Introduction

Legs with Back/Pulling

Legs with Chest/Pushing

Legs (including Deadlifts) with Shoulders/Overhead Pressing

Legs with Pull Progression

Legs with Shoulders/Overhead Press Progressions

Single Leg Touchdown with Shoulder Progressions

Legs with Chest Press/Push Progressions

Total Body Exercises and Functional Exercise Progressions

AOTA

AUSREPS

CanFitPro

ISSA

PTAGlobal

REPS

NASM

ACSM

AFAA

NCBTMB

PACE

REPSI

WITS

AUSPHYSIO

TPTA

NYPT

CIMSPA

Integrated Exercise Progressions

Total body exercises that <a id="integration" data-tip="1476" target="_blank" href="/glossary-term/integration" class="glossary">integrate</a> multiple muscles (including the core muscles) should be incorporated into any routine that is part of a functional training program, because these functional exercises are most likely to have a positive impact on everyday activity.
This course discusses variations, <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a>, and <a id="exercise-regression" data-tip="1178" target="_blank" href="/glossary-term/exercise-regression" class="glossary">regressions</a> of total body exercises (a.k.a. <a id="integration" data-tip="1473" target="_blank" href="/glossary-term/integration" class="glossary">integrated</a> exercises, functional exercises, functional training exercises, functional movements, whole-body exercises, total body workouts, etc). Almost all of these movement patterns include a compound upper body exercise with a compound lower body exercise, with the intent of integrating multiple <a id="muscle-cell" data-tip="1781" target="_blank" href="/glossary-term/muscle-cell" class="glossary">muscle</a> groups into a functional movement pattern. These functional exercises challenge core <a id="stability" data-tip="1191" target="_blank" href="/glossary-term/stability" class="glossary">stability</a> and neuromuscular control, and have particularly high transference to daily life and intense physical activity. Further, this course includes detailed directions for cueing to optimize recruitment (e.g. increase core <a id="stability" data-tip="1191" target="_blank" href="/glossary-term/stability" class="glossary">stability</a> and glute recruitment), optimize foot placement (e.g. shoulder width, or the correct distance between the right foot and left foot), address <a id="muscle-cell" data-tip="1781" target="_blank" href="/glossary-term/muscle-cell" class="glossary">muscle</a> imbalances (e.g. scapula position, pelvic position, etc.), and increase force production for use during strength training.&#xA0;
Additionally, this course covers the more advanced functional anatomy <a id="relevance" data-tip="1505" target="_blank" href="/glossary-term/relevance" class="glossary">relevant</a> to the analysis of compound movements and the recruitment of <a id="muscle-cell" data-tip="1781" target="_blank" href="/glossary-term/muscle-cell" class="glossary">muscle</a> synergies, including the contribution of core subsystems (e.g. <a href="https://brookbushinstitute.com/courses/posterior-oblique-subsystem-pos" target="_blank" rel="noopener">posterior oblique subsystem</a>) and the use of whole-body exercises during neuromuscular re-education (a.k.a. <a id="integration" data-tip="1472" target="_blank" href="/glossary-term/integration" class="glossary">integration</a> exercises). Note, analysis of <a id="integration" data-tip="1473" target="_blank" href="/glossary-term/integration" class="glossary">integrated</a> exercises is also excellent practice for developing the analysis skills that are necessary to breakdown the complex motions involved in everyday movement.&#xA0;
This course is built from a systematic research review, it is pre-approved for credits toward the Certified Personal Trainer (CPT) Certification, and pre-approved for continuing education credits for movement professionals (personal trainers, fitness instructors, physical therapists, athletic trainers, massage therapists, chiropractors, occupational therapists, etc.). We hope this course inspires the inclusion of whole-body (functional exercises) for all goals in fitness, performance, and physical rehabilitation. For example, total body work-outs for fitness enthusiasts (e.g. a series of whole-body exercises), functional strength training for athletes (e.g. holding your position in the paint during basketball, or pushing a defender out of position during football, etc.), or regaining function following an injury (e.g. step-up to press to prepare for pushing open a heavy door).
<h3>Additional Progression Courses:</h3>
<h4>Strength Progressions</h4>
<ul>
 <li><a href="https://brookbushinstitute.com/courses/chestpushing-movements">Chest Exercise and Pushing Progressions</a></li>
 <li><a href="https://brookbushinstitute.com/courses/back-pulling-movement-patterns">Back Exercise and Pulling Progressions</a></li>
 <li><a href="https://brookbushinstitute.com/courses/shoulderoverhead-pressing-patterns">Shoulder Exercise and Pressing Progressions</a></li>
 <li><a href="https://brookbushinstitute.com/courses/lower-bodytriple-extension-movements">Leg Exercise and Triple Extension Progressions</a></li>
 <li><a href="https://brookbushinstitute.com/courses/deadlift-progression">Deadlift Exercise Progressions</a></li>
 <li><a href="https://brookbushinstitute.com/courses/stability-progression-for-integrated-exercise">Total Body Exercise and </a><a id="integration" data-tip="1473" target="_blank" href="/glossary-term/integration" class="glossary">Integrated</a> Progressions</li>
</ul>
<h4>Core Progressions</h4>
<ul>
 <li><a href="https://brookbushinstitute.com/courses/transverse-abdominis-activation-quadrupeds-progressions">Quadruped and Progressions</a></li>
 <li><a href="https://brookbushinstitute.com/courses/plank-progression">Plank and Side Plank Progressions</a></li>
 <li><a href="https://brookbushinstitute.com/courses/bridge-progression">Glute Bridge and Progressions</a></li>
 <li><a href="https://brookbushinstitute.com/courses/chop-pattern-progressions">Wood Chop Exercise Progressions</a></li>
</ul>
<h4>Power Progressions</h4>
<ul>
 <li><a href="https://brookbushinstitute.com/courses/power-training-upper-and-total-body">Power Training: Upper Body and Total Body Exercise</a></li>
 <li><a href="https://brookbushinstitute.com/courses/power-training-lower-body-exercises">Power Training: Lower Body Exercise</a></li>
</ul>
<h2>Sample Progression: Legs with Pull (Posterior Obliques Subsystem)</h2>
<ol>
 <li>Squat to <a id="bilateral" data-tip="1552" target="_blank" href="/glossary-term/bilateral" class="glossary">bilateral</a> row</li>
 <li>Squat to <a id="unilateral" data-tip="1551" target="_blank" href="/glossary-term/unilateral" class="glossary">unilateral</a> row</li>
 <li>Step-up to <a id="bilateral" data-tip="1552" target="_blank" href="/glossary-term/bilateral" class="glossary">bilateral</a> row</li>
 <li>Step-up to <a id="unilateral" data-tip="1551" target="_blank" href="/glossary-term/unilateral" class="glossary">unilateral</a> row</li>
 <li>Static sagittal plane lunge to <a id="bilateral" data-tip="1552" target="_blank" href="/glossary-term/bilateral" class="glossary">bilateral</a> row
 <ul>
 <li>Unilateral row</li>
 <li>Bilateral row, front foot unstable</li>
 <li>Unilateral row, front foot unstable</li>
 </ul>
 </li>
 <li>Dynamic sagittal plane lunge to <a id="bilateral" data-tip="1552" target="_blank" href="/glossary-term/bilateral" class="glossary">bilateral</a> row
 <ul>
 <li>Unilateral row</li>
 <li>Bilateral row, to balance</li>
 <li>Unilateral row, to balance</li>
 <li>Bilateral row, to <a id="balance" data-tip="1190" target="_blank" href="/glossary-term/balance" class="glossary">balance</a>, front foot unstable</li>
 <li>Unilateral row, to <a id="balance" data-tip="1190" target="_blank" href="/glossary-term/balance" class="glossary">balance</a>, front foot unstable</li>
 </ul>
 </li>
 <li>Single-leg squat to <a id="bilateral" data-tip="1552" target="_blank" href="/glossary-term/bilateral" class="glossary">bilateral</a> cable pull-down</li>
</ol>

<h3>Sample Program</h3>
<span style="background-color: transparent; font-family: inherit; font-size: 1.25em; font-style: inherit; font-variant-ligatures: inherit; font-variant-caps: inherit; font-weight: bold; letter-spacing: 0px;">Routine 1 (Month 1)
Goal: Upper Body Strength Endurance/Stability
<ul>
 <li>
 Acute Variables:
 <ul>
 <li>Goal: <span style="background-color: transparent; font-family: inherit; font-size: inherit; font-style: inherit; font-variant-ligatures: inherit; font-variant-caps: inherit; font-weight: inherit; letter-spacing: 0px;">Upper Body Strength/Endurance and Stability</li>
 <li>Load: Lighter (60-75% of 1-RM)</li>
 <li>Reps/set: 12-20 reps</li>
 <li>Sets/exercise (circuits): 1-4 circuits</li>
 <li>Rest between exercises: 60 seconds (note, exercise performed in circuit)</li>
 <li>Training Time: 20 &#x2013; 45 minutes (excluding warm-up).</li>
 </ul>
 
 </li>
 <li>
 Endurance/Stability Circuit Routine: 
 <ul>
 <li>Total Body: <a href="https://brookbushinstitute.com/videos/static-lunge-to-row-posterior-oblique-subsystem-integration-progressions" target="_blank" rel="noopener">Static Lunge to </a><a id="unilateral" data-tip="1551" target="_blank" href="/glossary-term/unilateral" class="glossary">Unilateral</a> Row with Airex Pad under Front Foot</li>
 <li>Chest: <a href="https://brookbushinstitute.com/videos/stability-ball-push">Stability Ball Push Up</a></li>
 <li>Back: <a href="https://brookbushinstitute.com/videos/chaos-row">Chaos Row</a></li>
 <li>Shoulders: <a href="https://brookbushinstitute.com/videos/pnf-carry-away">Cable PNF Carry Away</a></li>
 <li>Back/Arms: <a href="https://brookbushinstitute.com/videos/prone-stability-ball-row-to-triceps-extension">Prone </a><a id="stability" data-tip="1191" target="_blank" href="/glossary-term/stability" class="glossary">Stability</a> Ball Row to Tricep Extension</li>
 </ul>
 </li>
</ul>

<h3>Routine 2 (Month 2)</h3>
Goal: Upper Body Hypertrophy (Strength/Stability Supersets)
<ul>
 <li>
 Acute Variables: 
 <ul>
 <li>Load: Moderate (75-90% 1-RM)/Light (60-75% 1-RM)</li>
 <li>Reps/set: 6-12/6-12</li>
 <li>Sets/exercise (or circuits): 1-5 circuits</li>
 <li>Rest between exercises: 30 seconds</li>
 <li>Rest between sets: 3 minutes (alternatively, can be performed in a circuit)</li>
 <li>Training time: 20 &#x2013; 60 minutes (excluding warm-up).</li>
 </ul>
 
 </li>
 <li>
 Strength/Stability Super-sets Routine: 
 <ul>
 <li>Total Body: <a href="https://brookbushinstitute.com/videos/front-squat-to-press">Front Squat to Press</a> and <a href="https://brookbushinstitute.com/videos/single-leg-touchdown-with-scaption-and-pnf-carry-away" target="_blank" rel="noopener">Single Leg Touchdown to PNF Carry Away</a></li>
 <li>Chest: <a href="https://brookbushinstitute.com/videos/bench-press-chest-press">Incline Bench Press</a> and <a href="https://brookbushinstitute.com/videos/asymmetrical-chest-press">Asymmetrical Dumbbell Press on Ball</a></li>
 <li>Back: <a href="https://brookbushinstitute.com/videos/kneeling-cable-pull-down-lat-pulldown-progression">Kneeling Cable Pull Down</a> and <a href="https://brookbushinstitute.com/videos/rope-row">Rope Row</a></li>
 <li>Legs: <a href="https://brookbushinstitute.com/videos/deadlift-progressions-cueing-and-questionable-variations" target="_blank" rel="noopener">Deadlift</a> and <a href="https://brookbushinstitute.com/videos/wobble-lunge" target="_blank" rel="noopener">Wobble Transverse Plane Lunge to Balance</a></li>
 </ul>
 <a href="https://brookbushinstitute.com/videos/wobble-lunge" target="_blank" rel="noopener"> </a>
 </li>
</ul>

