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Postural Findings
HIP
Hip ROM - Active/Passive
(L) Flexion /100
/
(R) Flexion /100
/
(L) Extension /30
/
(R) Extension /30
/
(L) Internal Rotation /40
/
(R) Internal Rotation /40
/
(L) External Rotation /50
/
(R) External Rotation /50
/
(L) Abduction /45
/
(R) Abduction /45
/
(L) Adduction /30
/
(R) Adduction /30
/
Reproduction of Pain/Symptoms
• • •
Notes
Hip Manual Muscle Testing (MMT)
Findings
Hip Orthopedic Tests
Findings
Hip Soft Tissue Findings
Hip Soft Tissue: 1
• • •
Finding(s)
• • •
Hip Soft Tissue: 2
• • •
Finding(s)
• • •
Hip Soft Tissue: 3
• • •
Finding(s)
• • •
Notes
Hip Joint Findings
Joint
Restriction(s)
• • •
Joint
Restriction(s)
• • •
Notes
Neuromuscular Patterns:
Findings
Additional Hip Findings
Findings
KNEE
Knee ROM - Active/Passive
(L) Flexion /150
/
(R) Flexion /150
/
(L) Extension /0
/
(R) Extension /0
/
Reproduction of Pain/Symptoms
• • •
Notes
Knee Manual Muscle Testing (MMT)
Findings
Knee Orthopedic Tests
Findings
Knee Soft Tissue Findings
Knee Soft Tissue: 1
• • •
Finding(s)
• • •
Knee Soft Tissue: 2
• • •
Finding(s)
• • •
Knee Soft Tissue: 3
• • •
Finding(s)
• • •
Notes
Knee Joint Findings
Joint: 1
• • •
Restriction
• • •
Joint: 2
• • •
Restriction
• • •
Joint: 3
• • •
Restriction
• • •
Notes
Additional Knee Findings
Findings
ANKLE
Ankle ROM - Active/Passive
(L) Dorsiflexion /20
/
(R) Dorsiflexion /20
/
(L) Plantarflexion /40
/
(R) Plantarflexion /40
/
(L) Hindfoot Inversion /30
/
(R) Hindfoot Inversion /30
/
(L) Hindfoot Eversion /20
/
(R) Hindfoot Eversion /20
/
Reproduction of Pain/Symptoms
• • •
Notes
Ankle/Foot Manual Muscle Testing
Findings
Ankle/Foot Orthopedic Tests
Findings
Ankle/Foot Soft Tissue Findings
Ankle/Foot Soft Tissue: 1
• • •
Finding(s)
• • •
Ankle/Foot Soft Tissue: 2
• • •
Finding(s)
• • •
Ankle/Foot Soft Tissue: 3
• • •
Finding(s)
• • •
Notes
Ankle/Foot Joint Findings
Joint: 1
• • •
Restriction
• • •
Joint: 2
• • •
Restriction
• • •
Joint: 3
• • •
Restriction
• • •
Notes
Additional Ankle/Foot Findings
Findings

Lower Extremity MSK Exam Medical Form

Physical Therapist

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Published: Feb. 18, 2016, 4:56 p.m.
Doctor: Dr. History Physical
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