Flexibility Tests

Definition

Flexibility tests assess the ability of muscles and joints to move with ease through their full range of motion.

Purpose

Joint conditions such as arthritis, shortened or tightened muscles, or other problems with the muscles and connective tissue surrounding joints can limit flexibility. Flexibility tests are used to diagnose muscle imbalances, arthritis in a joint, or conditions such as a sprain or shoulder impingement. They are also used to identify tight muscle groups that can lead to injury during everyday activities or exercise. Flexibility tests that assess range of motion in joints are often included in routine physical examinations to assess limitations in everyday activities, such as walking, reaching, or lifting. For example, walking with bent knees due to an inability to fully extend the knees places added strain on the hips and lower back. Shortening of the hamstrings (the muscles of the back of the thigh) restricts pelvic tilting. This impedes the lower or lumbar spine and can cause low back pain. Flexibility tests can indicate the need for specific exercises to improve flexibility.

Description

Different flexibility tests assess specific joints and muscles or movements. A flexibility test can be as simple as a physician asking a patient to reach, bend over, or move an arm or leg in a certain way. A single flexibility test—usually a sit-and-reach test—may be used for the flexibility component within a battery of fitness tests, as with the U.S. President's Challenge Adult Fitness Test, since there is no one test for overall flexibility.

Most flexibility tests are indirect. Indirect methods generally measure linear distance between body segments or the distance from a part of the body to an object or other point. Direct methods measure the angular displacement between adjacent body parts or between a body segment and an external reference point. Direct methods require specialized instruments, such as a goniometer or a flexometer. Instruments designed to measure the angle of a slope, such as an inclinometer or a clinometer, can also be used.

Sit-and-reach tests

The sit-and-reach test is the most common flexibility test. First described in 1952, it is often used as a measure of general flexibility. The sit-and-reach test assesses the flexibility of the hamstrings, hips, and lower back by measuring the ability to reach forward from a sitting position: the longer the reach, the less restricted the pelvic movement. Tightness in the hamstrings and lower back is often associated with low back pain, risk of injury, and other problems.

There are many variations of the sit-and-reach test, sometimes called the V-sit test. The basic test involves sitting on the floor, shoeless, with the legs fully extended, and the feet between about 2 in. (5 cm) and 12 in. (30 cm) apart, toes up. The arms are extended forward, palms down, with one hand on top of the other. Leading with the breastbone, bending at the hips, with the spine extended from the lower back, one slowly reaches forward as far as possible while exhaling, and holds the stretch for two seconds. The distance reached by the fingertips on the fourth attempt or the best of three or four attempts is measured. There should be several seconds of rest between each attempt.

There are numerous sit-and-reach variations:

There are various ways to measure the reach, including:

Other trunk and lower-body tests

Trunk rotation is important for daily activities such as fastening a seatbelt, as well as for sports such as golf and tennis. A vertical line is drawn on a wall with chalk. Standing with the back to the wall directly in front of the line, with the feet shoulder-width apart, arms' length away from the wall, and the arms outstretched in front parallel to the floor, the trunk is twisted to the each side without moving the feet, touching the wall with extended arms remaining parallel. The points where the fingers touch the wall on each side are marked and the distances from the vertical line are measured. A point before the line is a negative score and a point after the line is a positive score. Trunk-rotation tests can also be performed with specially designed equipment.

A lateral side stretch or lower-back flexibility test assesses flexibility in the lower back and obliques, the side abdominal muscles. The subject stands tall with the buttocks and back against a wall and the feet away from the wall. While side-bending by reaching up and over, without collapsing, a piece of tape is placed as far down each leg as possible, and the distance from the tape to the floor is measured.

KEY TERMS
Adductor—
Any of the three strong triangular muscles of the inside of the thigh.
Arthritis—
Inflammation of one or more joints.
Biceps—
The large flexor muscle of the front of the upper arm.
Dynamic stretches—
Stretches that involve smooth, gentle movements.
Flexometer—
An instrument for measuring the flexibility of a joint.
Goniometer—
An instrument that measures the axis and range of motion of a joint.
Hamstrings—
The three muscles at the back of the thigh.
Hip flexors—
The group of skeletal muscles that flex the thigh bone toward the pelvis to pull the knee up.
Obliques—
The two flat muscles on each side that form the middle and outer layers of the lateral walls of the abdomen.
Osteoporosis—
A disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility.
President's Challenge—
America's primary physical activity and fitness initiative.
Sit-and-reach box—
Equipment of various designs for performing sit-and-reach flexibility tests.
Static stretches—
Stretching of muscles while the body is at rest.

A groin flexibility test assesses the adductor muscles of the inside of the thighs, which are particularly important for activities involving kicking. Sitting on the floor without shoes, with the knees together and bent and the feet flat on the floor, the knees are moved as far apart as possible with the soles of the feet together. The feet then are pulled as close to the body as possible, and the distance between the heels and the groin is measured.

The calf flexibility test is performed sitting on the floor with the legs straight out in contact with the floor, feet up. The toes are pulled toward the body. A partner checks whether the toes are behind the ankle joints, above the joints, or closer to the body than the joints. Alternately, the maximum distance that one can stand flat-footed away from a wall and still touch the wall with a bended knee is measured.

Upper-body tests

Flexibility in the chest, shoulders, and biceps is very important for good posture. One test is performed standing with the feet hip-width apart, while holding the ends of a rolled-up towel. With the towel taut, the arms are lifted straight overhead and then gently moved slightly behind the body until the chest, shoulders, and biceps are comfortably stretched. The test is repeated with the hands closer together on the towel.