Course Detailis: Total Body Exercises and Functional Exercise Progressions

For a comprehensive review of <a id="stability" data-tip="1194" target="_blank" href="/glossary-term/stability" class="glossary">unstable</a> load and surface training:
<ul>
 <li><a href="https://brookbushinstitute.com/courses/stability-training" target="_blank" rel="noopener">Stability Training</a></li>
</ul>
<h3>Function:</h3>
<a id="integration" data-tip="1473" target="_blank" href="/glossary-term/integration" class="glossary">Integrated</a> exercise <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> combine upper and lower extremity exercise into functional patterns with the intent of improving inter-muscular coordination and strength during whole-body movement patterns. Although these <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> may not allow for enough load to maximize hypertrophy or strength sports performance, they are incredibly beneficial for field sports, improving functional strength, and may aid in optimizing movement patterns by targeting core subsystems. It is recommended that individual exercise <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> are practiced before they are combined into <a id="integration" data-tip="1473" target="_blank" href="/glossary-term/integration" class="glossary">Integrated</a> movement patterns:
<ul>
 <li><a href="https://brookbushinstitute.com/courses/chestpushing-movements" target="_blank" rel="noopener">Chest/Pushing Progressions</a></li>
 <li><a href="https://brookbushinstitute.com/courses/back-pulling-movement-patterns" target="_blank" rel="noopener">Back/Pulling Progressions</a></li>
 <li><a href="https://brookbushinstitute.com/courses/shoulderoverhead-pressing-patterns" target="_blank" rel="noopener">Shoulder/Overhead Pressing Progressions</a></li>
 <li><a href="https://brookbushinstitute.com/courses/lower-bodytriple-extension-movements" target="_blank" rel="noopener">Legs/Triple Extension Progressions</a></li>
 <li><a href="https://brookbushinstitute.com/courses/deadlift-progression" target="_blank" rel="noopener">Deadlift Progressions</a></li>
</ul>
<h3>Relative Flexibility Progression:</h3>
<a id="relative-flexibility" data-tip="1654" target="_blank" href="/glossary-term/relative-flexibility" class="glossary">Relative flexibility</a> <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> are general guidelines for exercise selection that can be used while correcting <a id="posture" data-tip="1659" target="_blank" href="/glossary-term/posture" class="glossary">postural</a> dysfunction/movement impairment. Within the <a id="exercise-progression" data-tip="1184" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progression</a> for each <a id="integration" data-tip="1473" target="_blank" href="/glossary-term/integration" class="glossary">integrated</a> movement pattern, <a id="relative-flexibility" data-tip="1654" target="_blank" href="/glossary-term/relative-flexibility" class="glossary">Relative flexibility</a> <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> for the movement patterns they comprise should be respected. Additionally, the introduction of the <a id="integration" data-tip="1473" target="_blank" href="/glossary-term/integration" class="glossary">integrated</a> movement patterns may be progressed from patterns least likely to result in compensation to patterns requiring <a id="optimal" data-tip="1571" target="_blank" href="/glossary-term/optimal" class="glossary">optimal</a> <a id="mobility" data-tip="1455" target="_blank" href="/glossary-term/mobility" class="glossary">mobility</a> and neuromuscular control.
<ol>
 <li>Legs with Back/Pulling</li>
 <li>Legs with Shoulders/Overhead Press</li>
 <li>Deadlift with Shoulders/Overhead Press</li>
 <li>Legs with Chest/Pushing</li>
</ol>
<h3>Subsystems Recruited:</h3>
The core subsystems recruited during <a id="integration" data-tip="1473" target="_blank" href="/glossary-term/integration" class="glossary">integrated</a> exercise <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> match the core subsystems used during the individual exercise progressions; however, each <a id="integration" data-tip="1473" target="_blank" href="/glossary-term/integration" class="glossary">integrated</a> <a id="exercise-progression" data-tip="1181" target="_blank" href="/glossary-term/exercise-progression" class="glossary">exercise progression</a> places additional emphasis on the <a id="integration" data-tip="1473" target="_blank" href="/glossary-term/integration" class="glossary">integrated</a> function of a corresponding core subsystem. <a id="integration" data-tip="1473" target="_blank" href="/glossary-term/integration" class="glossary">integrated</a> exercise <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> are used in the Brookbush Institute&apos;s Corrective Exercise Template to target core subsystems assessed as under-active.
<ul>
 <li><a href="https://brookbushinstitute.com/courses/posterior-oblique-subsystem-pos" target="_blank" rel="noopener">Posterior Oblique Subsystem (POS)</a> - Legs with Back/Pulling</li>
 <li><a href="https://brookbushinstitute.com/courses/anterior-oblique-subsystem-aos" target="_blank" rel="noopener">Anterior Oblique Subsystem (AOS)</a> - Legs with Chest/Pushing</li>
 <li>Coordinated recruitment of the <a href="https://brookbushinstitute.com/courses/posterior-oblique-subsystem-pos" target="_blank" rel="noopener">POS</a> and <a href="https://brookbushinstitute.com/courses/anterior-oblique-subsystem-aos" target="_blank" rel="noopener">AOS</a> - Legs with Shoulders/Overhead Press</li>
 <li>Coordinated recruitment of the <a href="https://brookbushinstitute.com/courses/posterior-oblique-subsystem-pos" target="_blank" rel="noopener">POS</a> and <a href="https://brookbushinstitute.com/courses/deep-longitudinal-subsystem" target="_blank" rel="noopener">Deep Longitudinal Subsystem (DLS)</a> - Deadlift and Shoulder/Overhead Pressing</li>
</ul>
<h3>Sample Program</h3>
<span style="background-color: transparent; font-family: inherit; font-size: 1.25em; font-style: inherit; font-variant-ligatures: inherit; font-variant-caps: inherit; font-weight: bold; letter-spacing: 0px;">Routine 1 (Month 1)
Goal: Upper Body Strength Endurance/Stability
<ul>
 <li>
 Acute Variables:
 <ul>
 <li>Goal: <span style="background-color: transparent; font-family: inherit; font-size: inherit; font-style: inherit; font-variant-ligatures: inherit; font-variant-caps: inherit; font-weight: inherit; letter-spacing: 0px;">Upper Body Strength/Endurance and Stability</li>
 <li>Load: Lighter (60-75% of 1-RM)</li>
 <li>Reps/set: 12-20 reps</li>
 <li>Sets/exercise (circuits): 1-4 circuits</li>
 <li>Rest between exercises: 60 seconds (note, exercise performed in circuit)</li>
 <li>Training Time: 20 &#x2013; 45 minutes (excluding warm-up).</li>
 </ul>
 
 </li>
 <li>
 Endurance/Stability Circuit Routine: 
 <ul>
 <li>Total Body: <a href="https://brookbushinstitute.com/videos/static-lunge-to-row-posterior-oblique-subsystem-integration-progressions" target="_blank" rel="noopener">Static Lunge to </a><a id="unilateral" data-tip="1551" target="_blank" href="/glossary-term/unilateral" class="glossary">Unilateral</a> Row with Airex Pad under Front Foot</li>
 <li>Chest: <a href="https://brookbushinstitute.com/videos/stability-ball-push">Stability Ball Push Up</a></li>
 <li>Back: <a href="https://brookbushinstitute.com/videos/chaos-row">Chaos Row</a></li>
 <li>Shoulders: <a href="https://brookbushinstitute.com/videos/pnf-carry-away">Cable PNF Carry Away</a></li>
 <li>Back/Arms: <a href="https://brookbushinstitute.com/videos/prone-stability-ball-row-to-triceps-extension">Prone </a><a id="stability" data-tip="1191" target="_blank" href="/glossary-term/stability" class="glossary">Stability</a> Ball Row to Tricep Extension</li>
 </ul>
 </li>
</ul>

<h3>Routine 2 (Month 2)</h3>
Goal: Upper Body Hypertrophy (Strength/Stability Supersets)
<ul>
 <li>
 Acute Variables: 
 <ul>
 <li>Load: Moderate (75-90% 1-RM)/Light (60-75% 1-RM)</li>
 <li>Reps/set: 6-12/6-12</li>
 <li>Sets/exercise (or circuits): 1-5 circuits</li>
 <li>Rest between exercises: 30 seconds</li>
 <li>Rest between sets: 3 minutes (alternatively, can be performed in a circuit)</li>
 <li>Training time: 20 &#x2013; 60 minutes (excluding warm-up).</li>
 </ul>
 
 </li>
 <li>
 Strength/Stability Super-sets Routine: 
 <ul>
 <li>Total Body: <a href="https://brookbushinstitute.com/videos/front-squat-to-press">Front Squat to Press</a> and <a href="https://brookbushinstitute.com/videos/single-leg-touchdown-with-scaption-and-pnf-carry-away" target="_blank" rel="noopener">Single Leg Touchdown to PNF Carry Away</a></li>
 <li>Chest: <a href="https://brookbushinstitute.com/videos/bench-press-chest-press">Incline Bench Press</a> and <a href="https://brookbushinstitute.com/videos/asymmetrical-chest-press">Asymmetrical Dumbbell Press on Ball</a></li>
 <li>Back: <a href="https://brookbushinstitute.com/videos/kneeling-cable-pull-down-lat-pulldown-progression">Kneeling Cable Pull Down</a> and <a href="https://brookbushinstitute.com/videos/rope-row">Rope Row</a></li>
 <li>Legs: <a href="https://brookbushinstitute.com/videos/deadlift-progressions-cueing-and-questionable-variations" target="_blank" rel="noopener">Deadlift</a> and <a href="https://brookbushinstitute.com/videos/wobble-lunge" target="_blank" rel="noopener">Wobble Transverse Plane Lunge to Balance</a></li>
 </ul>
 </li>
</ul>

<h3>Kinesiology</h3>
For a complete review of the <a id="kinesiology" data-tip="1692" target="_blank" href="/glossary-term/kinesiology" class="glossary">kinesiology</a> of the movement patterns used in the <a id="integration" data-tip="1473" target="_blank" href="/glossary-term/integration" class="glossary">integrated</a> exercise <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a>, please refer to the courses on the individual movement patterns:
<ul>
 <li><a href="https://brookbushinstitute.com/courses/chestpushing-movements" target="_blank" rel="noopener">Chest/Pushing Progressions</a></li>
 <li><a href="https://brookbushinstitute.com/article/back-pulling-movement-patterns" target="_blank" rel="noopener">B</a><a href="https://brookbushinstitute.com/courses/back-pulling-movement-patterns" target="_blank" rel="noopener">ack/Pulling Progressions</a></li>
 <li><a href="https://brookbushinstitute.com/courses/shoulderoverhead-pressing-patterns" target="_blank" rel="noopener">Shoulder/Overhead Pressing Progressions</a></li>
 <li><a href="https://brookbushinstitute.com/courses/lower-bodytriple-extension-movements" target="_blank" rel="noopener">Legs/Triple Extension Progressions</a></li>
 <li><a href="https://brookbushinstitute.com/courses/deadlift-progression" target="_blank" rel="noopener">Deadlift Progressions</a></li>
</ul>
<img title="Dr. Brent Brookbush demonstrating a single leg squat to pulldown" src="https://www.datocms-assets.com/25800/1649275037-sl-squat.png" alt="Single-Leg Squat to Bilateral Cable Pull Down">
Single-Leg Squat to <a id="bilateral" data-tip="1552" target="_blank" href="/glossary-term/bilateral" class="glossary">Bilateral</a> Cable Pull Down

Kinesiology

Research Corner

The concept of a <a href="https://brookbushinstitute.com/courses/posterior-oblique-subsystem-pos" target="_blank" rel="noopener">posterior oblique subsystem (POS)</a> is developed from studies that have demonstrated that force may be transmitted between the <a href="https://brookbushinstitute.com/courses/latissimus-dorsi" target="_blank" rel="noopener">latissimus dorsi</a> and <a href="https://brookbushinstitute.com/courses/gluteus-maximus" target="_blank" rel="noopener">gluteus maximus</a> via the thoracolumbar fascia (TLF), and further that these muscles act synergistically during functional tasks, including stabilization of the sacroiliac joint (SIJ) (1-23). Kim et al. and Shin et al. demonstrated <a id="contralateral" data-tip="1549" target="_blank" href="/glossary-term/contralateral" class="glossary">contralateral</a> <a id="muscle-cell" data-tip="1781" target="_blank" href="/glossary-term/muscle-cell" class="glossary">muscle</a> activity of the <a href="https://brookbushinstitute.com/courses/latissimus-dorsi" target="_blank" rel="noopener">latissimus dorsi</a> and <a href="https://brookbushinstitute.com/courses/gluteus-maximus" target="_blank" rel="noopener">gluteus maximus</a> during gait, which increased with speed or weights held in the hands (20, 21). Stevens et al. and Kim et al. demonstrated the co-contraction of various muscles investing in the TLF during a &quot;quadruped&quot; exercise, including muscles of the <a href="https://brookbushinstitute.com/courses/posterior-oblique-subsystem-pos" target="_blank" rel="noopener">POS</a> (22, 23). Further, Shin et al. demonstrated activation of the <a href="https://brookbushinstitute.com/courses/posterior-oblique-subsystem-pos" target="_blank" rel="noopener">POS</a> and <a href="https://brookbushinstitute.com/courses/deep-longitudinal-subsystem" target="_blank" rel="noopener">Deep Longitudinal Subsystems (DLS)</a> during <a href="https://brookbushinstitute.com/courses/bridge-progression" target="_blank" rel="noopener">bridge progressions</a>, including increased reliance on the <a href="https://brookbushinstitute.com/courses/deep-longitudinal-subsystem" target="_blank" rel="noopener">DLS</a> in those with low back pain. Several studies have demonstrated that the <a href="https://brookbushinstitute.com/courses/posterior-oblique-subsystem-pos" target="_blank" rel="noopener">POS</a> is not recruited alone, and must work in conjunction with the <a href="https://brookbushinstitute.com/courses/intrinsic-stabilization-subsystem" target="_blank" rel="noopener">Intrinsic Stabilization Subsystem (ISS)</a> and <a href="https://brookbushinstitute.com/courses/deep-longitudinal-subsystem" target="_blank" rel="noopener">Deep Longitudinal Subsystems (DLS)</a> (19 - 23). In summary, there is evidence to suggest that the muscles of the <a href="https://brookbushinstitute.com/courses/posterior-oblique-subsystem-pos" target="_blank" rel="noopener">POS</a> work synergistically during gait and core exercise, and work in conjunction with the <a href="https://brookbushinstitute.com/courses/intrinsic-stabilization-subsystem" target="_blank" rel="noopener">ISS</a> and <a href="https://brookbushinstitute.com/courses/deep-longitudinal-subsystem" target="_blank" rel="noopener">DLS</a>.
The legs with pull <a id="exercise-progression" data-tip="1184" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progression</a> may be an ideal exercise selection for reinforcing the coordinated recruitment of <a href="https://brookbushinstitute.com/courses/posterior-oblique-subsystem-pos" target="_blank" rel="noopener">POS</a> muscles. This <a id="exercise-progression" data-tip="1184" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progression</a> relies on the <a href="https://brookbushinstitute.com/courses/latissimus-dorsi" target="_blank" rel="noopener">latissimus dorsi</a> and <a href="https://brookbushinstitute.com/courses/gluteus-maximus" target="_blank" rel="noopener">gluteus maximus</a> as <a id="prime-mover" data-tip="1663" target="_blank" href="/glossary-term/prime-mover" class="glossary">prime movers</a>. One implication that may be gleaned from the research mentioned above is that large muscles are recruited less during low-intensity tasks (19 - 23), suggesting that the significant loads possible during this <a id="exercise-progression" data-tip="1184" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progression</a> may be necessary to <a id="optimal" data-tip="1573" target="_blank" href="/glossary-term/optimal" class="glossary">optimally</a> recruit the large muscles of the <a href="https://brookbushinstitute.com/courses/posterior-oblique-subsystem-pos" target="_blank" rel="noopener">POS</a>. Based on studies demonstrating a relative decrease in <a href="https://brookbushinstitute.com/courses/gluteus-maximus" target="_blank" rel="noopener">gluteus maximus</a> activity (24 - 31) and an increase in <a href="https://brookbushinstitute.com/courses/deep-longitudinal-subsystem" target="_blank" rel="noopener">DLS</a> activity in those exhibiting dysfunction (23), it may be hypothesized that reinforcing recruitment of the <a href="https://brookbushinstitute.com/courses/posterior-oblique-subsystem-pos" target="_blank" rel="noopener">POS</a> may be beneficial for optimizing motion. Last, if the patterns observed during gait and core activity also apply to sprinting, jumping, and other functional/sporting tasks, there may be benefits for increasing the endurance, strength, and <a id="power" data-tip="1399" target="_blank" href="/glossary-term/power" class="glossary">power</a> of this synergy with the intent of enhancing performance. Based on these findings, and observations in practice, it seems likely that the legs with pull <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> would effectively load the <a href="https://brookbushinstitute.com/courses/posterior-oblique-subsystem-pos" target="_blank" rel="noopener">POS</a> for benefits in rehabilitation and performance. Further research is needed.
<img alt="The Posterior Oblique Subsystem" title="Illustration of the Posterior Oblique Subsystem with Muscles Labeled" src="https://www.datocms-assets.com/25800/1649099506-posterior-oblique-subsystem.png">

