Musculoskeletal Examination of the Runner – Part 1 Clinical Examination of the Runner: Assessment, Testing, Gait Correlations, and Corrections Jay Dicharry – MPT, SCS

Exercise Slides (Ch. 2)

Image(s) Check Off

Bilateral Squat 6 - 8

Dynamic valgus or symmetry correlates to poor vs. effective movement strategy. Early heel rise can suggest tight chords. Knee forward suggests quad dominance and potential over-stride. Hips

back suggest good glut recruitment.

Single Leg Stance

8

Correlates to general balance. Pay special attention to foot contact of 1st ray. Wobble is ok, as long as the wobble “strategy” is to maintain 1st metatarsal head support. Ask the patient to keep

eyes up to increase the challenge

 

           

       

Single Leg Squat

10

Single leg squat presents challenge to foot and ankle control, and

highlights dynamic tracking of hip/pelvis in the frontal and rotational planes

Toe Yoga 11

The goal is to isolate the FHB, and to actively maintain MLA

height. Remember, shoes do not stabalize the foot, muscles do!

 

           

       

Posterior Tibialis Insufficiency

12

Rear foot on forefoot control. Implicated in plantar fascia issues, post tibialis, soleus, and gastrocnemius strains. Performance is

dependant on forefoot stability

Foot Alignment

13

Look for structural reasons why the patient may be staying excessively lateral or medial on the foot in stance. Examine need

for orthotic to provide full foot contact. Evaluate whethere the patient can paintain STJN with full contact of 1st ray.

ROT Trunk on Pelvis & Pelvis on Trunk

14

Evaluates lumbar coordination and stabilization, and separates

rotation vs. default to pelvic shift or extension.

 

           

       

Lumbar Range of Motion

15

Look for symmetry, do you see reveral of lordosis in flexion?

Correlation to psoas? Extension? Symmetric rotation and SB? Stiffness or pain may indicated a shift in pelvis and ML

stabilization.

VCT for Postural Stability

16

Athletes should know of to find neutral posture while walking, training, lifting, and under fatigue.

Overhead Reach Lunge Test

17

 

           

       

Thomas Test 18

Evaluate the patient for hip flexor tightness (unilateral and

biarticular). Runners need hp extension!

Craig’s Test 19

Evaluate the patient for femoral retroversion/neutral/antiversion,

tibial IR/ER torsion.

Hip Quadrant & Range of Motion

20

Evaluate the patient for IR, ER Shear, r/o SI, ADD shear, IR/ADD shear. Evaluate the mobility and integrity of the hip joint, checking

for impingement.

 

           

       

Notes: