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LTAD - a critique
Demands of the game
Profile of players
Functional screening
Resistance training
Speed and agility training
Integrated game conditioning

Range of motion testing

Test 1: The Modified Thomas Test or hip flexor test

The Modified Thomas Test is a frequently used test to assess degree of hip flexion/extension. The Modified Thomas Test helps indicate whether the player has:

  • Normal ROM about the knee and hip joints
  • Restricted ROM about the quadriceps
  • Restricted ROM about the hip flexors
  • Normal or restricted ROM in the ITBand
  • Lower leg mobility restrictions

Figure 1a. The player starts by sitting at the edge of a firm table.

Figure 1b. The player lies on his back tucking the knee of the non-tested side to the chest.

Note the flat lower back on the table. The side being tested shows normal ROM about the hip joint as the posterior of the thigh lies on the table.

We will use the test primarily as an indicator of quadriceps and hip flexor ROM. The player in Figure 1b demonstrates good flexibility about the hip joint (as indicated with the posterior thigh resting on the table). This indicates 0 degrees of hip extension.

Figure 2. The player extends the lower leg to determine if the tightness is within the hip flexor muscle group or the quadriceps.

The test will also differentiate between a tight quadriceps (rectus femoris) and tight hip flexor (iliopsoas). For example, during the completion of the test should the posterior thigh not rest on the table, then the S&C coach requests the player to extend the lower leg (figure 2 above). Moving the lower leg into extension takes the stress from the rectus femoris. When the lower leg is extended and the posterior thigh moves closer to the table, this indicates that the rectus femoris is tight. In contrast, if no change in the distance of the posterior thigh from the table occurs then the hip flexor (the iliopsoas) is tight.

Figure 2 shows that both the quadriceps and the hip flexors on the right side are tight. Please note that during this test if knee flexion is less than 80 degrees then the rectus femoris maybe short or tight. A normal ROM for the knee joint during the Modified Thomas Test will allow 80 degrees of flexion from the knee joint when the hip is at zero degree of extension. Where the lower leg does not flex actively to 80 degrees or lower, then a tight rectus femoris is indicated.

The evidence

It is generally accepted that tight hip flexors can be a concern for the player. This is supported by evidence from Gabbe et al (2005, 2006). The authors found that a lack of flexibility in the hip flexors of team sport players was associated with hamstring injury. While the factors associated with hamstring strain are varied and numerous, it does appear that hip flexor length is one such factor (Thelan et al 2006). Further, a lack of quadriceps flexibility was also associated with patellar tendinitis in physically active individuals (Witvrouw et al 2001).