The concept of an <a href="https://brookbushinstitute.com/courses/anterior-oblique-subsystem-aos" target="_blank" rel="noopener">anterior oblique subsystem (AOS)</a> is developed from studies that have demonstrated that force may be transmitted between muscles of the abdominal wall and abdominal fascia, and some evidence of continuity with the <a href="https://brookbushinstitute.com/courses/adductors" target="_blank" rel="noopener">adductors</a>. The rectus sheath envelopes the <a href="https://brookbushinstitute.com/courses/rectus-abdominis-pyramidalis" target="_blank" rel="noopener">rectus abdominis</a> <a href="https://brookbushinstitute.com/glossary/anterior/" target="_blank" rel="noopener">anteriorly</a> and <a href="https://brookbushinstitute.com/glossary/posterior/" target="_blank" rel="noopener">posteriorly</a>. From costal cartilage to the arcuate line (the level of the umbilicus), the <a href="https://brookbushinstitute.com/glossary/anterior/" target="_blank" rel="noopener">anterior</a> sheath is comprised of a continuation of the <a href="https://brookbushinstitute.com/courses/external-obliques" target="_blank" rel="noopener">external oblique</a> fascia while the <a href="https://brookbushinstitute.com/glossary/posterior/" target="_blank" rel="noopener">posterior</a> sheath is comprised of a continuation of the <a href="https://brookbushinstitute.com/courses/internal-obliques" target="_blank" rel="noopener">internal oblique</a> and transverse abdominis fascia (32). The fascial layers of the abdomen converge at the linea alba, where they continue into identical fascial sheaths on the opposite side. The linea alba, running vertically between the two <a href="https://brookbushinstitute.com/courses/rectus-abdominis-pyramidalis" target="_blank" rel="noopener">rectus abdominis</a> muscles, is a thickening created by the union of the transverse fibers (including the transverse inscriptions) of the fascial sheaths from either side (33, 34). In addition, fascia from the sternal fibers of the <a href="https://brookbushinstitute.com/courses/pectoralis-major" target="_blank" rel="noopener">pectoralis major</a> and the fascia of the <a href="https://brookbushinstitute.com/courses/serratus-anterior" target="_blank" rel="noopener">serratus anterior</a> invests in the fascia of the <a href="https://brookbushinstitute.com/courses/external-obliques" target="_blank" rel="noopener">external obliques</a> (and sometimes <a href="https://brookbushinstitute.com/courses/rectus-abdominis-pyramidalis" target="_blank" rel="noopener">rectus abdominis</a>) (32 - 38, 43). Relative to function, any significant <a href="https://brookbushinstitute.com/glossary/lateral/" target="_blank" rel="noopener">lateral</a>, <a href="https://brookbushinstitute.com/glossary/posterior/" target="_blank" rel="noopener">posterior</a>, or rotational force imparted on the trunk will result in an increase in <a href="https://brookbushinstitute.com/courses/rectus-abdominis-pyramidalis" target="_blank" rel="noopener">rectus abdominis</a>, <a href="https://brookbushinstitute.com/courses/rectus-abdominis-pyramidalis" target="_blank" rel="noopener">pyramidalis</a>, <a href="https://brookbushinstitute.com/courses/external-obliques" target="_blank" rel="noopener">external obliques</a>, <a href="https://brookbushinstitute.com/courses/internal-obliques" target="_blank" rel="noopener">internal obliques</a>, and transverse abdominis activity (33), may increase quadratus lumborum and psoas activity (38 - 40), and will be transmitted between all layers of the abdominal fascial network (41, 42).
One study by Snijders et al. suggests a relationship between the abdominal musculature and the lower extremity, demonstrating that crossing the legs decreased the activity of the <a href="https://brookbushinstitute.com/courses/internal-obliques" target="_blank" rel="noopener">internal obliques</a> (44). When this finding is considered relative to the fascial continuity between the <a href="https://brookbushinstitute.com/courses/muscular-anatomy" target="_blank" rel="noopener">rectus abdominis</a> tendons and tendons of the <a href="https://brookbushinstitute.com/courses/adductors" target="_blank" rel="noopener">adductors</a>, the possibility of a synergistic fascial relationship seems likely. The inclusion of the <a href="https://brookbushinstitute.com/courses/adductors" target="_blank" rel="noopener">adductors</a> in this fascial synergy suggests the lower extremity should be engaged in movements with the intent of targeting the <a href="https://brookbushinstitute.com/courses/anterior-oblique-subsystem-aos" target="_blank" rel="noopener">AOS</a>.
An interesting study by Hirashima et al. demonstrated that overhead throwing followed a <a id="proximal" data-tip="1564" target="_blank" href="/glossary-term/proximal" class="glossary">proximal</a> to <a id="distal" data-tip="1563" target="_blank" href="/glossary-term/distal" class="glossary">distal</a> recruitment pattern that started with <a id="contralateral" data-tip="1549" target="_blank" href="/glossary-term/contralateral" class="glossary">contralateral</a> than <a id="ipsilateral" data-tip="1550" target="_blank" href="/glossary-term/ipsilateral" class="glossary">ipsilateral</a> <a href="https://brookbushinstitute.com/courses/external-obliques" target="_blank" rel="noopener">external obliques</a>, then <a href="https://brookbushinstitute.com/courses/serratus-anterior" target="_blank" rel="noopener">serratus anterior</a>, then <a href="https://brookbushinstitute.com/courses/pectoralis-major" target="_blank" rel="noopener">pectoralis major</a> followed by elbow extensors (45); note, additional stabilizers were also recruited during this motion. The sequence of recruitment in this study may be the best research available implicating a synergy of muscles, described here as the <a href="https://brookbushinstitute.com/courses/anterior-oblique-subsystem-aos" target="_blank" rel="noopener">AOS</a>. Additional movement patterns that preferentially recruit the <a href="https://brookbushinstitute.com/courses/anterior-oblique-subsystem-aos" target="_blank" rel="noopener">AOS</a> may be deduced from the actions of the muscles that invest in the abdominal fascia (listed above). These muscles are not only adapted for throwing, but for activities like pushing open a door, pushing a defender out of position, resisting a force trying to push back, or simply &quot;pushing up&quot; off the floor. The push with legs <a id="exercise-progression" data-tip="1184" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progression</a> is recommended with the intent of increasing the endurance, strength, and <a id="power" data-tip="1399" target="_blank" href="/glossary-term/power" class="glossary">power</a> of the <a href="https://brookbushinstitute.com/courses/anterior-oblique-subsystem-aos" target="_blank" rel="noopener">AOS</a>. Note, most of the <a id="exercise-progression" data-tip="1184" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progression</a> combines pushing with &quot;triple extension&quot; of the lower extremity, which may have benefits for integrating the <a href="https://brookbushinstitute.com/courses/anterior-oblique-subsystem-aos" target="_blank" rel="noopener">AOS</a> and <a href="https://brookbushinstitute.com/courses/posterior-oblique-subsystem-pos" target="_blank" rel="noopener">POS</a>.
<img alt="Attachment of the adductors and obliques" title="Anterior Oblique Subsystem (Attachment of the Adductors and Obliques)" src="https://www.datocms-assets.com/25800/1649099601-aos.jpg">

Studies by Uribe et al. (46), Lehman et al. (47) and Kohler et al. (48) compared dumbbell overhead press on stable and <a id="stability" data-tip="1194" target="_blank" href="/glossary-term/stability" class="glossary">unstable</a> surfaces, demonstrating increased activity of muscles of the <a href="https://brookbushinstitute.com/courses/anterior-oblique-subsystem-aos" target="_blank" rel="noopener">AOS</a>, <a href="https://brookbushinstitute.com/courses/posterior-oblique-subsystem-pos" target="_blank" rel="noopener">POS</a>, and <a href="https://brookbushinstitute.com/courses/deep-longitudinal-subsystem" target="_blank" rel="noopener">deep longitudinal subsystem (DLS)</a>. The coordinated recruitment of these subsystems during these movements may be expected due to the large moment arms and <a id="torque" data-tip="1294" target="_blank" href="/glossary-term/torque" class="glossary">torque</a> created by shoulder exercise and overhead pressing motions. <a href="https://brookbushinstitute.com/video/single-leg-deadlift-touchdown" target="_blank" rel="noopener">Single-leg deadlifts</a> result in more <a href="https://brookbushinstitute.com/courses/deep-longitudinal-subsystem" target="_blank" rel="noopener">DLS</a> activity when compared to <a href="https://brookbushinstitute.com/video/back-squat" target="_blank" rel="noopener">squats</a>, step-ups, or lunges (49 - 52), but similar glute (<a href="https://brookbushinstitute.com/courses/posterior-oblique-subsystem-pos" target="_blank" rel="noopener">POS</a>) activity, implying coordinated recruitment of the <a href="https://brookbushinstitute.com/courses/deep-longitudinal-subsystem" target="_blank" rel="noopener">DLS</a> and <a href="https://brookbushinstitute.com/courses/posterior-oblique-subsystem-pos" target="_blank" rel="noopener">POS</a>. These studies may imply that the use of this <a id="exercise-progression" data-tip="1184" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progression</a> is beneficial to challenge the coordinated recruitment of all subsystems. As mentioned earlier, the <a href="https://brookbushinstitute.com/courses/deep-longitudinal-subsystem" target="_blank" rel="noopener">DLS</a> has a propensity to become <a id="synergistic-dominance" data-tip="1649" target="_blank" href="/glossary-term/synergistic-dominance" class="glossary">synergistically dominant</a> for an under-active <a href="https://brookbushinstitute.com/courses/posterior-oblique-subsystem-pos" target="_blank" rel="noopener">POS</a>, it might be suggested that this <a id="exercise-progression" data-tip="1184" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progression</a> be considered more advanced, and/or more appropriate for individuals who have demonstrated high-quality movement.
<a href="https://brookbush.s3.us-east-2.amazonaws.com/wordpress/wp-content/uploads/2017/10/lateral-lunge-with-front-rack-re.jpg" target="_blank" rel="noopener"><img src="https://brookbush.s3.us-east-2.amazonaws.com/wordpress/wp-content/uploads/2017/10/lateral-lunge-with-front-rack-re.jpg" alt="A lateral lunge with weights in front rack position" title="Dr. Brent Brookbush demonstrating a lateral lunge with front rack position"></a>

The <a id="integration" data-tip="1473" target="_blank" href="/glossary-term/integration" class="glossary">integrated</a> exercise pressing <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> discussed below are built upon several &quot;general progressions&quot; that can be applied to any exercise. In this course, these <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> were applied to the movement pattern in conjunction with the <a id="relative-flexibility" data-tip="1654" target="_blank" href="/glossary-term/relative-flexibility" class="glossary">relative flexibility</a> <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> and then edited based on feasibility and effectiveness.
<table>
 <tbody>
 <tr>
 <td>Unstable Load</td>
 <td>Unstable Surface</td>
 <td>Lower Extremity Stability:</td>
 </tr>
 <tr>
 <td>
 <ol>
 <li>Dumbbell/Kettlebell</li>
 <li>Cable/Band</li>
 <li>Earthquake Bar with weights suspended</li>
 </ol>
 </td>
 <td>
 <ul>
 <li>Airex Pad</li>
 <li>Half-Foam Roll</li>
 <li>Uni-planer <a id="balance" data-tip="1190" target="_blank" href="/glossary-term/balance" class="glossary">Balance</a> Board</li>
 <li>PB Disk</li>
 <li>Bosu Flat Side Up</li>
 <li>Etc.</li>
 </ul>
 </td>
 <td>
 <ul>
 <li>Squat</li>
 <li>Step-up</li>
 <li>Lunge</li>
 <li>Single-leg deadlift</li>
 </ul>
 </td>
 </tr>
 <tr>
 <td>Upper Extremity Stability:</td>
 <td colspan="2">Relative Flexibility Integrated Exercise Progressions:</td>
 </tr>
 <tr>
 <td>
 <ol>
 <li>Bilateral</li>
 <li>Alternating</li>
 <li>Unilateral</li>
 </ol>
 </td>
 <td colspan="2">
 <ol>
 <li>Legs with Back/Pulling</li>
 <li>Legs with Shoulders/Overhead Press</li>
 <li>Deadlift with Shoulders/Overhead Press</li>
 <li>Legs with Chest/Pushing</li>
 </ol>
 </td>
 </tr>
 </tbody>
</table>
<h4>Form Cues:</h4>
<ol>
 <li><a id="posture" data-tip="1658" target="_blank" href="/glossary-term/posture" class="glossary">Posture</a>
 <ul>
 <li>Feet parallel (2nd toe pointing forward)</li>
 <li>Feet, knees, and hips in alignment</li>
 <li>Pelvis neutral (no <a id="anterior" data-tip="1566" target="_blank" href="/glossary-term/anterior" class="glossary">anterior</a> pelvic tilt)</li>
 <li>Neural Spine (<a id="drawing-in" data-tip="1580" target="_blank" href="/glossary-term/drawing-in" class="glossary">drawing-in</a> maneuver or bracing if necessary)</li>
 <li>Neutral cervical spine (Chin-tucked &amp; head back)</li>
 </ul>
 </li>
</ol>
<h4>Key points:</h4>
<ul>
 <li>It is recommended that the courses on individual exercise <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> are reviewed before adding <a id="integration" data-tip="1473" target="_blank" href="/glossary-term/integration" class="glossary">integrated</a> exercises to a client/patient&apos;s routine.</li>
 <li>It is recommended that individual exercise <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> are practiced by the client/patient before <a id="integration" data-tip="1473" target="_blank" href="/glossary-term/integration" class="glossary">integrated</a> exercises are added to a client/patient&apos;s program.</li>
 <li>The <a id="posture" data-tip="1660" target="_blank" href="/glossary-term/posture" class="glossary">form</a> should not be sacrificed for the sake of complexity. Pay careful attention to how these exercise <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> are performed, especially the alignment of the lumbopelvic hip complex.</li>
</ul>

