Phelps Test

What is the gracilis muscle?

The gracilis muscle is a long, slender muscle located in the thigh's medial (inner) part. It is part of the adductor muscle group and is unique because it is biarticular, which crosses both the hip and knee joints.

Function of gracilis muscle

Its functions are crucial for comprehending how it contributes to daily activities and overall mobility. This muscle is actively involved in several essential actions, including hip flexion, knee flexion, internal rotation, and adduction.

Each function demonstrates the muscle's importance in facilitating smooth motion and coordinated movements of the lower extremities. Below, we explore these functions in detail:

• Hip flexion: The gracilis muscle helps to bend the hip joint, which is necessary for movements like lifting the leg or stepping forward. This action is crucial for activities such as walking, running, and climbing stairs, allowing for a full range of motion in the hip area. It works in conjunction with other hip flexor muscles to enable these movements efficiently.
• Knee flexion: This action involves bending the knee joint, and the gracilis muscle is one of four muscles responsible for this movement. It works together with the hamstrings and other muscles to help us walk, run, and perform everyday activities such as climbing stairs, sitting down, and standing up. Proper knee flexion is essential for maintaining joint stability and avoiding injury.
• Internal rotation: The gracilis muscle plays a crucial role in rotating the thigh inwards towards the body's midline. This motion is essential for maintaining balance while standing or walking, as well as for making quick directional changes during activities like sports.
• Adduction: As part of the adductor group, the gracilis muscle contributes to pulling the thigh back towards the midline of the body. This movement is vital for maintaining stability during activities like standing on one leg, walking in a straight line, and performing lateral movements.
• Overall mobility: The combined actions of the gracilis muscle are essential for various daily activities, such as walking, running, and even sitting down or standing up from a chair. The muscle's ability to perform hip flexion, knee flexion, internal rotation, and adduction ensures that we can move efficiently and effectively.

Physical problems related to the gracilis muscle

When impaired, the gracilis muscle can also cause several physical problems, including mobility and overall function. Recognizing these potential movement problems is essential for effectively diagnosing and treating related conditions.

The following are common physical problems associated with the gracilis muscle:

• Persistent shortening of the muscle limits hip flexion.
• Tightness in the gracilis leads to difficulties in fully extending the knee.
• Problems with internal and external rotation of the hip may arise if it is impaired.
• An imbalance in the muscle can cause pelvic obliquity, which affects the alignment of the pelvis.
• Altered muscle function can contribute to abnormal lumbar lordosis due to compensatory posture changes.
• The gracilis muscle impacts the function of the entire lower extremity, affecting the hips, knees, and ankles.

What are gracilis and hip flexion contractures?

Gracilis contractures refer to the shortening and tightening of the gracilis muscle, leading to restricted movements and flexibility. These can cause:

• Difficulty in moving the thigh away from the body.
• Reduced ability to bend the knee.
• Overall impairment in lower limb movements, affecting daily activities and mobility.
• Persistent tightness in the medial thigh causes discomfort and functional limitations.

What is the Phelps Test?

The Phelps Test is a diagnostic procedure used to assess the length of the gracilis muscle and identify contractures or shortening of this muscle. It helps detect abnormalities related to hip flexion contracture. The Phelps Test can also be conducted with the patient in a supine position to assess different aspects of the gracilis muscle.

How is this test conducted?

This test involves specific steps to be performed to ensure accurate test results and proper patient condition evaluation. We list the steps on how to perform the Phelps Test in this section:

1. The patient is positioned in a prone position with extended knees on an examination table.
2. The examiner passively abducts the patient’s legs as far as possible while keeping the knees extended.
3. The patient is then asked to flex their knees to 90° with the knee flexed.
4. The examiner attempts to abduct the hips further with the knees flexed passively.

The angle formed between the horizontal axis of the thigh and a horizontal line parallel to the floor is measured to assess hip flexion contracture.

How are the results interpreted?

