Goniometric Assessment

Joints NASM only chose a select number of joints to be measured Foot

Dorisflexion Hip

Flexion (Bent knee and 90/90 position) Internal Rotation External Rotation Extension Abduction

Shoulder Flexion External Rotation Internal Rotation

Measurements were selected because of their overall importance to optimum human movement as well as their ability to correlate to the overhead squat and single movement assessment.

The Foot Joint motion being assessed

Dorsiflexion of talocrural joint Muscles being assessed

Gastrocnemius and soleus Posterior tibialis, peroneus longus, flexor hallicus longus, and

flexor digitorum longus.

Antagonists potentially underactive if ROM is limited Anterior tibialis Extensor digitorum longus, extensor digitorum brevis, extensor

hallicus longus and peroneus tertius. Normal Value- 20o

Client Positioning Supine with Knee extended Ankle is subtalar neutral

Placement of Goniometer Axis (A)- Directly below the lateral mallelous near the base Stationary Arm (SA) – Lateral aspect of fibula Movement Arm- (MA) Midline of 5th metatarsal.

Pressure Hold planter surface of foot right below MTP joints Client/Patient actively DF while you are passively assisting the

glide of motion Compensation during Goniometer Assessment

Everson of the ankle Flexing of the knee

Over Head Squat/ Single Leg Squat Foot compensations ( feet going outwardFlattening and/or heels rising) Excessive forward leaning

A lack of DF in the ankle has been know to lead to knee injuries.

Hip Flexion Joint motion being assessed

Extension of the tibiofemoral joint Flexion of iliofemoral joint

Muscles being assessed Hamstrings, Gastrocnemius, neural tissue (sciatic nerve)

Antagonists potentially underactive if ROM is limited

Hip flexor complex Quadriceps complex

Normal Value- 20o

Client Positioning Supine with Hip flexed and knee flexed to 90o

Hip is in neutral (0o rotation, abduction and adduction)

Placement of Goniometer Axis (A)- lateral joint line of the tibiofemoral joint Stationary Arm (SA) – Lateral midline of femur Movement Arm (MA)- lateral midline of fibula

Pressure Hold lower leg and thigh of client Passively extend the knee until first compensations

Compensation during Goniometer Assessment Posterior tilting of the pelvis Hip extension

Over Head Squat/ Single Leg Squat Feet turned out (External rotated) Feet flattening Knee moving inward or outward Low back rounding

Hip Flexion (Bent Knee) Joint motion being assessed

Flexion of iliofemoral joint

Muscles being assessed Gluteus maximus, adductor magnus, upper portion of

hamstrings Psoas, rectus femoris, hip capsule.

Antagonists potentially underactive if ROM is limited Hip flexor complex Hip extensor complex (gluteus maximus)

Normal Value- 120o

Client Positioning Supine with knee flexed Hip is in neutral (0o rotation, abduction and adduction)

Placement of Goniometer Axis (A)- Great trochanter Stationary Arm (SA) – Lateral midline of pelvis Movement Arm (MA)- lateral midline of femur

Pressure Hold clients knee Passively flex the hip until first compensation.

Compensation during Goniometer Assessment Posterior tilting of the pelvis Adbuction of the femur

Over Head Squat/ Single Leg Squat Rounding of the lower back

Hip (Internal Rotation) Joint motion being assessed

Internal rotation of iliofemoral joint

Muscles being assessed Piriformis and hip external rotators and adductor magnus,

ischiofemoral ligaments Gluteus medius, gluteus maximus

Antagonists potentially underactive if ROM is limited Adductor magnus, TFL, gluteus minimus, glutues medius,

adductor longus, adductor brevis, pectineus, gracilis, medial hamstrings.

Normal Value- 45o

Client Positioning Supine with Hip flexed and knee flexed to 90o

0o of abduction and adduction

Placement of Goniometer Axis (A)- Anterior aspect of patella Stationary Arm (SA) – parallel to imaginary line down the center

of the body Movement Arm (MA)- Anterior midline of the lower leg

(referencing the tibial tuberosity). Pressure

Hold lower leg and thigh of client Passively rotate the femur internally until first

compensation Compensation during Goniometer Assessment

Hip hike ( lateral flexion of spine) on side of measurement

Over Head Squat/ Single Leg Squat Knee moving inward or outward Asymmetrical weight shift

The Hip (External Rotation) Joint motion being assessed

External rotation of iliofemoral joint

Muscles being assessed Adductor magnus, iliofemoral ligament, and pubofemoral

ligament TFL, gluteus minimus, and gluteus medius

Antagonists potentially underactive if ROM is limited Piriformis and hip external rotators and adductor magnus Gluteus medius and gluteus maximus.