Stability Progressions and Form

The <a id="integration" data-tip="1473" target="_blank" href="/glossary-term/integration" class="glossary">integrated</a> exercise pressing <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> discussed below are built upon several &quot;general progressions&quot; that can be applied to any exercise. In this course, these <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> were applied to the movement pattern in conjunction with the <a id="relative-flexibility" data-tip="1654" target="_blank" href="/glossary-term/relative-flexibility" class="glossary">relative flexibility</a> <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> and then edited based on feasibility and effectiveness.
<table>
 <tbody>
 <tr>
 <td>Unstable Load</td>
 <td>Unstable Surface</td>
 <td>Lower Extremity Stability:</td>
 </tr>
 <tr>
 <td>
 <ol>
 <li>Dumbbell/Kettlebell</li>
 <li>Cable/Band</li>
 <li>Earthquake Bar with weights suspended</li>
 </ol>
 </td>
 <td>
 <ul>
 <li>Airex Pad</li>
 <li>Half-Foam Roll</li>
 <li>Uni-planer <a id="balance" data-tip="1190" target="_blank" href="/glossary-term/balance" class="glossary">Balance</a> Board</li>
 <li>PB Disk</li>
 <li>Bosu Flat Side Up</li>
 <li>Etc.</li>
 </ul>
 </td>
 <td>
 <ul>
 <li>Squat</li>
 <li>Step-up</li>
 <li>Lunge</li>
 <li>Single-leg deadlift</li>
 </ul>
 </td>
 </tr>
 <tr>
 <td>Upper Extremity Stability:</td>
 <td colspan="2">Relative Flexibility Integrated Exercise Progressions:</td>
 </tr>
 <tr>
 <td>
 <ol>
 <li>Bilateral</li>
 <li>Alternating</li>
 <li>Unilateral</li>
 </ol>
 </td>
 <td colspan="2">
 <ol>
 <li>Legs with Back/Pulling</li>
 <li>Legs with Shoulders/Overhead Press</li>
 <li>Deadlift with Shoulders/Overhead Press</li>
 <li>Legs with Chest/Pushing</li>
 </ol>
 </td>
 </tr>
 </tbody>
</table>
<h4>Key points:</h4>
<ul>
 <li>It is recommended that the courses on individual exercise <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> are reviewed before adding <a id="integration" data-tip="1473" target="_blank" href="/glossary-term/integration" class="glossary">integrated</a> exercises to a client/patient&apos;s routine.</li>
 <li>It is recommended that individual exercise <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> are practiced by the client/patient before <a id="integration" data-tip="1473" target="_blank" href="/glossary-term/integration" class="glossary">integrated</a> exercises are added to a client/patient&apos;s program.</li>
 <li>The <a id="posture" data-tip="1660" target="_blank" href="/glossary-term/posture" class="glossary">form</a> should not be sacrificed for the sake of complexity. Pay careful attention to how these exercise <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> are performed, especially the alignment of the lumbopelvic hip complex.</li>
</ul>

Points on Form

Our recommendation for feet hip width and parallel is based on reinforcing form/posture that is absent of signs correlated with pain and injury, including feet flatten (pes planus), feet turn out, knees bow out (knee varus), and knees bow in (knee valgus). Further, our recommendations are likely to ensure the largest transfer to daily activity and sport; that is, you do not walk, run, or jump, with legs wide, and feet turned out. &#x201C;Feet parallel and hip width&#x201D; implies that the 2nd toe is pointing forward and underneath the <a id="anterior" data-tip="1566" target="_blank" href="/glossary-term/anterior" class="glossary">anterior</a> <a id="superior" data-tip="1570" target="_blank" href="/glossary-term/superior" class="glossary">superior</a> iliac spine (ASIS). The reasons for this are that the 2nd toe aligns with the center of the foot, and the ASIS is located <a id="superior" data-tip="1570" target="_blank" href="/glossary-term/superior" class="glossary">superior</a>, and nearly in alignment, with the center of rotation of the hip joints. The greater trochanter, which people often call &#x201C;their hips&#x201D;, is located at the end of the femoral neck, which is several centimeters <a id="lateral" data-tip="1567" target="_blank" href="/glossary-term/lateral" class="glossary">lateral</a> to the center of rotation of your hip joints. We understand that &#x201C;shoulder width&#x201D; may feel more comfortable and may be acceptable for some individuals. However, we also suggest that a lack of comfort with ideal alignment may be a sign of less-than-optimal <a id="mobility" data-tip="1455" target="_blank" href="/glossary-term/mobility" class="glossary">mobility</a> or recruitment, and a corrective exercise/movement prep warm-up should be recommended. Powerlifters may adopt a foot position that allows them to move the most weight, but this should be viewed as &#x201C;practicing for a sport.&#x201D; Just as depth jumps are recommended for basketball players looking to increase their vertical but are not recommended for every individual who exercises; a powerlifters squat technique may be essential for their sport, but not ideal for most athletes and/or the general public.

Foot Position

Ideally, squats would be performed while maintaining a tibia angle and a torso angle that are close to parallel. This body position will result in ample motion of the hip, knees, and ankles; resulting in less stress on any one joint, and maximal recruitment of the lower extremity muscles. However, this assertion does have two important implications. First, it implies that a &#x201C;forward lean&#x201D; of the torso is necessary. It is impossible to squat with a completely vertical torso (without assistance from a machine). The result would be the body&#x2019;s <a id="center-of-mass-gravity" data-tip="1186" target="_blank" href="/glossary-term/center-of-mass-gravity" class="glossary">center of mass</a> (near the core) traveling behind the <a id="base-of-support" data-tip="1195" target="_blank" href="/glossary-term/base-of-support" class="glossary">base of support</a> (feet) and falling over backward. There is also some research to demonstrate that a &#x201C;forward lean&#x201D; of the torso increases gluteus maximus recruitment. Second, the knees must pass the toes as an individual descends into a half-squat or deeper. No research suggests that the knees passing the toes increases the risk of knee pain or injury. However, the knees passing the toes will require more dorsiflexion, and increasing dorsiflexion allows for more recruitment of the calf complex. Further, more dorsiflexion aids in shifting the body&#x2019;s <a id="center-of-mass-gravity" data-tip="1186" target="_blank" href="/glossary-term/center-of-mass-gravity" class="glossary">center of mass</a> anteriorly, making it easier to maintain any external load in a more biomechanically advantageous position.

Knees Over Toes (Tibia and Torso Parallel)

Cues should be developed based on a movement professional&#x2019;s desire to optimize form/posture, and any cue should be communicated to the client or patient, based on their needs, in a way that makes sense to them. Although cues like &#x201C;head up&#x201D;, &#x201C;shoulders back&#x201D;, and &#x201C;chest up&#x201D; may be appropriate for someone exhibiting signs of upper extremity dysfunction, they should not be cued to the extremes of these positions, nor should they be recommended to someone who does not exhibit signs of upper body dysfunction. Although BI professionals use these examples of cues when appropriate, we have also seen them result in some dogmatic thinking. For example, &#x201C;chest up&#x201D; is an appropriate cue, until &#x201C;chest up&#x201D; results in excessive thoracic or lumbar extension, and &#x201C;shoulder blades down and back&#x201D; is a good cue until <a id="optimal" data-tip="1571" target="_blank" href="/glossary-term/optimal" class="glossary">optimal</a> scapula <a id="posterior" data-tip="1565" target="_blank" href="/glossary-term/posterior" class="glossary">posterior</a> tipping is exceeded to result in excessive retraction. And, &#x201C;head up&#x201D; is a great cue until &#x201C;head up&#x201D; results in excessive cervical extension rather than the cervical spine maintaining neutral alignment with the torso, and the eyes naturally following a path from straight ahead during standing, to the bottom of a mirror or the floor 1-2 meters in front of the individual at the bottom of the squat. In short, it is our recommendation, that cuing is appropriately modified for the client, and is used to find neutral (<a id="optimal" data-tip="1571" target="_blank" href="/glossary-term/optimal" class="glossary">optimal</a>) alignment, not extreme positions. This recommendation may be especially appropriate regarding the alignment of the torso, scapula, cervical spine, and head.

Head, Torso, and Scapula Neutral

Target Leg: The length of the client&#x2019;s or patient&#x2019;s stride can be determined by the <a id="posture" data-tip="1660" target="_blank" href="/glossary-term/posture" class="glossary">form</a> achieved during the bottom position of the lunge. In the bottom position, the alignment of the target leg and torso should be similar to the ideal alignment achieved during the bottom position of a squat. That is, from a <a id="lateral" data-tip="1567" target="_blank" href="/glossary-term/lateral" class="glossary">lateral</a> view of the target leg side, the bottom position of a lunge should look like the bottom position of a squat (with the other leg acting as a <a id="base-of-support" data-tip="1197" target="_blank" href="/glossary-term/base-of-support" class="glossary">support</a>). This is true regardless of whether the lunge is performed in the sagittal, frontal, or transverse planes, regardless of the type or position of load, and regardless of whether the lunge is incorporated into a total body exercise (<a id="integration" data-tip="1473" target="_blank" href="/glossary-term/integration" class="glossary">integrated</a> exercise).
<ul>
 <li>Ideal Target Leg (e.g. squat) Alignment:
 <ul>
 <li>2nd toe pointing forward and under the ASIS</li>
 <li>Ankles, knees, and hips in alignment</li>
 <li>Pelvis neutral (absence of <a id="anterior" data-tip="1566" target="_blank" href="/glossary-term/anterior" class="glossary">anterior</a> or <a id="posterior" data-tip="1565" target="_blank" href="/glossary-term/posterior" class="glossary">posterior</a> pelvic tilt)</li>
 <li>Tibia and Torso Neutral</li>
 <li>Torso, scapula, and head in neutral alignment</li>
 </ul>
 </li>
</ul>
Non-target Leg: The femur of the non-target leg should be near vertical in the bottom position of a sagittal plane or transverse plane lunge. During a frontal plane lunge the foot of the non-target leg should be parallel and nearly in frontal plane alignment with the foot of the target leg, the knee should maintain near terminal extension, and it is often important to cue the client or patient to &#x201C;sit back&#x201D; to ensure the hips translate posteriorly as seen during <a id="optimal" data-tip="1571" target="_blank" href="/glossary-term/optimal" class="glossary">optimal</a> squat mechanics. It may be helpful to think of a frontal plane lunge as a squat with the non-target leg straight and out to the side.
&#xA0;
<ul>
 <li>No Vertical Torso: A common mistake during a lunge is maintaining a vertical torso. This reduces contribution from the gluteus maximus and increases the load on the knee of the non-target leg.</li>
</ul>

Stride Length During a Lunge

Holding a load in a front rack position can be a great <a id="exercise-progression" data-tip="1184" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progression</a> for squat, step-up, and lunge variations. By holding the weight in front of the body, the load creates larger moment arms relative to the core and lower extremities, resulting in more resistance to stabilize and overcome. Further, practicing the Front Rack Position can be used to increase upper extremity <a id="stability" data-tip="1191" target="_blank" href="/glossary-term/stability" class="glossary">stability</a> and isometric strength.
<h4>Front Rack Instructions:</h4>
<ul>
 <li>Firmly Grip the Resistance: Firmly grip the weights/load in the hands (dumbbells, kettlebells, sandbags, slosh pipes, etc.).</li>
 <li>Stabilize the Scapula: Protract and depress the scapula.</li>
 <li>Cradle the Weight: Attempt to maintain the forearms near vertical by cueing elbows high and shoulder width (the load should be &#x201C;carried&#x201D; by the arms; not &#x201C;curled&#x201D;),</li>
 <li>Support the Weight: Cue enough elbow flexion to ensure some of the load is supported by the upper arm and/or <a id="anterior" data-tip="1566" target="_blank" href="/glossary-term/anterior" class="glossary">anterior</a> shoulder.</li>
 <li>Barbells are Not Recommended (unless required by the sport). Front rack position with a barbell tends to promote <a id="hypermobility" data-tip="1677" target="_blank" href="/glossary-term/hypermobility" class="glossary">hypermobility</a> in the hands, wrists, and elbows and may increase the risk of pain and dysfunction.</li>
</ul>

Front Rack Position

Squat Form and Modifications

Videos and Progressions

<ol>
 <li>Squat to <a id="bilateral" data-tip="1552" target="_blank" href="/glossary-term/bilateral" class="glossary">bilateral</a> row</li>
 <li>Squat to <a id="unilateral" data-tip="1551" target="_blank" href="/glossary-term/unilateral" class="glossary">unilateral</a> row</li>
 <li>Step-up to <a id="bilateral" data-tip="1552" target="_blank" href="/glossary-term/bilateral" class="glossary">bilateral</a> row</li>
 <li>Step-up to <a id="unilateral" data-tip="1551" target="_blank" href="/glossary-term/unilateral" class="glossary">unilateral</a> row</li>
 <li>Static sagittal plane lunge to <a id="bilateral" data-tip="1552" target="_blank" href="/glossary-term/bilateral" class="glossary">bilateral</a> row
 <ul>
 <li>Unilateral row</li>
 <li>Bilateral row, front foot unstable</li>
 <li>Unilateral row, front foot unstable</li>
 </ul>
 </li>
 <li>Dynamic sagittal plane lunge to <a id="bilateral" data-tip="1552" target="_blank" href="/glossary-term/bilateral" class="glossary">bilateral</a> row
 <ul>
 <li>Unilateral row</li>
 <li>Bilateral row, to balance</li>
 <li>Unilateral row, to balance</li>
 <li>Bilateral row, to <a id="balance" data-tip="1190" target="_blank" href="/glossary-term/balance" class="glossary">balance</a>, front foot unstable</li>
 <li>Unilateral row, to <a id="balance" data-tip="1190" target="_blank" href="/glossary-term/balance" class="glossary">balance</a>, front foot unstable</li>
 </ul>
 </li>
 <li>Single leg squat to <a id="bilateral" data-tip="1552" target="_blank" href="/glossary-term/bilateral" class="glossary">bilateral</a> cable pull down</li>
</ol>

