To Measure Hamstring Flexibility and Deficiency in In-Season Runners

Emily Acton

Tech/Assess- 9:30-10:45

Assessment Project

Problem

1.  Identify the purpose/objective/outcome of the rating scale/assessment instrument/evaluation tool.

To measure hamstring flexibility and deficiency in in-season runners.

Refining the Problem

2.  Provide a description of the student/client/athlete population for which the rating scale is designed.

To be a part of this rating and assessment, each athlete must have some experience not only running, but racing and competing. Specifically, I will be looking at a women’s university cross country team who runs more than 50 miles each week. In this specific case, ability does not matter because every runner has their own different abilities. What does matter, however, is pain they experience in hips, glutes, hamstrings, and low back. Each runner must have symptoms of some type in any of these areas to really benefit from taking part in the assessment.

3.  Identify how and why you could/would use the rating scale.

During the pretest, I will have a survey prepared for each runner to complete. The survey will consist of a general rating of pain associated in the hips, glutes, hamstrings, and low back. If the pain is severe in any of these areas, the athlete will be withheld from running until pain decreases and referred to a sports medicine doctor for clearance to return to running. I will also be looking at hamstring flexibility in each athlete. I will measure hamstring flexibility by using a goniometer, which is used to measure the angle of joints on the body. To do this, each athlete will lay supine (on their back), use a rope or rubber band around the ball of their foot and holding the ends with their hands, and raise their leg off the ground as high as they can. While their leg is up in the air, I will use the goniometer to measure the angle at the knee, essentially looking at how straight their leg is. I will also have each athlete attempt to touch their toes, viewing how far they can reach. I will measure in centimeters from the tip of their middle finger to the ground if they are unable to touch. I will keep track of the angle and the toe touch measurement in a chart with each athlete’s name.

In order to improve hamstring flexibility in these athletes, I will have them perform hamstring stretches two times a day, as well as some hamstring strengthening exercises. The strengthening exercises, for example, will be single leg bridges and putting lower legs on a medicine ball while performing leg curls.

At the end of each week, I will give each athlete the pain survey as well as look at the angle with the goniometer during the hamstring stretch. I can also view progress by looking at the measurement during the toe touch test. Decreased pain, greater angles, and fewer centimeters from finger tip to floor indicate improvement.

4.  Identify the components/characteristics/parts of the skill/issue you have selected to evaluate and why you have selected to emphasize these specific items.

The reason I chose to track and help runners improve hamstring flexibility is because tight hamstrings can cause havoc on the body if they are left untreated. Over time, they will continue to tighten, making it even more difficult for the body to move the way it is supposed to. Lower back pain, glute pain, and hip pain are key characteristics that something is not functioning the way it is supposed to.

The components of testing hamstring flexibility is as follows; hamstring angle using a goniometer, distance in centimeters from middle finger tip to floor while trying to touch toes, pain levels doing everyday activity, pain levels while exercising, and limitations if the runner has severe pain. All of these tests will be done initially, as well as at the end of each week. The runner will have a copy of their own charts so they can view how they are doing as they strengthen and loosen their hamstrings.

Finding the angle with a goniometer and distance in centimeters from finger tip to floor while trying to touch toes is important because these are specific measurements to each individual runner. By doing and recording these, I am able to see how flexible/inflexible they are and work with them to improve that. Recording pain levels is also important while keeping track of hamstring flexibility. If the runner has pain at the beginning and is able to view it decrease on their charts, it will help them realize the importance of their hamstring flexibility and the huge role it plays in running and racing. Finally, keeping track of limitations is vital. If a runner is in severe pain and doesn’t stop running, that pain will only get worse until they are physically unable to run or even sometimes walk. A runner will also be able to see their pain levels and limitations drop as they continue working on their hamstring flexibility, which can act as a motivator to continue doing it.

Instrumentation and Methodology

5.  Your scale should differentiate between levels of correct/acceptable performance - this must be a specific scale with values/qualities - consider using a rubric

Using my according to ExRx (2015), I was able to see the range of numbers that indicate poor, fair, and excellent using the goniometer. A poor result in the goniometer test is an angle of 60degrees or lower. The runner will have a lot of difficulty doing the test and report discomfort in their hamstring. Fair would result in an angle of 60 degrees to around 100 degrees. The runner would likely experience some kind of discomfort, but should be able to perform the test. Excellent would result in an angle over 100 degrees. The runner will have no difficult with the test if the angle is over 100 degrees. If a runner is less than 60 degrees, they are likely experiencing pain and have some type of limitation.

The standing toe-touch test would have a varying field range like the angle recorded with the goniometer. Starting with an excellent score, the runner would be able to bend down and place their palms flat on the floor, indicating a 0cm distance between fingertip and the floor, resulting in no difficulty doing the test. A fair score for this test would in the range or fingertips brushing the floor to around 10cm away from the floor. There may be some discomfort or difficulty with, but nothing that stops them from completing the test. Lastly, a poor score would be anything above 10cm. The runner will experience a lot of discomfort in the hamstrings and lower back areas, as well as not performing the test efficiently. This information correlated with the PhysicalTherapyWeb source, but was altered to fit my test.

