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Dynamic Postural Assessment

Single Leg Squat Test (SLS)

Pre-test

Explain the test procedures to the subject

 

Procedure

 Stand on one leg while the other leg is lifted off the ground in front of the body so that the hip is flexed to approximately 45° and the knee of the non-stance leg flexed to approximately 90°. The arms are held straight out in front, with the hands shoulder width apart. From this position, squat down until about 60° knee flexion, then return to the start position. Repeat 5-6 times or as needed and remember to record the results of the leg that was tested.
 

Results

The coach's roll is to observe and record what happens at the hips, knees and ankles during the test.

 

Hips

a) Does the hip of the non-stance leg drop during the squat?
 
b) Does the hip of the non-stance leg rotate away from the stance leg during the squat?
 
c) Do the hips stay stable and horizontally at the same height?
 

Knees

a) Does the knee track INWARDS towards the centre of the body during the squat 
(dynamic knee valgus)?
 
c) Does the knee track OUTWARDS towards the centre of the body during the squat 
(dynamic knee valgus)?
 
b) Does the knee remain lined up over the 2nd and 3rd toes during the squat?

 

Ankles

a) Does the foot roll IN (pronate) flattening the arch of the foot during the squat? Does the medial ankle bone (malleolus) move LOWER than the lateral ankle bone at the lower point of the squat?
 
a) Does the foot roll OUT (supinate) accentuating the arch of the foot during the squat? Does the medial ankle bone (malleolus) move HIGHER than the lateral ankle bone at the lower point of the squat?
 
c) Does the arch of the foot remain unchanged and do the medial and lateral ankle bones remain horizontally at the same height throughout the squatting pattern?

#1 Hip Drop 

Identify and help correct this very common dynamic postural dysfunction. (front view)

Identifying Hip Drop

 
Look for the hip dropping down on the opposite side to the stance leg.
 

At-a-glance Summary

 
Possible Weak Muscles : Gluteus medius (stance leg), (QL) Quadratus lumborum (opposite side). 
Possible Tight Muscles : Adductor complex, Lateral calf.

#2 Hip Rotation

Identify and help correct this very common dynamic postural dysfunction. (front view)

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Identifying Hip Rotation

 
Look for the hip on the opposite side to the stance leg rotating around away from the stance leg.
 

At-a-glance Summary

 
Possible Weak Muscles: Gluteus maximus and/or Opposite external obliques.
Possible Tight Muscles: Hip flexors.

#3 Knee Tracking IN

Identify and help correct this very common dynamic postural dysfunction. (front view)

Identifying Dynamic Knee Valgus

 
Look for the knee tracking-in towards the centre of the body. 
 

Note

 
A knee valgus (in) alignment increases the load in the lateral compartment of the knee and can lead to knee pain. 
 

Good to know

 
Many recent studies have shown that there is a significant decrease in knee valgus motion during the double-leg and single-leg squat as ankle dorsiflexion R.O.M was increased. 
Rolling and stretching of the gastrocnemius, soleus and hip adductor muscles to facilitate increased ankle dorsiflexion and hip abduction R.O.M gave the best results in decreasing knee valgus. (see the 'Ankle Dorsiflexion test' on the 'Assess' page in a client evaluation'.)
 

At-a-glance Summary

 
Possible Weak Muscles: Gluteus Medius, VMO, Medial hamstring, Medial gastrocnemius.
Possible Tight Muscles: Adductors, Biceps femoris (short head), TFL, Vastus lateralis, Lateral gastrocnemius.

#4  Knee Tracking OUT

Identify and help correct this very common dynamic postural dysfunction. (front view)

Identifying Dynamic Knee Varus

 
To identify a functional knee 'varus' during the Single-Leg Squat test look for 
your client's knee tracking-out away from the centre of the body. 

 

Good to know

 
Many recent studies have shown that functional knee varus during double-leg and single-leg squats 
was greater in those with restricted ankle dorsiflexion R.O.M.
 

At-a-glance Summary

 
Possible Weak Muscles: Adductor complex, Medial hamstring.
Possible Tight Muscles: Piriformis, Biceps femoris, TFL, Glute medius and minimus.
 

Static postural observation

 
Bow-legged (Genu Varum); visually, the legs of people with genu varum are bowed outward, this causes increased stress on the medial compartment of the knee and puts the individual at risk of developing osteoarthritis (bone-on-bone). The most common cause of genu varum is rickets or any condition that prevents bones from forming properly. 

#5 Foot Hyperpronation

Identify and help correct this very common dynamic postural dysfunction. (front view)

Identifying Foot Hyperpronation

 
Look for the ankle rolling in and flat feet. From the rear view look to see if the achilles tendon is vertically straight or if it curves in. Foot hyper-pronation can be seen in the mid-foot or rear foot and sometimes in both.
 

Note for Anatomy Nerds

 
Excessive pronation during gait and running is associated with conditions such as : ACL injury, plantar fasciitis, medial tibial stress syndrome, and stress fractures (Beck-ett et al. 1992; Delacerda 1980; Giladi et al. 1985; Smith et al. 1997).
 

At-a-glance Summary

 
Possible Weak Muscles: Intrinsic Foot Muscles, Gluteus Medius, Tibialis posterior, Medial gastrocnemius
Possible Tight Muscles: Soleus, Gastrocnemius, Biceps femoris (short head), TFL

#6 Foot Supination

Identify and help correct this very common dynamic postural dysfunction. (front view)

Identifying Foot Supination

 
 Look for high arches and excessive outward roll of the foot; either mid-foot, rear foot or both. Supinators place their weight on the outside of the foot while walking, running and single-leg squatting.
 

At-a-glance Summary

 
Possible Weak Muscles: Peroneals (tight and weak)
Possible Tight Muscles: Peroneals, Gastrocnemius, TFL
 

Good to know

 
People who excessively supinate are at greater risk of developing certain conditions and symptoms, including :
- ankle sprains - hammer toes or clawed toes
- iliotibial band pain syndrome - pain in the ball of the foot
- plantar fasciitis - shin splints
- stress fractures in the feet and legs - swelling of the ankle or foot
- weakness in the foot or ankle that gets worse when running, walking, or standing for long periods.
 
 

Congratulations, you're all done!

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