A test for shoulder elevation—the ability to lift the arms overhead—is performed lying on one's back on the floor. The arms are alternately raised overhead to rest on the floor with the palm up.

External or outward shoulder rotation is important for activities ranging from dressing to playing racquet sports. Lying on the back on a firm surface with the knees bend and feet flat, an arm is moved to the side at shoulder level and the elbow is bent with the upper arm on the floor. The hand and forearm fall back toward the head as far as possible.

The back scratch, shoulder stretch, or shoulder flexibility test assesses internal or inward shoulder rotation. One arm is raised overhead, bent at the elbow, and reaches as far down the back as possible. The other hand reaches around the waist and attempts to touch the fingers of the upper hand. The distance between the fingers is measured.

Precautions

Flexibility tests should not be painful, and stretches should never be taken to the point of pain. It is very important to perform flexibility tests gently and smoothly, without bouncing or jerking. Quick movements may cause injury.

Body proportions can affect the results of flexibility tests. For example, people with long arms and/or short legs do better on sit-and-reach tests than those with short arms and/or long legs. Rounding the back during a sit-and-reach test negates the results.

There are specific precautions for various flexibility tests:

Preparation

Clothing for flexibility testing should allow complete freedom of movement. An observer should be able to see that correct procedures are being followed at all times.

Some flexibility tests require a warm-up, whereas others require that the subject does not warm-up or engage in prior activity; however most protocols suggest at least five minutes of gentle walking before testing. The President's Challenge sit-and-reach protocol calls for a warm-up of static stretches for the trunk and legs, followed by brisk walking. However it is now generally suggested that static stretches be performed only after an active warm-up such as walking. Suggested static stretches include knee-to-chest, modified hurdler's stretch, spinal twist, and doorframe hamstring stretches. Static stretches should be taken to the point of tension, never pain, held for 10–30 seconds, and repeated once or twice.

Aftercare

In many cases, flexibility tests are identical to exercises for improving flexibility. Flexibility exercises should be performed at least three times per week. Retesting should be done at least every two to three months but can be performed as often as once a week. Dynamic warm-up stretches can be added to a flexibility exercise routine. These include double-hip rotations, shoulder stretches, neck rotations, and hamstring stretches. Regimens such as yoga and Pilates always include exercises to improve flexibility.

Complications

Flexibility tests rarely involve complications. However, it is important to perform the stretches correctly and to follow all precautions.

QUESTIONS TO ASK YOUR DOCTOR

Results

Online calculators and charts are available for scoring flexibility tests and comparing the results to those of people of the same age and gender. However, because of the many variations in testing protocols and individual and developmental differences in arm, leg, and trunk lengths, it is usually preferable to record test results and compare them over time to assess individual progress.

Depending on how the measurements are taken, typical average results on a home sit-and-reach test might range from 0–2 in. (5 cm) for men and 0.5–4 in. (1–10 cm) for women. Superior results might be above 10.5 in. (27 cm) for men and above 11.5 in. (29 cm) for women. Very poor results might be less than -8.0 in. (-20 cm) for men and less than -6.0 in. (-15 cm) for women.

Other typical flexibility test results include:

Resources

BOOKS

Sharkey, Brian J. Fitness Illustrated. Champaign: Human Kinetics, 2011.

Wright, Vonda, and Ruth Winter. Fitness after 40: How to Stay Strong at Any Age. New York: AMACOM, 2009.

PERIODICALS

Bozic, Predrag R., et al. “Evaluation of the Field Tests of Flexibility of the Lower Extremity: Reliability and the Concurrent and Factorial Validity.” Journal of Strength and Conditioning Research 24, no. 9 (September 2010): 2523–31.

Shimon, Jane M., et al. “Initial Reliability and Validity of the Lift-and-Raise Hamstring Test.” Journal of Strength and Conditioning Research 24, no. 2 (February 2010): 517–21.

Sporis, Goran, et al. “Reliability and Factorial Validity of Flexibility Tests for Team Sports.” Journal of Strength and Conditioning Research 25, no. 4 (April 2011): 1168–76.

WEBSITES

“Flexibility Tests.” Topend Sports. January 13, 2011. http://www.topendsports.com/testing/flex.htm (accessed January 17, 2017).

Mallett, Tracey. “Three Ways to Test Your Flexibility.” Parenting Bookmark. http://www.parentingbookmark.com/pages/TM03.htm (accessed January 17, 2017).

Mayo Clinic. “How Fit Are You? See How You Measure Up.” February 27, 2014. http://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/fitness/art-20046433 (accessed January 18, 2017).

ORGANIZATIONS

American Academy of Orthopaedic Surgeons, 9400 W Higgins Rd., Rosemont, IL, 60018, (847) 823-7186, (800) 626-6726, Fax: (847) 823-8125, customerservice@ aaos.org, http://www.aaos.org .

President's Council on Fitness, Sports & Nutrition, 1101 Wootton Pkwy., Ste. 560, Rockville, MD, 20852, (240) 276-9567, Fax: (240) 276-9860, fitness@hhs.gov, http://www.presidentschallenge.org .

YMCA of the USA, 101 N Wacker Dr., Chicago, IL, 60606, (800) 872-9622, http://www.ymca.net .

Margaret Alic, Ph.D.

  This information is not a tool for self-diagnosis or a substitute for professional care.