Normal Value- 45o

Client Positioning Supine with hip and knee flexed to 90o

\ Placement of Goniometer Axis (A)- Anterior aspect of patella Stationary Arm (SA) – parallel to imaginary line down the center of the

body Movement Arm (MA)- Anterior midline of the lower leg (referencing the

tibial tuberosity). Pressure

Hold lower leg and thigh of client Passively rotate the femur externally until first compensation

Compensation during Goniometer Assessment Motion of ASIS

Over Head Squat/ Single Leg Squat Knee moving inward or outward Asymmetrical weight shift

Hip (Extension) Joint motion being assessed

Extension of iliofemoral joint

Muscles being assessed Psoas, iliacus, rectus femoris, tensor fascia latae and

sartorius Adductor complex and anterior hip capsule

Antagonists potentially underactive if ROM is limited Gluteus maximus, glutues medius Hamstring complex, adductor magnus

Normal Value- 0-10o

Client Positioning Supine with opposite hip flexed Knee of testing leg should be flexed to ~ 90o

Placement of Goniometer Axis (A)- Greater Trochanter Stationary Arm (SA) – lateral midline of the trunk Movement Arm (MA)- Lateral midline of the femur

Pressure Hold thigh of client Passively allow the hip to extend until first compensation.

Compensation during Goniometer Assessment Anterior tilting Low back arching

Over Head Squat/ Single Leg Squat Arching of the lower back Excessive forward lean

Hip (Abduction) Joint motion being assessed

Abduction of iliofemoral joint

Muscles being assessed Adductor complex, pubofemoral ligament, iliofemoral ligament,

medial hip capsule Medial Hamstrings

Antagonists potentially underactive if ROM is limited Gluteus medius, Gluteus minimus, TFL, Satorius Bicep Femoris

Normal Value- 40o

Client Positioning Supine with knee extend Hip is neutral

Placement of Goniometer Axis (A)- ASIS Stationary Arm (SA) – Imaginary line b/w ASIS’s Movement Arm (MA)- Anterior midline of femur

Pressure Holding Clients lower leg Passively abduct the leg until first compensation

Compensation during Goniometer Assessment Motion of opposite ASIS Hip Hike on side of movement

Over Head Squat/ Single Leg Squat Knees moving inward Asymmetrical weight shift

Shoulder (Flexion) Joint motion being assessed

Flexion of Shoulder complex

Muscles being assessed Latissimus dorsi, teres major, teres minor, infraspinatus,

subscapularis, pectoralis major, triceps

Antagonists potentially underactive if ROM is limited

Anterior deltoid, pectoralis major, middle deltoid Lower and middle trapezius, rhomboids.

Normal Value- 160o

Client Positioning Supine with should neutral Knee’s in hook-lying position Arm in external rotation

Placement of Goniometer Axis (A)- Distal to the acromion process Stationary Arm (SA) – mid-axillary line of upper thorax Movement Arm (MA)- Lateral epicondyle of the humerus

Pressure Hold arm in external rotation Place thumb on the lateral border of the scapula and passively

flex the shoulder until excessive scapular movement is felt or resistance is felt.

Over Head Squat/ Single Leg Squat Arching of the lower back Arms falling forward

Shoulder (External Rotation) Joint motion being assessed

External rotation of glenohumeral joint

Muscles being assessed Subscapularis, latissimus dorsi, teres major, pectoralis major,

anterior deltoid and anterior glenohumeral joint capsule.

Antagonists potentially underactive if ROM is limited

Infraspinatus, teres minor, posterior glenohumeral joint capsule

Normal Value- 90o

Client Positioning Supine with humerus abducted to 90o

Elbow flexed to 90o

Towel is placed under humerus

Placement of Goniometer Axis (A)- Olecranon process Stationary Arm (SA) – Perpendicular to the arm Movement Arm (MA)- Ulnar styloid

Pressure Hold arm in external rotation till first resistance

Compensation during Goniometer Assessment Upward migration of the humeral head into the hand over the

anterior shoulder.

Over Head Squat/ Single Leg Squat Arms falling forward

Shoulder (Internal Rotation) Joint motion being assessed

Internal rotation of glenohumeral joint

Muscles being assessed Infraspinatus, teres minor, posterior glenohumeral joint

capsule

Antagonists potentially underactive if ROM is limited

Subscapularis, latissimus dorsi, teres major, pectoralis major, anterior deltoid.

Normal Value- 70o

Client Positioning Supine with humerus abducted to 90o

Elbow flexed to 90o

Towel is placed under humerus

Placement of Goniometer Axis (A)- Olecranon process of elbow Stationary Arm (SA) – Perpendicular to the floor Movement Arm (MA)- Ulnar styloid and olecranon process

Pressure Hold arm in internal rotation until first resistance.

Compensation during Goniometer Assessment Upward migration of the humeral head into the hand over the

anterior shoulder.

Over Head Squat/ Single Leg Squat Arms falling forward

Reference

National Academy of Sports Medicine. Goniometric assessments. California, 2005 (1-38).

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