Br J Sports Med 1998;32:68–70
Assessment of the ﬂexibility of elite athletes using the modiﬁed Thomas test
Abstract Aim—To analyse the modiﬁed Thomas test and obtain measures of ﬂexibility for the iliopsoas, quadriceps and tensor fascia lata/iliotibial band. Method—The modiﬁed Thomas test was used to determine the range of ﬂexibility of 117 elite athletes intennis, basketball, rowing, and running. Results and conclusion—The study has provided objective data for a clinical test measuring ﬂexibility of the iliopsoas, quadriceps, and tensor fascia lata/ iliotibial band. It is recommended that suYcient ﬂexibility is obtained to perform a speciﬁc sport and that asymmetries between limbs are addressed.
(Br J Sports Med 1998;32:68–70) Keywords: ﬂexibility;iliopsoas; quadriceps; tensor fascia lata/iliotibial band; elite athletes
Modiﬁed Thomas test position.
Australian Sports Injury Prevention Taskforce, Australian Institute of Sport, P O Box 176, Belconnen, ACT 2616, Australia D Harvey
Correspondence to: D Harvey. Accepted for publication 13 November 1997
Sports injury prevention is the most desirable and cost eVective way ofreducing the risk of injury in sport. Not all injuries are “unavoidable accidents”, therefore, with increased participation, injury prevention should be encouraged as a complementary process. Injury prevention ﬁrstly requires injury analysis to establish the magnitude, extent, and cause of the problem.1–3 Interventions designed to reduce the eVect of the injury such as protective equipment ormuscle strengthening can be introduced and then evaluated.4–6 Identiﬁcation of risk factors for injury is critical for the eVective prevention of injury. Risk factors are categorised into internal (personal) and external (environment).3 7 Environmental factors can be addressed with protective equipment and rule changes, but the internal factors are more diYcult to address.2 8 Most injuries resultfrom a multitude of factors, so it is very diYcult to ascertain the direct influence of a factor such as ﬂexibility, muscle strength, and athletic technique.1 To be able to measure the inﬂuence of these factors on the risk, incidence, and severity of injury, objective and speciﬁc tests need to be developed and validated. Musculoskeletal screening of athletes is an assessment designed to detectinternal abnormalities that may increase the risk of injury for an individual.5 9
Aims and methods The purpose of this study was to analyse the modiﬁed Thomas test and obtain measures of ﬂexibility for the iliopsoas, quadriceps, and tensor fascia lata/iliotibial band (TFL/ITB).10 Flexibility measures are one of the components of musculoskeletal screening. This study compared 117 elite athletes intennis, basketball, rowing, and running to determine their range of ﬂexibility. Comparisons between sports, gender, and limb dominance were also analysed. For the modiﬁed Thomas test, the subject sat on the end of the plinth, rolled back on to the plinth, and held both knees to the chest. This ensured that the lumbar spine was ﬂat on the plinth and the pelvis was in posterior rotation. The subjectheld the contralateral hip in maximal ﬂexion with the arms, while the tested limb was lowered towards the ﬂoor (ﬁg 1). Three angles were measured for each limb and were repeated on alternate limbs to obtain data for two trials. Length of iliopsoas (test 1) was determined by measuring the angle of hip ﬂexion (ﬁg 2). Test 2 measured the passive length of the quadriceps by determining the knee ﬂexionangle (ﬁg 3). The hip abduction angle relative to the femur and angle of the pelvis represents the eVect of TFL/ITB ﬂexibility (ﬁg 4). Results Raw data were collected for 117 subjects; the intraclass correlations for the two trials were extremely high (0.91 to 0.94). As the frequency distributions of the results approximated to a normal curve, parametric statistics were considered appropriate....