Legs with Pull  Videos and Progressions

Squat to Row

Step-up to Row

Static Lunge to Row

Reverse Lunge to Row

Single-Leg Squat to Bilateral Cable Pull Down

<h3>Squats and Shoulders</h3>
<ol>
 <li>Ball wall squats to curl</li>
 <li>Ball wall squats to scaption</li>
 <li>Ball wall squats to curl and press</li>
 <li>Squats to curl</li>
 <li>Squat to scaption</li>
 <li>Squats to curl and press</li>
 <li>Front squat to press</li>
 <li><a id="unilateral" data-tip="1551" target="_blank" href="/glossary-term/unilateral" class="glossary">Unilateral</a> front squat to press</li>
</ol>

Legs with Shoulders/Overhead Press Videos and Progressions

Front squat to press

<ol>
 <li>Step-up to curl
 <ul>
 <li>to scaption</li>
 <li>to curl and press</li>
 <li>to <a id="unilateral" data-tip="1551" target="_blank" href="/glossary-term/unilateral" class="glossary">unilateral</a> scaption</li>
 <li>to <a id="unilateral" data-tip="1551" target="_blank" href="/glossary-term/unilateral" class="glossary">unilateral</a> curl and press</li>
 <li>All <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> may be repeated with the following progressions:
 <ul>
 <li>to <a id="balance" data-tip="1190" target="_blank" href="/glossary-term/balance" class="glossary">balance</a> (step up, but only planted foot touches step)</li>
 <li>frontal plane
 <ul>
 <li>to balance</li>
 </ul>
 </li>
 <li>transverse plane
 <ul>
 <li>transverse plane to balance</li>
 </ul>
 </li>
 </ul>
 </li>
 </ul>
 </li>
 <li>Static sagittal plane lunge
 <ul>
 <li>to scaption</li>
 <li>to curl and press</li>
 <li>to <a id="unilateral" data-tip="1551" target="_blank" href="/glossary-term/unilateral" class="glossary">unilateral</a> scaption</li>
 <li>to <a id="unilateral" data-tip="1551" target="_blank" href="/glossary-term/unilateral" class="glossary">unilateral</a> curl and press</li>
 <li>front rack position to press</li>
 <li>unilateral front rack to press</li>
 </ul>
 </li>
 <li>Static frontal plane lunge
 <ul>
 <li>to scaption</li>
 <li>to curl and press</li>
 <li>to <a id="unilateral" data-tip="1551" target="_blank" href="/glossary-term/unilateral" class="glossary">unilateral</a> scaption</li>
 <li>to <a id="unilateral" data-tip="1551" target="_blank" href="/glossary-term/unilateral" class="glossary">unilateral</a> curl and press</li>
 <li>front rack position to press</li>
 <li>unilateral front rack to press</li>
 </ul>
 </li>
 <li>Dynamic sagittal plane lunge
 <ul>
 <li>to scaption</li>
 <li>to curl and press</li>
 <li>to <a id="unilateral" data-tip="1551" target="_blank" href="/glossary-term/unilateral" class="glossary">unilateral</a> scaption</li>
 <li>to <a id="unilateral" data-tip="1551" target="_blank" href="/glossary-term/unilateral" class="glossary">unilateral</a> curl and press</li>
 <li>front rack position to press</li>
 <li>unilateral front rack to press</li>
 </ul>
 </li>
 <li>All <a id="exercise-progression" data-tip="1184" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progression</a> of the dynamic lunge to shoulders can be repeated with the following progressions:
 <ul>
 <li>to <a id="balance" data-tip="1190" target="_blank" href="/glossary-term/balance" class="glossary">balance</a> (back leg only touches the ground at the back position, <a id="balance" data-tip="1190" target="_blank" href="/glossary-term/balance" class="glossary">balance</a> on stance leg at the top).
 <ul>
 <li>to <a id="balance" data-tip="1190" target="_blank" href="/glossary-term/balance" class="glossary">balance</a>, front leg unstable</li>
 </ul>
 </li>
 <li>frontal plane
 <ul>
 <li>to <a id="balance" data-tip="1190" target="_blank" href="/glossary-term/balance" class="glossary">balance</a>
 <ul>
 <li>to <a id="balance" data-tip="1190" target="_blank" href="/glossary-term/balance" class="glossary">balance</a>, front leg unstable</li>
 </ul>
 </li>
 </ul>
 </li>
 <li>transverse plane
 <ul>
 <li>transverse plane to <a id="balance" data-tip="1190" target="_blank" href="/glossary-term/balance" class="glossary">balance</a>
 <ul>
 <li>to <a id="balance" data-tip="1190" target="_blank" href="/glossary-term/balance" class="glossary">balance</a>, front leg unstable</li>
 </ul>
 </li>
 </ul>
 </li>
 </ul>
 </li>
</ol>

Legs with Shoulders (Continued) 

Side Step & Frontal Plane Step Up with Shoulder Series

Dynamic Lateral Lunge with Shoulder Series

Front Rack Lateral Lunge and Progressions

<ol>
 <li>Single-Leg Touchdown to curl
 <ul>
 <li>to scaption</li>
 <li>to press</li>
 <li>to <a id="unilateral" data-tip="1551" target="_blank" href="/glossary-term/unilateral" class="glossary">unilateral</a> scaption</li>
 <li>to <a id="unilateral" data-tip="1551" target="_blank" href="/glossary-term/unilateral" class="glossary">unilateral</a> PNF Carry Away</li>
 <li>to <a id="unilateral" data-tip="1551" target="_blank" href="/glossary-term/unilateral" class="glossary">unilateral</a> curl and press
 <ul>
 <li>All <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a> can be performed
 <ul>
 <li>On <a id="stability" data-tip="1194" target="_blank" href="/glossary-term/stability" class="glossary">unstable</a> surface</li>
 <li>with <a id="anterior" data-tip="1566" target="_blank" href="/glossary-term/anterior" class="glossary">anterior</a> to <a id="posterior" data-tip="1565" target="_blank" href="/glossary-term/posterior" class="glossary">posterior</a> pull</li>
 <li>with <a id="anterior" data-tip="1566" target="_blank" href="/glossary-term/anterior" class="glossary">anterior</a> to <a id="posterior" data-tip="1565" target="_blank" href="/glossary-term/posterior" class="glossary">posterior</a> pull on an <a id="stability" data-tip="1194" target="_blank" href="/glossary-term/stability" class="glossary">unstable</a> surface</li>
 </ul>
 </li>
 </ul>
 </li>
 </ul>
 </li>
</ol>

Single Leg Touchdown with Shoulder Videos and Progressions

Single-Leg Touchdown with Scaption and PNF Carry Away

Single-leg Touchdown with Anterior to Posterior Pull

Note: <a href="https://brookbushinstitute.com/courses/axe-chop-progression" target="_blank" rel="noopener">Chop Patterns</a> are a great precursor to legs with chest press/push exercise <a id="exercise-progression" data-tip="1182" target="_blank" href="/glossary-term/exercise-progression" class="glossary">progressions</a>. It is suggested that <a href="https://brookbushinstitute.com/courses/axe-chop-progression" target="_blank" rel="noopener">Chop Patterns</a> are added to your core program a month or more before adding this <a id="exercise-progression" data-tip="1181" target="_blank" href="/glossary-term/exercise-progression" class="glossary">exercise progression</a> to your resistance training routine.
<ol>
 <li>Step-up to <a id="bilateral" data-tip="1552" target="_blank" href="/glossary-term/bilateral" class="glossary">bilateral</a> chest press
 <ul>
 <li>to balance</li>
 <li>to <a id="balance" data-tip="1190" target="_blank" href="/glossary-term/balance" class="glossary">balance</a> to <a id="unilateral" data-tip="1551" target="_blank" href="/glossary-term/unilateral" class="glossary">unilateral</a> chest press
 <ul>
 <li>Frontal plane</li>
 <li>Transerve plane</li>
 </ul>
 </li>
 </ul>
 </li>
 <li>Dynamic reverse lunge to <a id="bilateral" data-tip="1552" target="_blank" href="/glossary-term/bilateral" class="glossary">bilateral</a> chest press
 <ul>
 <li>to balance</li>
 <li>to <a id="balance" data-tip="1190" target="_blank" href="/glossary-term/balance" class="glossary">balance</a> to <a id="unilateral" data-tip="1551" target="_blank" href="/glossary-term/unilateral" class="glossary">unilateral</a> chest press
 <ul>
 <li>Transerve plane</li>
 </ul>
 </li>
 </ul>
 </li>
</ol>

