needs to place other foot down or touchdown or how many touchdowns in 30 seconds
  • Repeat test on both sides
  • Start with runner performing test with their eyes open
  • Progress to more challenging position with runner's eyes closed
• The test can also be used as rehabilitation exercise

Lateral Step down

Sit to stand

Knee to wall

Calf raise test to fatigue

Reverse Lunge

Side Copenhagen Bridge Hold

Forward Plank

Side Plank

Single leg bridge to fatigue

Thomas Test

Slump

Leg Length Discrepancy

Single leg bridge test

Conclusion

This musculoskeletal screening can be done in conjunction with a treadmill analysis with video recording. This will enable a full assessment of the runner from subjective history, their gear, their body mechanics as well as how they run. Taking all this information will give a great over view of your runner and enable you to fully assess any imbalances, weaknesses or changes in gear that need to be made in order to optimise their training and prevent injury.

Conclusion

There are many tests which could be used to assess our runners. I found that these ones gave a great overview of muscle length, strength and movement related especially for a runner. If further testing is needed – for example ankle stiffness seen while doing calf raises – this can be done at a follow up session with more depth.

Articles

Leg length Discrepancy

This article suggests that there is poor consensus on a definitive treatment and diagnosis of leg length discrepancy. Treatments that can be considered include a shoe insert, a high shoe, or an orthosis, surgically induced slowing of growth by blockade of the epiphyseal plates around the knee joint, or leg lengthening with osteotomy and subsequent distraction of the bone callus with fully implanted or external apparatus. The option to treat conservatively or surgically remains elective. Leg length differences between 2 and 5 cm can be normalised using one of the above mentioned methods.

Slump Test

Slump Test combined with the Dejerine’s triad have clinical validity to discard lumbar or lumbar-sacral radiculopathy. The slump test is used as one of the neurodynamic tests for neural tension.

Copenhagen Adductor Exercise (CAE)

Leading on from the Side Copenhagen Bridge hold this article shows how the Copenhagen adductor exercise has a positive influence on eccentric hip adductor strength and the importance of strengthening this muscle to prevent groin injuries.

Calf raise senior test

Although tested on an older population this article shows the importance of strength in the calf muscle and how by exercising it with calf raises shows strength in these muscles.

Single leg sit to stand test (SLSTST)

Functional test to assess quadriceps strength. This article describes how one can use the test to see how many SLSTST can be done in 30 seconds and how long it takes to perform 5. This may be a useful guideline for our runners comparing how many they can do in 30 seconds – comparing left to right and then have a score which can later be used as a baseline for future assessments.

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