Name:

Date

D.O.B

Weight

Limb Length

Current injury

Subscap

Beighton
Score

Triceps

Low back

Height

Biceps

Knee
L R

Thomas 1
(Thigh)

Suprailiac

Elbow
L R
Desirable

Above Avg

Horizontal

5 above

Average

Below Avg

Poor

80-90

70-79

60-69

50-59

40-49

Right
Desirable

Above Avg

Average

Below Avg

Poor

Aligned

0-5

5-10

10-15

>15

Below Avg

Poor

Right
Above Avg

20-30

10-20

5-10

0-5

Below Avg

Poor

Right
Above Avg

Average

40-50

30-40

20-30

10-20

<10

Average

Below Avg

Right

Core
Endurance

Above Avg

Poor

90sec

67-89

44-66

20-43

<20sec

Sit-Up

Core stabiliy

Average

30-40

Left

Score

Desirable

Leg Lower
Test

10 above >10 above

Above Avg

Desirable

2
1
<30 >30

Poor

Left

3
0

Below Avg

Desirable

Desirable

Active
External
Rotation

Total

Thumb
L R

Right

Left

Active
Internal
Rotation

Average

5 below

Left

Thomas 3
(Aligment)

Bodyfat

Pinky
L R

Left

Thomas 2
(Knee)

L/R

Back
Hold
3

Diagonal Lift
Core stabiliy

Score

Desirable

Hamstring
Flexibility

Above Avg

Average

Poor

>90

85-90

80-84

75-79

<75

Left

Right

Adductors
Flexibility

Desirable

Above Avg

Average

Below Avg

Poor

>1,75

1,6 - 1,75

1,5 - 1,6

1,4-1,5

>1,4

Score
(ratio)

Spread

Ankle
Mobility

Below Avg

Desirable

Above Avg

Average

Below Avg

Poor

>12cm

10-12cm

7-9cm

4-6cm

1-3cm

Left

Right
* Calculate ratio to limb length and/or height

Stork
Balance Test

Desirable

Average

Poor

60sec stable

60sec "shaky"

less than 60sec

Left

Right
* Eyes closed

Overhead
Squat

Above Avg

Average

Below Avg

Poor

Thighs to
parallel

Inline
Lunge

Landing
Proficiency

Desirable

Arms

Desirable

Average

Poor

Left

Right

Desirable

Average

Poor

Left

Right

Double

* Barefoot fom the box (small box & medium box)

Push-up
Row & Bridge

ISO Holds

Row Hold

Desirable

Above Avg

Average

Below Avg

Poor

>60sec
>40sec

45-60
30-40

30-45
20-30

15-30
10-20

<15sec
<10sec

Left on
top

Push-up
* 60seconds recovery between trials

Right on
top