Legs with Chest Press/Push Videos and Progressions

Step-up to Chest Press

Dynamic Lunge to Chest Press

<ol>
 <li>Andry Vleeming, Vert Mooney, Rob Stoeckart. Movement, Stability &amp; Lumbopelvic Pain: Integration of Research and Therapy. (c) 2007 Elsevier Limited</li>
 <li>Willard, F.H., Vleeming, A., Schuenke, M.D., Danneels, L., Schleip, R. The thoracolumbar fascia: anatomy, function and clinical considerations. Journal of Anatomy, 2012. 221, 507-536.</li>
 <li>Vleeming, A., Pool-Goudzwaard, A. L., Stoeckart, R., van Wingerden, J. P., &amp; Snijders, C. J. (1995). The Posterior Layer of the Thoracolumbar Fascia| Its Function in Load Transfer From Spine to Legs. Spine, 20(7), 753-758.</li>
 <li>Vleeming, A., van Wingerden, J.P., Buyruk, H.M., Raissadat, K. Stabilization of the sacroiliac joint in vivo: verification of muscular contribution to force closure of the pelvis. European Spine Journal, 2004. 13: 199-205</li>
 <li>Hodges, P. W., &amp; Richardson, C. A. (1997). Relationship between limb movement speed and associated contraction of the trunk muscles. Ergonomics, 40(11), 1220-1230.</li>
 <li>Hodges, P. W., &amp; Moseley, G. L. (2003). Pain and motor control of the lumbopelvic region: effect and possible mechanisms. Journal of Electromyography and Kinesiology, 13(4), 361-370.</li>
 <li>Gracovetsky, S. (1990). Musculoskeletal function of the spine. Multiple Muscle Systems: Biomechanics and Movement Organization, 410-437.</li>
 <li>Kumar, S., Narayan, Y., &amp; Zedka, M. (1996). An electromyographic study of unresisted trunk rotation with normal velocity among healthy subjects. Spine, 21(13), 1500-1512.</li>
 <li>Fairbanks, J. C. T., &amp; OBrien, J. P. (1980, May). The Abdominal Cavity and Thoracolumbar Fascia as Stabilizers of the Lumbar Spine in Patients with Low Back Pain. The Institute of Mechanical Engineers. In Conference on Engineering Aspects of the Spine. Westminster, London.</li>
 <li>Vleeming, A., Volkers, A. C. W., Snijders, C. J., &amp; Stoeckart, R. (1990). Relation Between Form and Function in the Sacroiliac Joint: Part I: Clinical Anatomical Aspects. Spine, 15(2), 133-136.</li>
 <li>Vleeming, A., Volkers, A. C. W., Snijders, C. J., &amp; Stoeckart, R. (1990). Relation Between Form and Function in the Sacroiliac Joint: Part II: Biomechanical Aspects. Spine, 15(2), 133-136.</li>
 <li>Crisco, J. J., Panjabi, M. M., Yamamoto, I., &amp; Oxland, T. R. (1992). Euler stability of the human ligamentous lumbar spine. Part II: Experiment. Clinical biomechanics, 7(1), 27-32.</li>
 <li>Gracovetsky, S., Farfan, H. F., &amp; Lamy, C. (1981). The mechanism of the lumbar spine. Spine, 6(3), 249-262.</li>
 <li>Gracovetsky, S., Farfan, H., &amp; Helleur, C. (1985). The abdominal mechanism. Spine, 10(4), 317-324.</li>
 <li>Macintosh, J. E., Bogduk, N., &amp; Gracovetsky, S. (1987). The biomechanics of the thoracolumbar fascia. Clinical biomechanics, 2(2), 78-83.</li>
 <li>McGill, S. M., &amp; Norman, R. W. (1988). Potential of lumbodorsal fascia forces to generate back extension moments during squat lifts. Journal of biomedical engineering, 10(4), 312-318.</li>
 <li>Barker, PJ., Hapuarachchi, K.S., Ross, J.A., Sambaiew, E., Ranger, T.A., and Briggs, C.A. (2013) Anatomy and biomechanics of gluteus maximus and the thoracolumbar fascia at the sacroiliac joint.</li>
 <li>Vleeming, A., Pool-Goudzwaard, A. L., Stoeckart, R., van Wingerden, J. P., &amp; Snijders, C. J. (1995). The Posterior Layer of the Thoracolumbar Fascia| Its Function in Load Transfer From Spine to Legs. Spine, 20(7), 753-758.</li>
 <li>Kim, T., Yoo, W., An, D., Oh, J., Shin, S. (2013). The effects of different gait speeds and lower arm weight on the activities of the latissimus dorsi, gluteus medius, and gluteus maximus. Journal of Physical Therapy Science 25:11 1483-1484</li>
 <li>Shin, S. J., Kim, T. Y., &amp; Yoo, W. G. (2013). Effects of various gait speeds on the latissimus dorsi and gluteus maximus muscles associated with the posterior oblique sling system. Journal of physical therapy science, 25(11), 1391-1392.</li>
 <li>Kim, J. W., Han, J. Y., Kang, M. H., Ha, S. M., &amp; Oh, J. S. (2013). Comparison of posterior oblique sling activity during hip extension in the prone position on the floor and on a round foam roll. Journal of physical therapy science, 25(8), 977-979.</li>
 <li>Stevens, V.K., Vleeming, A., Bouche, KG., Mahieu, N.N., Vanderstraeten, G.G., Danneels, L.A. Electromyograhpic activity of trunk and hip muscles during stabilization exercises in four-point kneeling in healthy volunteers. European Spine Journal, 2007. 16: 711-718.</li>
 <li>Kim, J. W., Kang, M. H., &amp; Oh, J. S. (2014). Patients with low back pain demonstrate increased activity of the posterior oblique sling muscle during prone hip extension. PM&amp;R, 6(5), 400-405.</li>
 <li>Franettovich, S. M., Honeywill, C. O. N. O. R., Wyndow, N., Crossley, K. M., &amp; Creaby, M. W. (2014). Neuromotor control of gluteal muscles in runners with achilles tendinopathy. Medicine and science in sports and exercise, 46(3), 594-599.</li>
 <li>Hungerford, B., Gilleard, W., Hodges, P. (2003) Evidence of altered lumbopelvic muscle recruitment in the presence of sacroiliac joint pain. Spine 28(14), 1593-1600</li>
 <li>Grimaldi, A., Richardson, C., Stanton, W., Durbridge, G., Donnelly, W., &amp; Hides, J. (2009). The association between degenerative hip joint pathology and size of the gluteus medius, gluteus minimus and piriformis muscles. Manual therapy, 14(6), 605-610.</li>
 <li>Cooper, N., Scavo, K., Strickland, K., Tipayamongkol, N., Nicholson, J., Bewyer, D., Sluka, K. Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls. J Euro Spine. 26 May 2015</li>
 <li>Padua, D. A., Bell, D. R., &amp; Clark, M. A. (2012). Neuromuscular characteristics of individuals displaying excessive medial knee displacement. Journal of athletic training, 47(5), 525.</li>
 <li>Mauntel, T., Begalle, R., Cram, T., Frank, B., Hirth, C., Blackburn, T., &amp; Padua, D. (2013). The effects of lower extremity muscle activation and passive range of motion on single leg squat performance. Journal Of Strength And Conditioning Research / National Strength &amp; Conditioning Association, 27(7), 1813-1823</li>
 <li>Tateuchi, H., Taniguchi, M., Mori, N., Ichihashi, N. Balance of hip and trunk muscle activity is associated with increased anterior pelvic tilt during prone hip extension (2013) Journal of Electromyography and Kinesiology 22 (3). 391-397</li>
 <li>Bell, D. R., Padua, D. A., &amp; Clark, M. A. (2008). Muscle strength and flexibility characteristics of people displaying excessive medial knee displacement. Archives of physical medicine and rehabilitation, 89(7), 1323-1328.
 <ul>
 <li>Legs with Pushing</li>
 </ul>
 </li>
 <li>Andry Vleeming, Vert Mooney, Rob Stoeckart. Movement, Stability &amp; Lumbopelvic Pain: Integration of Research and Therapy. (c) 2007 Elsevier Limited</li>
 <li>Donald A. Neumann, &ldquo;Kinesiology of the Musculoskeletal System: Foundations of Rehabilitation &ndash; 2nd Edition&rdquo; &copy; 2012 Mosby, Inc.</li>
 <li>Willard, F.H., Vleeming, A., Schuenke, M.D., Danneels, L., Schleip, R. The thoracolumbar fascia: anatomy, function and clinical considerations. Journal of Anatomy, 2012. 221, 507-536.</li>
 <li>David G. Simons, Janet Travell, Lois S. Simons, Travell &amp; Simmons&rsquo; Myofascial Pain and Dysfunction, The Trigger Point Manual, Volume 1. Upper Half of Body: Second Edition,&copy; 1999 Williams and Wilkens</li>
 <li>Sanchez ER, Sanchez R, Moliver C. (2014). Anatomic relationship of pectoralis major and minor muscles: a cadaveric study. Aesthet. Surg. J. 34(2): 258-263.</li>
 <li>Porterfield, J. A., &amp; Derosa, C. (1998). Mechanical low back pain: perspectives in functional anatomy.</li>
 <li>Juker, D., McGILL, S., Kropf, P., &amp; Steffen, T. (1998). Quantitative intramuscular myoelectric activity of lumbar portions of psoas and the abdominal wall during a wide variety of tasks. Medicine and science in sports and exercise, 30(2), 301-310.</li>
 <li>Andersson, E., Oddsson, L., Grundstr&ouml;m, H., &amp; Thorstensson, A. (1995). The role of the psoas and iliacus muscles for stability and movement of the lumbar spine, pelvis and hip. Scandinavian journal of medicine &amp; science in sports, 5(1), 10-16.</li>
 <li>McGill, S., Juker, D., &amp; Kropf, P. (1996). Quantitative intramuscular myoelectric activity of quadratus lumborum during a wide variety of tasks. Clinical Biomechanics, 11(3), 170-172.</li>
 <li>Brown, S. H., &amp; McGill, S. M. (2009). Transmission of muscularly generated force and stiffness between layers of the rat abdominal wall. Spine, 34(2), E70-E75.</li>
 <li>Folkow, B., Gelin, L. E., Lindell, S. E., Stenberg, K., &amp; Thor&eacute;n, O. (1962). Cardiovascular reactions during abdominal surgery. Annals of Surgery, 156(6), 905.</li>
 <li>Sanchez ER, Sanchez R, Moliver C. (2014). Anatomic relationship of pectoralis major and minor muscles: a cadaveric study. Aesthet. Surg. J. 34(2): 258-263.</li>
 <li>Snijders, C. J., Slagter, A. H., van Strik, R., Vleeming, A., Stoeckart, R., &amp; Stam, H. J. (1995). Why Leg Crossing?: The Influence of Common Postures on Abdominal Muscle Activity. Spine, 20(18), 1989-1993.</li>
 <li>Hirashima, M., Kadota, H., Sakurai, S., Kudo, K., &amp; Ohtsuki, T. (2002). Sequential muscle activity and its functional role in the upper extremity and trunk during overarm throwing. Journal of sports sciences, 20(4), 301-310.
 <ul>
 <li>Legs and Shoulders</li>
 </ul>
 </li>
 <li>Uribe, B. P., Coburn, J. W., Brown, L. E., Judelson, D. A., Khamoui, A. V. and Nguyen, D. (2010) Muscle activation when performing the chest press and shoulder press on a stable bench vs. a Swiss ball. The Journal of Strength and Conditioning Research, 24(4), 1028-1033</li>
 <li>Lehman, G. J., Gordon, T., Langley, J., Pemrose, P. and Tregaskis, S. (2005) Replacing a Swiss ball for an exercise bench causes variable changes in trunk muscle activity during limb strength exercises. Dynamic Medicine, 4(6), doi: 10.1186/1476-5918-4-6</li>
 <li>Kohler, J. M., Flanagan, S. P. and Whiting, W. C. (2010) Muscle activation patterns while lifting stable and unstable loads on stable and unstable surfaces. Journal of Strength and Conditioning Research, 24(2), 313-321.</li>
 <li>DiStefano, L. J., Blackburn, J. T., Marshall, S. W. and Padua, D. A. (2009) Gluteal muscle activation during common therapeutic exercises. Journal of Orthopaedic and Sports Physical Therapy, 39(7), 532-540</li>
 <li>Begalle, R. L., DiStefano, L. J., Blackburn, T. and Padua, D. A. (2012) Quadriceps and hamstrings coactivation during common therapeutic exercises. Journal of Athletic Training, 47(4), 396-405</li>
 <li>Schellenberg, F., Taylor, W. R., &amp; Lorenzetti, S. (2015). Exercise Specific Loading Conditions and Movements of Squats, Lunges, Goodmornings and Deadlifts. In ISBS-Conference Proceedings Archive.</li>
 <li>Ebben, W. P., Leigh, D. H., Long, N., Clewien, R., &amp; Davies, J. A. (2006). Electromyographical analysis of hamstring resistance training exercises. In ISBS-Conference Proceedings Archive.</li>
</ol>

Bibliography

© 2019 Brent Brookbush
Questions, comments, and criticisms are welcomed and encouraged

Copyright

A-Band - Refers to the part of the muscle cell that looks darker under a microscope.  This area of the cell is darker due to parallel arrangement of thicker filaments (myosin) and overlap with the thinner filaments (actin).
<ul>
 	<li>As a muscle contracts, the A-band is where actin and myosin interact.</li>
</ul>
<ol>
 	<li>Saladin, K. (2014). Anatomy &amp; physiology: The unity of form and function. McGraw-Hill Higher Education, New York. ISBN: 9780073403717</li>
</ol>

Accuracy - the proportion of individuals correctly identified by the test results.
<ul>
 	<li>For example, a special test with perfect accuracy would imply a test has 100% specificity, 100% sensitivity, 100% positive predictive value and 100% negative predictive values.</li>
</ul>

Action Potential - A rapid change in voltage, resulting in a wave of excitation, that may result in stimulation of a nerve or muscle cell.
<ul>
 	<li>In order for an action potential to be initiated, the resting membrane voltage must exceed the excitation threshold, which then results in a cascade of depolarization and the "wave of excitation." Any stimulus below that threshold will not result in an action potential, and a stimulus greater than the threshold will not increase a single action potential, but may result in additional action potentials.  In this way, the action potential functions more like an on/off switch (all or none), and less like a dimmer switch.</li>
</ul>

A single-joint movement pattern (most often) designed to load a specific under-active muscle(s), while minimizing the contribution of over-active synergists via specific cues/joint motions.
<ul>
 	<li style="text-align: left;">Activation techniques/exercises are performed with the intent of addressing a muscle exhibiting a reduction in activity (tone) as a result of, or contributing to postural dysfunction.</li>
 	<li style="text-align: left;">Activation techniques/exercises cannot be multi-joint movement patterns due to relative flexibility, altered reciprocal inhibition, and synergistic dominance resulting in compensation patterns.</li>
</ul>
Example, <a href="https://brentbrookbush.com/articles/corrective-exercise-articles/activation/gluteus-medius-activation-progression/" target="_blank">gluteus medius activation</a> involves resisted hip abduction while minimizing the contribution of the TFL via hip extension.

Active stretching is a term used to describe a stretch that involves an active contraction of opposing musculature to lengthen a muscle to its end range. Generally these stretches are held for 2-5 seconds and repeated for 8-15 repetitions.

Adenosine triphosphatase (ATPase): is the enzyme responsible for catalyzing (initiating and accelerating) the decomposition of ATP to ADP.
<ul>
 	<li>This dephosphorylation (breakdown) reaction releases energy for processes like muscular contraction.</li>
</ul>

Adenosine triphosphate (ATP): The molecule that functions as a universal energy-transfer molecule, providing most of the energy associated with muscular contraction and human movement. ATP is composed of an adenine group, a ribose group, and three molecules of inorganic phosphates.
<ul>
 	<li>Energy is provided when hydrolysis results in the cleaving of a phophate group; resulting in adenosine diphosphate, an inorganigic phosphate group, and energy.</li>
</ul>

Algometry - measuring the amount of pressure to result in sensitivity or pain, using an algometer.
<ul>
 	<li>Generally, research uses algometry to establish a minimum pain pressure threshold (PPT), in which a lower PPT implies more sensitivity and pain, and a higher PPT implies less sensitivity and pain. PPT is a common outcome measure in trigger point research.</li>
</ul>
<a href="https://brentbrookbush.com/wp-content/uploads/2019/07/Algometer.jpg"><img class="aligncenter wp-image-140177" src="https://brentbrookbush.com/wp-content/uploads/2019/07/Algometer.jpg" alt="Image of an Algometer" width="500" height="333" /></a>

All-or-none principle - a nerve or muscle cell's response to a stimulus is independent of the strength of the stimulus. If that stimulus exceeds the threshold potential (threshold of an action potential), the nerve or muscle fiber will respond completely; otherwise, there is no response.

Example, when a motor unit in the biceps brachii is stimulated it contracts the same way whether a 10 lb or 50 lb dumbbell is lifted.  It is actually the number of muscle cells and the size of the motor unit that determines force output.

&nbsp;

The transition period between eccentric load and concentric contraction during a repetition of an exercise.  This term is most often used in reference to power/plyometric exercises, in which a shorter amortization phase is believed to be beneficial.  The shorter amortization phase may better use the stored energy from the elastic deformation of connective tissue and enhance synchronization of myotatic (stretch) reflex with maximum voluntary contraction.

Example, the athlete was cued to spend as little time as possible in the bottom of their squat stance (the amortization phase) during a set of box jumps.

Muscles that oppose the prime mover and synergists for a given joint action.

That is, all the muscles that can perform the opposing joint action.

Example: The triceps and anconeus are antagonists during elbow flexion.

An anatomical direction; toward the front

Example, the face is on the anterior aspect of the head

Appendicular Skeleton - referring to the bones the bones of the arms and legs, as well as the bones that support them. This includes the pelvis, clavicle and scapula. There are approximately 126 bones in the appendicular skeleton.
<ul>
 	<li>Etymology - Appendicular, as in appendage, "that which is appended to something as a proper part," 1640s, from <a class="crossreference" href="https://www.etymonline.com/word/append?ref=etymonline_crossreference">append</a> + <a class="crossreference" href="https://www.etymonline.com/word/-age?ref=etymonline_crossreference">-age</a>. - <a href="https://www.etymonline.com/word/appendage" target="_blank" rel="noopener">Etymology Online</a></li>
</ul>
"Appendicular skeleton" is a label referring to a set of bones whose function is distinct from the bones of the "<a href="https://brentbrookbush.com/glossary/axial-skeleton/" target="_blank" rel="noopener">axial skeleton</a>".

A reflexive decrease in muscle activity due to joint dyskinesis.
For example, a reduction in deep cervical flexor activity as a result of cervical spine dyskinesis.

