Physiotherapy Running Screening with Bestselling Author Brad Beer
The key test in the running screening is the calf length test. This test assesses runner’s ability to have sufficient length through their calf and also determines the degree, if any, of stiffness in the ankle joint, both the key measures for pain free and fast running. So, I’m going to demonstrate here with Peter. Peter is going to take his knee towards the wall and the idea is that the heel stays on the floor. Knee touches the wall so for Peter the distance from the wall and his big toe is 12 centimetres which is great that’s above the minimal benchmark of 10 centimetres required for runners to have healthy calf length, obviously a physiotherapist will assess the other side and record your data in the running screening table in the appendices in the back of the book.
So one of the key measures we need to identify for a runner for their running chassis or their running body is the hamstring length. Let’s have a look at how we measure this it’s called a straight leg raise test, so that the physiotherapist will take the leg up to the first point of resistance. At that point the physiotherapist uses a goniometer. Measure the angle of the thigh the midline of the thigh relative to the horizontal, and that’s the score. Peter’s angle here is 66 degrees. Ideally this leg length would be 80 degrees for runners, that is the safe zone. Let’s go over to the other side and on this side Peter is 69 degrees so that’s the straight leg raise test, one of the key messages of the running screening. Have your physiotherapist measure both sides and record it in the running screening table in the appendix of the book.
A key measure for a runner is the length of their quadriceps; if these are tight the runner may be headed for all sorts of problems. How we test the quadriceps length by doing what we call the prone knee bend – is we take the runners foot towards their bottom, it’s at the first point of resistance that we get a measure, of how far the heal is from the bottom, and here we can see that Peter’s heel is at 18 centimetres from his bottom. Ideally the heal would touch the bottom i.e.: zero centimetres. That’s where you get a pass mark. Have your physiotherapist record your score in the back of the book in the running screening table in the Appendix.
Hip flexes are a key measure of a runners screening so for the hip flexor length test the runner positions the bottom on the edge of the physiotherapist table. They hug their knee into the chest with both hands, slowly lay back, and head back on the table. We are then interested to see what the angle is to Peter’s leg relative to the horizontal. Here we can see that Peter’s leg is horizontal which indicates a pass mark or a tick, if however Peter’s leg or thigh was hinged up above horizontal that would indicate that Peter has marked hip flexor tightness. You want your physiotherapist to grade it as either ok, tight, or below 90 degrees, have a look at the table and the physiotherapists you can complete that in the appendix.
A critical test for a runner is to determine what activity exists in the hip external rotation muscles. The test that we used to assess this, is called a hip external rotation test and I’m going to demonstrate with Peter. Peter just lifting up his leg and pop a towel under it. It is important for the leg to be at 90 degrees you need your physiotherapist to then do the following test. The runners going to take the foot into the middle here as far as they can, so come into the middle there Peter, without lifting the thigh of the towel and without leaning the body, we simply drop the goniometer down and measure the angle, and Peter’s angle is 26 degrees. The ideal measure for this test is 40 degrees so have your physiotherapist record it in the table in the appendix and don’t forget to test both sides.
A key test for a runner with their running screening is to determine how stiff or how much extension they’ve got in the middle of their shoulders. So for this test it’s called the combined elevation test incidentally also extremely useful for triathletes and swimmers. I’m going to get Peter to have a lay on the table while I demonstrate. Peter come have a lay, head down the hole there, and come up to a streamlined position and arms up and overhead. Hands together, on the count of three Peter is going to take his hands up as high as you can without lifting his head. 1, 2, 3, and relax.
A key test for a runner is there side bridge endurance test; this is a measure of ability to withstand the forces of collapsing as a runner gets fatigued. So the test for this is side bridge, plank test, and from here Peter is simply going to come up into a side plank position, hanging onto the shoulder, putting the bottom forwards, so it’s a nice straight line, top foot is across the bottom, and elbows directly under the shoulder and supported, just to take a load of the shoulder. Now I have a stopwatch on here and I will time Peter to the point of exhaustion, so it is a test of maximum endurance. What we will notice when Peter gets fatigued is that this will start to drop and collapse and there will be a bow in the hip. That is when we call timeout and record the test. Obviously we will test both sides. Have your physiotherapist test you and record your score in the appendix in the running screening table.
Yours in running,
Brad Beer (APAM)
Physiotherapist, Author You CAN Run Pain Free!, Founder POGO Physio