Topics Discussed: bowstring test; examination of hamstring reflex; examination of spine; examination of thigh adductor reflex; gillet's test; hamstring stretching; hoover's test; injury of thoracic spine; kyphosis; leg muscle; lumbar spine range of motion; lumbar spine, injury of; modified schober test; muscle strength; patrick's test; posterior muscle of thigh; reflex test; sacroiliac joint; sacroiliac joint pain; sacroiliac provocation test; scoliosis; slump neural tension test; spinal dermatome; thoracic spine range of motion; thoracolumbar spine instability; trendelenburg test; tripod sign.
Sections: Diagnosis, Treatment, Acute Soft Tissue Sprains, Strains, and Muscle Contusions, Thoracic Scheuermann Disease (Juvenile Disk Disease), Thoracolumbar (Atypical) Scheuermann Disease, Adolescent Idiopathic Scoliosis, Lumbar Spondylolysis, Spondylolisthesis, Disk Herniation, Slipped Vertebral Apophysis (Fracture of Ring Apophysis), Fractures of the Thoracolumbar Spine, References.
Excerpt:"History should include the mechanism of injury and detailed history characterizing the pain. Pain should be characterized by onset, location, duration, progression, exacerbating factors and relieving factors. Is there night pain? Is there radiation of pain in legs? Ascertain past history of back pain or injury. Has the athlete sought any previous medical care?See references 13–16.
- Gait: Observe for pain during full weight bearing or any protective posture. Also judge the degree of pain or discomfort.
- Observe the overall standing posture from behind and from side. Note any asymmetry. Note the normal thoracic (convex) and lumbar (lordotic) curves. Note listing. Note tendency to stand or walk with flexed hips and knees (crouching).
- Have the athlete bend over (flexion) and observe the spine from front, behind, and side of the athlete. Note scoliosis (Adam test) or kyphosis (Figure 30-8).
- Observe from the front the symmetry of hips and alignment of iliac crests.
- Assess active range of motion of the spine (Table 30-3). Schober test (Figure 30-9) is helpful to measure the degree of flexion of the thoracolumbar spine. To measure the lateral flexion first mark the point on the lateral aspect of the thigh where the tip of middle finger reaches; followed by marking the point on lateral flexion. The distance between the two points is useful to assess the amount of lateral flexion.
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