The outcomes of this test provide insights into the functionality and limitations of the gracilis muscle, which guides assessment and subsequent medical interventions. Here’s how to interpret the results of the Phelps Test:

• Positive test: If the hip abduction range increases after the knees are flexed to 90°, this indicates potential contractures in the gracilis muscle. Knee flexion shortens the gracilis muscle, allowing more hip abduction if the gracilis is the limiting factor.
• Negative test: If there is no significant increase in hip abduction after knee flexion, this suggests that the gracilis muscle is not the limiting factor.

Next steps after conducting this test

After performing the Phelps Test and interpreting its results, take the appropriate next steps to address any identified issues and provide the patient with an effective treatment plan. Here are the key steps to follow after conducting the test:

1. The results can be used to determine the presence of gracilis contractures and how they affect the patient's lower limbs and overall movement.
2. Additional tests and measurements should be conducted to assess the impact on other muscles, such as the hamstrings, and to evaluate related spine and lower limb abnormalities.
3. Develop a treatment plan that may include physical therapy, stretching exercises, and other interventions to address the contracture and improve hip flexion and overall mobility.
4. Schedule follow-up assessments to measure progress and adjust the treatment plan as needed to ensure optimal patient outcomes.

How to use our Phelps Test template

The Phelps Test template is a valuable tool for assessing and testing the length of the gracilis muscle and identifying potential contractures. Follow these steps to ensure accurate and consistent testing, leading to effective diagnosis and intervention planning for issues related to the gracilis muscle.

Step 1: Fill in patient information and understand the test

Start by filling in the patient's full name, date of birth, examination date, and examiner's name. Review and understand the Phelps Test's purpose and the gracilis muscle's anatomical background. This knowledge is essential for accurate assessment and interpretation of results.

Step 2: Position the patient and conduct the test

Follow the provided steps to position the patient correctly according to the template instructions. Proper positioning is crucial for the accuracy and outcome of the test. The greater trochanter of the femur is used as a reference point during the test to measure specific pathologies. Perform the Phelps Test by measuring hip abduction before and after knee flexion to assess the length of the gracilis muscle.

Step 3: Record and interpret the results

Document the initial and post-knee flexion abduction ranges in degrees. Use the provided guide to interpret the results: an increase in the hip abduction angle after knee flexion indicates a positive result for gracilis contracture, while no significant change indicates a negative result.

Step 4: Identify test results and note symptoms

Tick the appropriate checkbox to indicate whether the test is positive or negative for gracilis contracture. Record any patient-reported symptoms and include recommendations, such as physical therapy. This information helps create a comprehensive care plan tailored to patients' needs.

By following these steps and documenting the results correctly, you can effectively diagnose and plan interventions for issues related to the gracilis muscle using the Phelps Test template.

Phelps Test example

The Phelps Test template is an essential tool designed to streamline the assessment of the gracilis muscle and identify potential contractures. This user-friendly template guides you through each step, from documenting patient details to interpreting test results. Clear instructions on positioning the patient, conducting the test, and measuring outcomes ensure accuracy and consistency in your evaluations.

The template includes sections for patient information, test purpose, anatomical background, required materials, and step-by-step test procedures. It also provides guidelines for interpreting results and documenting findings, making it easier to determine whether the test indicates a positive or negative result for gracilis muscle contractures.

Download our free Phelps Test template example here:

Benefits of conducting this test

This test is a valuable diagnostic tool, as it can help assess and manage gracilis muscle contractures. Incorporating the test into routine examinations can enhance patient care and effectively address musculoskeletal challenges.

• The Phelps Test allows for precise measurement of hip abduction angles when the knee is flexed to 90 degrees, which helps to detect muscle contractures and deformities accurately.
• It is beneficial for children and school health programs, aiding in the early detection of developmental challenges and trauma-related issues and ensuring timely interventions.
• Identifying affected areas and understanding the severity of contractures can help develop targeted treatment plans and improve outcomes for patients facing musculoskeletal problems.
• The test supports broader public health initiatives by providing critical data for community health programs and enhances overall community interest in musculoskeletal health.
• Regular use of the test in examinations ensures every aspect of the patient's condition is measured and managed effectively, leading to greater patient care and functional mobility achievement.

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