1. Goniometric Assessment

2. 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
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.

3. The Foot Joint motion being assessed Muscles 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

4. 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 outward
Flattening and/or heels rising)
Excessive forward leaning
A lack of DF in the ankle has been know
to lead to knee injuries.

5. Hip Flexion Joint motion being assessed Muscles 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)

6. 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

7. 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)

8. 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

9. 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

10. 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

11. 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

12. \ Placement of Goniometer Pressure Hold lower leg and thigh of client
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 \

13. Hip (Extension) Joint motion being assessed Muscles 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

14. 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

15. Hip (Abduction) Joint motion being assessed Muscles 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

16. 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

17. Shoulder (Flexion) Joint motion being assessed Muscles 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

18. 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

19. 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

20. 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

21. 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

22. 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

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

24. Jessica will talk about the next step which is………