TEST #3: Plank Test (PT): The plank test is designed to assess the strength and endurance of some of the key core muscles. It is the number one test to assess the strength and endurance of the multifidus (a thick muscle in the lumbar spine which plays a critical role in stability of lumbar spine) as well as the abdominals and transverse abdominus.[i] This test can also give us some indication of the balance of the muscles on the anterior aspect (abdominals and associated musculature) and posterior aspect (multifidus and associated musculature). Because the core is so active in sports, assessing the ability to perform the test as well as the endurance with the test is vital.
In the plank test, the subject is asked to do a modified push-up position with their feet close together and up on their elbows (as indicated in picture). The key is to maintain this position without raising the hips in the air or “slumping” in the mid-section. This test is scored or assessed on the ability to hold the position for time without losing form or balance. Scoring is based on how long the subject can hold the position within a 2" window. They are given 1 point for every 2 seconds they are able to hold the position within 2" of the starting position.
The subject also receives a lower score if unable to maintain position or presents with one of the compensations throughout the testing protocol. The time at which the compensation starts to occur is the point at which the time is taken and the score given.
Clinical Implications of Plank Test
There are numerous deviations that athletes can present with when performing the Plank Test. Below is a list of some of the most common deviations seen with the PT and the associated clinical implications.
Arching back (slumping) – if the athlete is hips are dropping toward the floor or slumping in the lumbar spine, this can be a result of poor technique, decreased strength/endurance of transverse abdominus, lower abdominals or rectus abdominus.
Suggested Corrective Exercise: These athletes typically respond well to core training with specific isolation to lower abdominals, tranverse abdominus and rectus abdominus as well as plank progressions.
Hips too high – if the athlete is unable to perform without keeping their hips high, this can be the result of poor technique, decreased strength/endurance of mutifidus, trying to facilitate more quads, and/or hip flexor tightness (which can be cleared with a Thomas Test).
Suggested Corrective Exercise: These individuals respond well to hip flexor stretching, 6 pack on the physioball, back ext over physioball or plinth as well as plank progressions.
Trunk rotation – if the athlete is unable to perform without one hip dropping then this is typically the result of asymmetry in strength of the system. Closer evaluation of where the movement is breaking down will guide isolated manual muscle testing for differential diagnosis to identify specific weaknesses in the kinetic chain.
Suggested Corrective Exercise: Treatment considerations should be based on the specific assessment, but these individuals also do well with plank progressions.
TEST #4: Side Plank Test (SPT): The side plank test is also designed to assess the strength and endurance of some of the key core muscles. It is the number one test to assess the strength and endurance of the gluteus medius[ii] as well as the obliques and quadratus lumborum. This test can also give us some indication of the balance of the muscles on right and left side of the body. Because the core is so active in sports, assessing the ability to perform the test as well as the endurance with the test is vital.
In the side plank test, the athlete lies on their side while placing their feet together. They are asked to raise up on one elbow while placing the opposite hand on their hip. The key is to maintain this position without dropping your hip to the table, keeping your feet together or allowing rotation throughout the test. This test is scored or assessed on the ability to hold the position for time without losing form or balance and is conducted on both the left and right sides.
Scoring is based on how long the subject can hold the position within a 2" window. They are given 1 point for every 2 seconds they are able to hold the position within 2" of the starting position.
The subject also receives a lower score if unable to maintain position or presents with one of the compensations throughout the testing protocol. The time at which the compensation starts to occur is the point at which the time is taken and the score given.
Clinical Implications of Side Plank Test
There are numerous deviations that
athletes can present with when performing the Side Plank Test. Below is a list of some of the most common
deviations seen with the SPT and the associated clinical implications.
Hip Drop – If the athlete is
unable to perform without allowing the hip to droop or drop to the table this
could be an indication of poor technique, decreased strength/endurance of
obliques, quadratus lumborum or gluteus medius or overall decreased core
stability.
Suggested
Corrective Exercise: These athletes
respond well to a core training routine with specific isolation to obliques,
side-plank progression, side-stepping, monster walk, and PNF step-ups.
Trunk rotation – If an
athlete is unable to perform without allowing for rotation to occur during,
this may be an indication of poor technique, decreased strength/endurance of
obliques, quadratus lumborum or gluteus medius, or decreased proprioception in
lumbar spine/hips.
Suggested
Corrective Exercise: These athletes
respond well to a core training routine with specific isolation to obliques,
side-plank progression, Single Leg with Dynamic Lower Extremity Movement
exercise progression, and side-lying gluteus medius on a physioball.
Scapular winging – In some
athletes, you will notice excessive scapular winging during this test. This will sometimes present as trunk rotation
due to the loss of control at the scapula.
It is therefore essential to determine if this rotation is the loss of
scapular stability or the above.
Suggested
Corrective Exercise: If the result
of excessive scapular winging, these athletes respond well to isolated parascapular
strengthening, serratus anterior strengthening and 6 pack on the
physioball.
[ii] Boren K, Conrey C, Le Coguic J, Paprocki L, Voight M, Robinson TK. Electromyographic
analysis of gluteus medius and gluteus maximus during rehabilitation exercises.
Int J Sports Phys Ther. 2011 Sep;6(3):206-23.
[i] EMG
Analysis of Transverse Abdominis and Lumbar Multifidus Using Fine Wire
Electrodes During Lumbar Stabilization Exercises. Journal of
Orthopedic and Sports Physical Therapy, 2010;40(11):743-750.
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