Arthrokinematic Motion - Small amplitude motions between bone surfaces at a joint.  The arthrokinematic motions are roll, glide (slide or translation), spin, compression and distraction (traction). Arthrokinematic motions accompany osteokinematic motions to maintain joint congruence.
<ul>
 	<li>Example, arthrokinematic motion of the talus includes posterior glide on the tibia during ankle dorsiflexion.</li>
</ul>
Synonyms include: arthrokinematics, passive accessory motion, joint play and component motion

&nbsp;

Assessment - is the act of assessing, i.e. determining the importance, size, or value of -

In most cases, the results of an assessment are compared to normative data. If the individual exhibits values that are within normal parameters, it may be assumed that the aspect of health or motion assessed is not contributing to the patient's complaint, symptoms or movement impairment. If the results fall outside of normal parameters, it may indicate that the aspect of health or motion assessed is contributing to, or being affected by the patient/client's complaint, symptoms, or movement impairment. In some cases, the results of an assessment are compared to an "ideal model." In this case, deviations from the ideal are noted as potential issues. For example, deviations noted in the <a title="Introduction to the Overhead Squat Assessment" href="https://brentbrookbush.com/online-courses/articles/assessment/introduction-overhead-squat-assessment/" target="_blank">Overhead Squat Assessment</a> are compared to an "ideal model" of posture and motion.

Assessments used by human movement professionals can be divided into three broad categories:
<ul>
 	<li>"Clear" the Patient/Client for Intervention - These are tests, assessments and evaluations used to determine if a patient/client's issue may improve given the assessing professional's scope, skills, abilities and willingness to treat that individual.
<ul>
 	<li>For example, many of the special tests used in orthopedic medicine assist in determining the level of pathology or likelihood of a particular diagnosis. Certain issues and diagnoses are beyond the scope of the human movement professional, and are better treated by diagnostic professionals in the medical community (physicians, podiatrists, surgeons, etc.). A Calf Squeeze (Thompson) Test is one example, in which a positive sign may indicate a rupture of the Achilles tendon that may be better treated via surgical intervention.</li>
</ul>
</li>
 	<li>Highlight Contraindications - Tests, assessments and evaluations used to stratify risk or preclude a professional from addressing certain tissues, motions or using a particular technique.
<ul>
 	<li>For example, the Vertebral Artery Test (VBI) is often used to determine if high velocity thrust mobilizations (manipulations) are safe for a patient with cervical dysfunction.</li>
</ul>
</li>
 	<li>Refine Exercise/Intervention Selection: Tests, assessments and evaluations used to assist the professional in determining which techniques, modalities and exercises will best address a patient/client's complaints or desired goals.
<ul>
 	<li>Most movement assessments fall into this category. For example, a positive <a href="https://brentbrookbush.com/vimeo_videos/elys-test-rectus-femoris-flexibility-assessment/" target="_blank">Ely's Test</a> may indicate a need to release and/or lengthen the <a href="https://brentbrookbush.com/articles/anatomy-articles/muscular-anatomy/rectus-femoris/" target="_blank">rectus femoris</a>.</li>
</ul>
</li>
</ul>
Note: An assessment, or assessment result, may fall into more than one category. For example, although goniometry is an assessment most often used to Refine Exercise/Intervention Selection, if a range of motion is significantly altered, with an abnormal end-feel, and/or causes the patient or client/pain, the individual may need to be referred to a physician for further testing and Clearance to resume rehab activities.  Further, that same patient may return to the human movement professional with a list of Contraindicated Activities from the physician. - "When in doubt, refer out!"

Axial Skeleton - referring to the bones of the head, neck, trunk and spinal column (does not include pelvis). There are approximately 80 bones in the axial skeleton.
<ul>
 	<li>Etymology - Axial, as in "axis", referring to "imaginary motionless straight line around which a body (such as the Earth) rotates," from Latin axis "axle, pivot, axis of the earth or sky" - <a href="https://www.etymonline.com/word/axis" target="_blank" rel="noopener">Etymology Online</a></li>
</ul>
"Axial skeleton" is a label referring to a set of bones whose function is distinct from the bones of the "<a href="https://brentbrookbush.com/glossary/appendicular-skeleton/" target="_blank" rel="noopener">appendicular skeleton</a>".

Balance - The ability to maintain a body’s center of mass over its base of support. Balance can be static or dynamic.
<ul>
 	<li>For example, maintaining balance is harder on one leg because the center of mass must stay over a much smaller base of support.</li>
</ul>

A ball and socket joint (also called a spheroid joint or spheroidal joint) is a synovial joint in which the rounded or spherical end of one bone fits into a cup-like depression of another bone. The distal bone is capable of motion around an indefinite number of axes, which have one common center. Examples include the hip and shoulder (glenohumeral joint)

Base of support (BoS) - refers to the area beneath an object or person, and the area within the perimeter created by every point of contact that the object or person makes with the supporting surface. This may include the <a href="https://brentbrookbush.com/articles/anatomy-articles/muscular-anatomy/gluteus-maximus/" target="_blank" rel="noopener">glutes</a> of someone sitting on a chair, or the back of someone leaning against a wall.
<ul>
 	<li>For example, during a single leg balance the BoS is the area of the foot in contact with the surface; however, when a person is standing on two feet, the BoS is the area of both feet and the surface between them.</li>
</ul>

Pertaining to both sides

Example, bilateral rows are performed with both arms at the same time.

Case-control Study - a particular form of retrospective study that samples a matched group of people who have, and do not have the outcome being studied. A case-control study is a quasi-experimental design, often used in medicine to aid in determining potential contributing factors (cannot determine causality). In this study type exposure is the dependent variable and outcome is independent.
<ul>
 	<li>Example, in this retrospective case-control, medical records were investigated for trends correlated with cervical pain (1).
<ol>
 	<li>Mäkela, M., Heliövaara, M., Sievers, K., Impivaara, O., Knekt, P., &amp; Aromaa, A. (1991). Prevalence, determinants, and consequences of chronic neck pain in Finland. American journal of epidemiology, 134(11), 1356-1367.</li>
</ol>
</li>
</ul>

An anatomical direction; toward the tail, relative to humans this term is often used to refer to "in the direction of the tale (toward the feet)".

Example, to release the trapezius muscle the therapist used a force directed caudally.

Center of mass (CoM) - an object's mean position of mass; that is, a point that is perfectly surrounded by an equal amount mass in all directions.

Center of gravity (CoG) - point where gravity appears to act. Since the human body is so small compared to the earth, we can assume gravity acts uniformly on the body, and that CoG and CoM are the same.
<ul>
 	<li>Example, the CoM of the human body while lying down or standing straight up is close to our navel. However, it is possible that during a resistance exercise, the combination of the body's weight and the weight of the resistance will place the combined CoM outside the body. For example, during the mid-portion of a <a href="https://brentbrookbush.com/vimeo_videos/back-squat/" target="_blank" rel="noopener">back squat</a> the CoM would be several anterior to the naval.</li>
</ul>

An anatomical direction; toward the head (synonym: cranial)

Example, hip pain was felt with any force directed cephalad.

Cohort Study - a particular form of longitudinal study that samples a cohort (a group of people who share a defining characteristic), performing a cross-section at intervals through-out a period of time. A cohort study is a quasi-experimental design often used in medicine to aid in determining etiology or a cause-and-effect relationship. In this study type exposure is the independent variable and outcome is dependent.
<ul>
 	<li>Example, the study by Cholewicki et al. (1) investigated Yale Varsity Athletes (the cohort) with 2 and 3 year follow up (longitudinal design) and found that trunk muscle response time to off-loading was predictive of future low back injury.</li>
</ul>
<ol>
 	<li><a href="https://brentbrookbush.com/articles/research-corner/core/increased-trunk-muscle-latency-may-cause-rather-than-result-from-low-back-pain/" target="_blank" rel="noopener noreferrer">Cholewicki, J., Silfies, S., Shah, R., Greene, H., Reeves, N. Alvi, K., Goldberg, B. (2005). Delayed trunk muscle reflex responses increase the risk of low back injuries. Spine. 30(23), 2614-2620</a></li>
</ol>

Comparable Sign: A combination of pain, stiffness and/or spasm during examination that is comparable to the patients symptoms.
<ul>
 	<li>One common error made during evaluation with special tests is attention given to any discomfort or pain, rather than attempting to identify the pain/discomfort related to the patient's complaint (concordant/comparable sign). Many special tests purposefully test tissue limits and are at least mildly uncomfortable in every individual. Basing your assessment on positive tests that resulted in "concordant/comparable signs" will improve your chances of arriving at the correct diagnosis.</li>
</ul>

An alternative movement pattern that has been adopted to compensate for dysfunction/impairment in the human movement system.
Example: A lack of calf extensibility may limit dorsiflexion, leading to the knees bowing inward (functional valgus) and excessive forward lean of the torso during a squat.

An arthrokinematic motion - the approximation of joint surfaces; that is, a force that directs one bone surface into another resulting in a reduction in intra-articular volume. Although widely thought of as a "destructive force", it is likely best to consider compression as a naturally occurring, stabilizing force. Any arthrokinematic force in excess (spin, glide, roll, traction) may be viewed as potentially deleterious.

For example, during a squat the femoral head is compressed into the acetabulum by muscular forces, bodyweight and any additional external load.

Concave (Concavity) - Having an outline or surface curved like the interior surface of a bowl or sphere - to cave-in or curve inward.
<ul>
 	<li>Example, the internal surfaces of the pelvis is concave, holding some of the bodies viscera.</li>
</ul>

Concordant Sign - The patient's specific pain, symptom or complaint. 
<ul>
 	<li>One common error made during evaluation with special tests is attention given to any discomfort or pain, rather than attempting to identify the pain/discomfort related to the patient's complaint (concordant/comparable sign). Many special tests purposefully test tissue limits and are at least mildly uncomfortable in every individual. Basing your assessment on positive tests that resulted in "concordant/comparable signs" will improve your chances of arriving at the correct diagnosis.</li>
</ul>

Conductivity: Stimulation results in more than a local effect (1).
<ul>
 	<li>For example, in a muscle cell the stimulation of a motor endplate results in a change in cell membrane polarity that rapidly propagates (is conducted) along the entire length of the muscle cell, stimulating all sacromere.</li>
</ul>
<ol>
 	<li>Saladin, K. (2012). Anatomy &amp; Physiology: The unity of form and function. (6th ed.). New York: McGraw-Hill.</li>
</ol>

A condyloid joint (also called condylar, bicondylar, ellipsoid, or ellipsoidal) is an ovoid articular surface, or condyle, that is received into an elliptical cavity.  These joints permit movement in two planes.  Examples include the knee, metacarpophalangeal joints and metatarsophalangeal joints.

Connective Tissue Cell - One of the four basic types of animal tissue, consisting mostly fibers and ground substance.  These cells are specialized to binds organs together, holds them in place, protect them from external forces, and may fill space in the body's cavities.

Example, the body's muscles are enclosed in durable connective tissue sheets known as the "epimysium", "perimysium", and "endomysium," which and in support and transmitting force.
<ol>
 	<li>Saladin, K. (2014). Anatomy &amp; physiology: The unity of form and function. McGraw-Hill Higher Education, New York. ISBN: 9780073403717</li>
</ol>

Contractility: The ability to shorten (1).
<ul>
 	<li>Contractility: Muscle cells are unique in the amount they can shorten when stimulated; this is this largerly due to the highly organized and unique arrangement of myofilaments (actin and myosin).</li>
</ul>
<ol>
 	<li>Saladin, K. (2012). Anatomy &amp; Physiology: The unity of form and function. (6th ed.). New York: McGraw-Hill.</li>
</ol>

Pertaining to the opposite side

Example, the external oblique muscle performs contralateral rotation; rotation to the opposite side.

Convex (Convexity) - Having an outline or surface curved like the exterior of a circle or sphere - to bulge or curve outward.
<ul>
 	<li>Example, the top of your head is shaped by the convex exterior surface of your skull.</li>
</ul>

Correlational Research - Non-experimental <a href="https://www.questionpro.com/blog/what-is-research/">research</a> method in which the statistical relationship between two variables is investigated.
<ul>
 	<li>In this research by Kwon et al., a correlation was noted between a decrease in extensibility during a hamstring length test (goniometry) and current knee pain (1).</li>
</ul>
<ol>
 	<li><a href="https://brentbrookbush.com/articles/research-corner/knee/correlation-patellofemoral-pain-syndrome-pfps-hamstring-activity/" target="_blank" rel="noopener">Kwon O, Yun M, and Lee W. (2014). Correlation between intrinsic patellofemoral pain syndrome in young adults and lower extremity biomechanics. J. Phys. Ther. Sci. 26: 961-964</a></li>
</ol>

Counter-nutation - posterior rotation of sacrum relative to ilium, and/or anterior rotation of ilium relative to sacrum.
<ul>
 	<li>The pelvic floor muscles are examples of muscle that may counter-nutate the sacrum.</li>
</ul>
[caption id="attachment_126335" align="aligncenter" width="400"]<a href="https://brentbrookbush.com/wp-content/uploads/2018/10/Nutation.png"><img class=" wp-image-126335" src="https://brentbrookbush.com/wp-content/uploads/2018/10/Nutation.png" alt="Nutation and Counter-nutation of the Sacroiliac Joint" width="400" height="967" /></a> Nutation and Counter-nutation of the Sacroiliac Joint[/caption]

&nbsp;

Crossover (Study) Design - A type of longitudinal, repeated measures quasi-experimental design in which each group receives both treatments, but at different times. It is named "crossover" due to the patients "crossing-over" to the other treatment or sham group after a specified period of time.
<ul>
 	<li>This type of study has the advantage of every individual serving as their own control, which may reduce the influence of confounding variables.</li>
 	<li>Unfortunately, the design itself introduces the chances that anyone receiving the experimental variable in the first period will continue to be effected in the second period.</li>
</ul>
In a study by Senna et al., a cross-over design was used to investigate the difference load made on inter-set rest intervals (1).
<ol>
 	<li><a href="https://brentbrookbush.com/articles/research-corner/strength-training-research-corner/heavy-vs-light-load-single-joint-exercise-performance-with-different-rest-periods/" target="_blank" rel="noopener">Senna, G.W., Rodrigues, B.M., Sandy, Scudese, Bianco, A, &amp; Dantas, E.H.M. (2017). Heavy vs light load single-joint exercise performance with different intervals. Journal of Human Kinetics, 58, 197-206. </a></li>
</ol>

