Active Straight-Leg Raise screening and scoring
Setup and purpose
The Active Straight-Leg Raise tests hamstring flexibility, hip mobility, pelvic control, and core stability. The patient lies supine with arms at the sides, palms up, and head on the floor. A dowel is placed vertically at the mid-point between the anterior superior iliac spine (ASIS) and the knee joint line of the down leg. The patient raises one leg with the ankle dorsiflexed and knee straight, then lowers it. Both sides are tested. The test is not a measure of hamstring strength; it reflects flexibility and pelvic control.
Scoring criteria
- 3: The malleolus of the raised leg reaches the dowel at the mid-point between the ASIS and the knee joint line of the down leg.
- 2: The malleolus is between the mid-point and the knee joint line of the down leg.
- 1: The malleolus is below the knee joint line of the down leg.
- 0: Pain. The down leg must remain flat, and the pelvis must not rotate. The lower side score counts, and a difference is an asymmetry.
Worked example
Left leg: the malleolus reaches the dowel at mid-thigh. Score 3. Right leg: the malleolus rises only to just above the knee joint line. That is between the mid-point and the knee, so score 2. The asymmetry is flagged. If the right malleolus stays below the knee joint line, the score is 1. If the patient reports posterior thigh pain, the score is 0.
Traps
- Letting the down leg bend or the pelvis rotate.
- Not dorsiflexing the ankle.
- Guessing the height instead of using the dowel reference.
- Scoring by angle in degrees; the FMS uses the dowel landmark.
- Missing pain or testing only one side. Keep the down leg flat on the floor.