Overhead Squat Assessment: Sign Clusters and Compensation Patterns

All fitness, performance, and rehabilitation programs should start with an assessment. The goal of assessment is to refine exercise and technique recommendations, with the intent of improving client or patient outcomes. This is an advanced course on the interpretation of clusters or patterns of the signs identified during the Overhead Squat Assessment (a.k.a OSA, OHSA, squat assessment, overhead squat, and similar to the deep squat of the Functional Movement Screen). This course builds on the concepts in previous courses:

• Overhead Squat Assessment: Introduction
• Overhead Squat Assessment: Signs of Dysfunction

The Overhead Squat Assessment is particularly effective as a starting point for movement quality evaluation because it challenges the dynamic flexibility and neuromuscular control of the large joints of the kinetic chain. The Overhead Squat Assessment is the assessment of a set of reliable signs:

• Feet flatten
• Feet turn-out
• Knees bow-in
• Knees bow-out
• Excessive lordosis (Anterior pelvic tilt)
• Excessive forward lean
• Arms fall
• Shoulder girdle elevation

If you use the OHSA in practice, you have probably noticed it is very rare that an individual presents with a single "sign" of dysfunction. If you look closely at the tables in the article Overhead Squat Assessment: Signs of Dysfunction , you will note that many of the same muscles continue to appear, exhibiting the same changes in activity and length, throughout multiple signs/tables. This is especially true of signs related to the same joint or proximal joints (for example, "feet flatten ," "feet turn-out ," "knees bow in ," etc). This repetition gives inference to signs being related to one another, resulting in "sign clusters," and these clusters are likely representative of compensation patterns. In fact, practice may highlight that dysfunction most often presents in patterns. Fortunately, these patterns are repetitive, predictable, and easily categorized into a few over-arching models of postural dysfunction/movement impairment. Below you will find tables with an analysis of each compensation pattern, with the muscles and interventions hyperlinked, hyperlinks for further reading on each pattern, a video description of how to identify the compensation pattern using the OHSA, how to use the Modified OHSA for differentiation, and a brief discussion on relevant research.

Advantages of Identifying Compensation Patterns:

• Consideration of multi-joint structures (e.g. sciatic nerve, iliotibial band, biceps femoris , etc.)
• Consideration of muscle synergies (e.g. core subsystems)
• Consideration of how one sign may be related to, or contribute to other signs
• Optimizing "Integration Exercise" selection
• Create "more complete" corrective/therapeutic interventions

The Sign Clusters Discussed:

• Lower Extremity Dysfunction
• Lumbo Pelvic Hip Complex Dysfunction
• Lumbosacral Dysfunction
• Upper Body Dysfunction

Printable PDF of the Movement Assessment Template (including the OHSA):

• Movement Assessment Template

Caption: Identifying dysfunction using the Overhead Squat Assessment with modified