The pain test will be on a simple scale of 1-3. The runner themselves will record this aspect since they are the ones experiencing it. One would be a lot of pain, two would be moderate pain, and three would be no pain. A runner with a pain level of one would likely be on some kind of limitation. The limitation will simply be recorded as having or not having a limitation, including what that limitation specifically is.

6.  What would the test administrator need to know about using this instrument and the procedures followed to administer the rating scale.

The person administering the tests will be able to perform them anywhere the runner can lay or stand for the angle test and toe touch test. The equipment for each of these tests will be a goniometer, a large exercise band or rope, and a ruler. Ideally, the runner will have a copy of their own chart so they can view their scores and pain level each week.

Overall, these tests will not take longer than two minutes per individual. The runner will be informing the administrator their pain level so they are mostly in charge of that aspect. The only other aspect, besides administering the flexibility tests, that the administrator is in charge of is the limitations. Not all runners should need a limitation so this will take less time. The important part about limitations is to keep track of who has them for what reason, as well as tracking improvement in pain so they can return to running gradually.

In order do to these tests, you need a general knowledge about how muscles work, as well as how to use a goniometer in order to get accurate results. It would be ideal if the administrator was a physical therapist or athletic trainer so they could continue working with the athletes until they feel confident to do on their own, as well as assess limitations more efficiently due to having more knowledge about them.

Analysis of Results

7.  Describe how you would use the results of the rating scale.

As previously discussed, each test has a poor, fair, and excellent category based on the outcome result of the test. On the chart that the runner will be given is a category for each test and rating. When the result of the test is filed into the chart, the exact measurement will be recorded, as well as the description category so the runner can see what constitutes being in each category and how they fit into the one they are in. There will be no letter grading system because of this reason.

The pain scale and limitations are going to be rated differently based on results. For the pain, if the runner experiences a one (a lot of pain) that keeps them from doing day to day activities in a normal fashion, I am going to recommend the athlete to see a sports medicine doctor. Persistent pain that interferes with daily living is something to be of concern due to a more serious injury. Seeing a sports medicine doctor will give a clear diagnosis of the problem and what steps to take to recover. This falls under the limitation category which will state specifically what the runner is limited to doing. If the injury is serious, such as a stress fracture, a note from the doctor will be required in order to return to ensure the runner is fully healed and does not risk worsening the injury.

This assessment does not have a final set grade or evaluation. After a month of doing the assessment with the runners, they should see some improvement, even just a small degree. By experiencing ways to strengthen and stretch their hamstrings, they are also learning how to manage and maintain in for their future endeavors of fitness. Performing the assessment on them is a way to bring attention to the issue and show how it can be changed for the better by strengthening and stretching.

This specific assessment is a summative evaluation. A summative evaluation is one that tracks knowledge or improvement over a given time period. An example besides this evaluation would be taking a test in class after learning a chapter. This assessment is a summative evaluation because I am testing the improvement each week in individual runners after they perform hamstring strengthening and stretches.

Sources:

"Active Lying Straight-leg Raise (goniometer)." ExRx Fitness Testing. 1 June 2015. Web. 29 Mar. 2016. <http://www.exrx.net/Testing/FlexFunction/LyingLegRaiseGoni.html>.

Jam, Bahram, Dr. "Fingertip-to-Floor (FTF) Test: Simple, Reliable and Valid - Physical Therapy Web." Physical Therapy Web. JDC Mediaworks. Web. 29 Mar. 2016. <http://physicaltherapyweb.com/fingertip-floor-ftf-test-simple-reliable-valid/> .

Name: ______Week of Observation: ______College/University:______

Directions:

If you are receiving this tracking chart, you should be a female collegiate runner suffering from low back, hip, glute, or hamstring pain. If you are not, please speak to the test administrator.

·  You will be going through a series of tests in order to determine your hamstring flexibility, pain, and limitations, if any.

·  The goniometer test measures the angle produced while you lay on your back, keep one leg planted on the ground, and lift the other as high as you can while keeping your knee straight. Record the angle you are given that week in the chart, as well as circle which category you fall under (poor, fair, excellent).

·  The finger-to-floor test measures hamstring flexibility while you bend over and attempt to reach as far to the ground as you can. You will be measured from the tip of your finger to the floor. Record how far your fingertip as from the floor in the chart, as well as circle which category you fall under (poor, fair, excellent).

·  Circle the average amount of pain you felt before running. Circle one for severe pain, two for moderate pain, and three for little to no pain. Do this after running as well.

·  Write any limitations you are given. List what they are and why you have them.

Weekly Hamstring Flexibility Tracking Chart

Goniometer Test / Finger-To-Floor Test / Pain Before Activity / Pain After Activity / Limitations
Results / Actual Angle:______
Poor: < 60 degrees
Fair: 60-100 degrees
Excellent: >100 degrees / Actual Measurement (cm): ______
Poor: >10cm.
Fair: 1-10cm.
Excellent: 0cm. / 1
(severe)
2
(moderate)
3
(very little-none) / 1
(severe)
2
(moderate)
3
(very little-none)