Cross-sectional Study - a research design that involves gathering data from a population or representative subset at a specific point in time.
<ul>
 	<li>Example, the study by Karimi-Mobarake et al.(1) investigated the prevalence of genu varum and genu valgum among school children 7-11 years old in Iran.</li>
</ul>
<ol>
 	<li><a href="https://brentbrookbush.com/articles/research-corner/knee/low-prevalence-of-genu-varum-and-valgum-among-elementary-school-children/" target="_blank" rel="noopener noreferrer">Karimi-Mobarake, M., Kashefipour, A., Yousfnejad, Z. The prevalence of genu varum and genu valgum in primary school children in Iran 2003-2004. (2005) Journal of Medical Science 5(1). 52-54</a></li>
</ol>

Cytokine - A broad and loose category of small proteins that act through receptors, and are especially important to immune function (inflammation).
<ul>
 	<li>Cytokines include substances such as interferon, interleukin, and growth factors, which are secreted by certain cells of the immune system and have an effect on other cells. Their definite distinction from hormones is a topic of continued research.</li>
</ul>
&nbsp;

Dependent variable - in research, this is the variable that is changed by the independent variable, most often this is the "outcome" of the study.
<ul>
 	<li>Example, in the study by Cleland et al. (1), the independent variable is "thoracic manipulation," and the dependent variable is "lower trapezius muscle strength."</li>
</ul>
<ol>
 	<li><a href="https://brentbrookbush.com/articles/research-corner/short-term-effects-lower-thoracic-manipulation-lower-trapezius-muscle-strength/" target="_blank" rel="noopener noreferrer">Cleland J, Selleck B, Stowell T, Brown L, Alberini S, St. Cyr H, Caron T. Short-term Effects of Thoracic Manipulation on Lower Trapezius Muscle Strength.  Journal of Manual &amp; Manipulative Therapy. 2004; 12(2): 82-90</a></li>
</ol>

An anatomical direction; further from the trunk or center of the body

Example, the foot is at the distal end of the leg.

An arthrokinematic motion - a force applied to a body part that may result in the separation of joint surfaces, a reduction in intra-articular pressure, and/or an increase in intra-articlar space.

For example, to hang from one's hands (i.g. in preparation for a pull-up) results in a traction force on the glenohumeral joint (shoulder).

An anatomical term of location; back or upper surface

Example, shoe laces may compress tissues on the dorsal surface of the foot

The "drawing-in" maneuver is a common cue used during exercise and rehabilitation programs. A light contraction of the <a href="https://brentbrookbush.com/articles/muscular-anatomy/transverse-abdominis/" target="_blank" rel="noopener">transverse abominis</a> (and potentially the entire <a href="https://brentbrookbush.com/articles/corrective-exercise-articles/core-subsystems/intrinsic-stabilization-subsystem/" target="_blank" rel="noopener">intrinsic stabilization subsystem</a>) achieved by gently pulling the lower abdominal region away from one's waist band. This should have minimal effect on breathing, and should not be confused with a maximal contraction of the <a href="https://brentbrookbush.com/articles/muscular-anatomy/transverse-abdominis/" target="_blank" rel="noopener">transverse abdominis</a> resulting in a "vacuum pose".
<ul>
 	<li>Research often refers to this maneuver as the "abdominal drawing-in maneuver"; abbreviated ADIM.</li>
</ul>
Development and introduction of this cue into practice is based on the pivotal research and resulting text:
<ol>
 	<li>Carolyn Richardson, Paul Hodges, Julie Hides. Therapeutic Exercise for Lumbo Pelvic Stabilization – A Motor Control Approach for the Treatment and Prevention of Low Back Pain: 2nd Edition (c) Elsevier Limited, 2004</li>
</ol>

Faulty or abnormal movement; an alteration of normal kinematics.

For example, joint stiffness or a reduction in arthrokinematics motion that results in limited osteokinematic range of motion - inadequate inferior glide of the femoral head resulting in limited abduction of the hip.

The seeping into, or abnormal collection of fluid in a body cavity.

For example, knee effusion describes swelling within the knee joint.

Note: the word "effusion" is used differently in medicine than it is used in reference to the movement (seeping out) of liquids and gases, for example in chemistry.

&nbsp;

A trait of body tissues that allows a tissue to return to its resting length or state after deformation or stretch.
Example:  Muscle is elastic tissue; many muscles will return to their resting length after being stretched to 150% of that length without any appreciable change in tissue quality.

Elasticity: Elasticity refers to the ability of a cell to return to its resting length after being stretched/lengthened.
<ul>
 	<li>Note: this term is often confused with extensibility. Elasticity is not the ability to stretch; it is the ability to return to normal length after being stretched. Muscle tissue, connective tissue and even nerve tissue have varying levels of elasticity.</li>
</ul>
<ol>
 	<li>Saladin, K. (2012). Anatomy &amp; Physiology: The unity of form and function. (6th ed.). New York: McGraw-Hill.</li>
</ol>

Epithelial cell - One of the four basic cell types, found lining the body's cavities, blood vessels, organs and constitutes most gland tissue.  These cells are specialized to aid with absorption, secretion, or act as a barrier from foreign objects.
<ol>
 	<li>Saladin, K. S., &amp; Miller, L. (1998). Anatomy &amp; physiology. New York (NY): WCB/McGraw-Hill.</li>
</ol>

Equilibrium - a state in which opposing forces or influences are balanced.
<ul>
 	<li>For example, to maintain a neutral trunk while pushing or pulling a weight in one hand, your core musculature must balance the force by creating an equal amount of force in the opposite direction.</li>
</ul>

The study of causation, or origination. The word is commonly used in the medical professions, where it may refer to the study of why things occur, or the reason behind why things act a certain way.

For example, the etiology of low back pain is a complex subject, with multiple contributing factors and various structures implicated.

<div class="gs_citr" tabindex="0">Evidence-based medicine (practice) is the integration of best research evidence with clinical expertise and patient(client) values (2)."</div>
<ul>
 	<li class="gs_citr" tabindex="0">...the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients (clients).  It involves the integration of at least (a) clinical expertise/expert opinion, (b) external scientific evidence, and (c) client/patient/caregiver perspectives to provide high-quality services reflecting the interests, values, needs, and choices of the individuals we serve (1).</li>
</ul>
&nbsp;
<ol>
 	<li id="gs_cit1" class="gs_citr" tabindex="0">Sackett, D. L., Rosenberg, W. M., Gray, J. M., Haynes, R. B., &amp; Richardson, W. S. (1996). Evidence based medicine: what it is and what it isn't. Bmj, 312(7023), 71-72.</li>
 	<li class="gs_citr" tabindex="0">Sackett D et al. Evidence-Based Medicine: How to Practice and Teach EBM, 2nd edition. Churchill Livingstone, Edinburgh, 2000, p.1</li>
</ol>

Excitability: The ability of a cell to change in membrane conductance as a response to stimulation.

<ul>
 	<li>For example, muscle cells are specialized to react to a change in membrane potential with contraction, where as nerve cells are specialized to propagate a change in membrane potential along there axons and communicate that message to other tissues via neurotransmitters.
</li>
</ul>
<ol>
 	<li>Saladin, K. (2012). Anatomy &amp; Physiology: The unity of form and function. (6th ed.). New York: McGraw-Hill.</li>
</ol>

Excitation threshold: The level that a depolarization must reach for an action potential to occur.
<ul>
 	<li>The excitation threshold is a contributing factor to the "all-or-none" response of muscle and nerves cells to a stimulus.</li>
</ul>

Exercise Progression - Modification of an exercise with the intent of promoting adaptation by increasing demand. This can be accomplished by increasing reps, load, tempo, range of motion, complexity, and/or challenge to an individual's stability.
<ul>
 	<li>Because load, reps, tempo and complexity are often explicitly noted, the term "exercise progression" is most often used throughout Brookbush Institute (BI) content to refer to an exercise, or series of exercises that make it harder to maintain stability with good form.
<ul>
 	<li>Sample Exercise Progression: <a href="https://brentbrookbush.com/vimeo_videos/kneeling-chop-pattern/" target="_blank" rel="noopener">Kneeling Chop</a> to <a href="https://brentbrookbush.com/vimeo_videos/static-standing-chop-pattern/" target="_blank" rel="noopener">Standing Chop</a> to <a href="https://brentbrookbush.com/vimeo_videos/single-leg-chop-pattern/" target="_blank" rel="noopener">Single-leg Chop</a></li>
</ul>
</li>
</ul>

Exercise regression - The opposite of progression; that is, modification of an exercise with the intent of reducing demand. This can be accomplished by decreasing reps, load, tempo, range of motion, complexity, and/or challenge to an individual's stability. Generally, regressions are used to modify an exercise to the client's current level of ability, with the intent of improving form, motor learning and retention.
<ul>
 	<li>Because load, reps, tempo and complexity are often explicitly noted, the term "exercise regression" is most often used throughout Brookbush Institute (BI) content to refer to an exercise or series of exercises that make it easier to maintain stability with good form.
<ul>
 	<li>Sample Exercise Regression: <a href="https://brentbrookbush.com/vimeo_videos/single-leg-chop-pattern/" target="_blank" rel="noopener">Single-leg Chop</a> to <a href="https://brentbrookbush.com/vimeo_videos/static-standing-chop-pattern/" target="_blank" rel="noopener">Standing Chop</a> to <a href="https://brentbrookbush.com/vimeo_videos/kneeling-chop-pattern/" target="_blank" rel="noopener">Kneeling Chop</a></li>
</ul>
</li>
</ul>

Experimental Research - Studies in which the researchers introduce the variable to be studied, with the intent of observing the outcome. This is different than observational research which observes the effect of a variable already present. Many texts also assert that experimental research should include randomization and ideally a control group, as is seen in Randomized Control Trials. Studies in which the variable is introduced by the researchers, but participants are not randomized may be considered Quasi-experimental research.
<ul>
 	<li>In this study by Esformes, the experimental variable was squat depth and the outcome measures observed were various performance measures related to power (1).</li>
</ul>
<ol>
 	<li><a href="https://brookbushinstitute.com/article/back-squat-depth-lower-body-post-activation-potentiation/" target="_blank" rel="noopener">Esformes, J., &amp; Bampouras, T. (2013). Effect of back squat depth on lower-body postactivation potentiation. Journal of Strength and Conditioning Research, 27(11), 2997-3000.</a></li>
</ol>
&nbsp;

Extensibility: The ability of a cell to be stretched or lengthened without damage (1).
<ul>
 	<li>For example, most cells would rupture with even a modest stretch, but muscles can stretch up to 3 times their contracted length.</li>
</ul>
<ol>
 	<li>Saladin, K. (2012). Anatomy &amp; Physiology: The unity of form and function. (6th ed.). New York: McGraw-Hill.</li>
</ol>

False Negative - the proportion of negatives in a group that were assessed incorrectly (assessed as negative when the patient was actually positive)
<ul>
 	<li>Test Results: Although most tests/assessments result in either a positive or negative, the accuracy of a test is dependent on the number  of positives and negatives that are correct. Therefore, when the accuracy of a test is determined, their are 4 possible results, because a positive or negative result could be right (true) or wrong (false).</li>
</ul>

False Positive - the proportion of positives in a group that were assessed incorrectly (assessed as positive when the patient was actually negative)
<ul>
 	<li>Test Results: Although most tests/assessments result in either a positive or negative, the accuracy of a test is dependent on the number  of positives and negatives that are correct. Therefore, when the accuracy of a test is determined, their are 4 possible results, because a positive or negative result could be right (true) or wrong (false).</li>
</ul>

The function of fascia is to transmit force, provide support, and protect tissues. Fascia can effect motion by:
Transmitting force from one or more muscles (example: the thoracolumbar fascia)
Restricting motion in cases of adaptive shortening and/or adhesion to proximal structures (example: iliotibial band in cases of lower-leg dysfunction)
Elastic recoil after stretching can contribute to force production (example: plyometric exercise)

Note: There is evidence that fascia may house more receptors related to human movement than other tissues. In this way fascia may act as a motherboard for the nervous system

The fascial system does not contract or develop trigger points, and its capacity to adapt to stretching and or strengthening exercise is limited, especially when compared to the adaptive capacity of muscle tissue.

Fibromyalgia - A loosely defined diagnosis that is associated with a combination of widespread pain in combination with 2) tenderness at 11 or more of the 18 specific tender point sites. Consideration may also be given to the presence of psychosocial stressors and inflammatory disease in the patients history. Newer research suggests that fibromyalgia may be at least in part due to central sensitization of myofascial pain, often associated with trigger points (1 - 4).
<ol>
 	<li>Wolfe, F. (2018). Fibromyalgia Syndrome and Fibromyalgia Syndrome Criteria: Problems in Definition and Validity. Fibromyalgia Syndrome and Widespread Pain: From Construction to Relevant Recognition.</li>
 	<li>Wolfe, F., Smythe, H. A., Yunus, M. B., Bennett, R. M., Bombardier, C., Goldenberg, D. L., ... &amp; Fam, A. G. (1990). The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Arthritis &amp; Rheumatism: Official Journal of the American College of Rheumatology, 33(2), 160-172.</li>
 	<li>Alonso-Blanco, C., Fernandez-de-las-Penas, C., Morales-Cabezas, M., Zarco-Moreno, P., Ge, H. Y., &amp; Florez-García, M. (2011). Multiple active myofascial trigger points reproduce the overall spontaneous pain pattern in women with fibromyalgia and are related to widespread mechanical hypersensitivity. The Clinical journal of pain, 27(5), 405-413.</li>
 	<li>Staud, R., Nagel, S., Robinson, M. E., &amp; Price, D. D. (2009). Enhanced central pain processing of fibromyalgia patients is maintained by muscle afferent input: a randomized, double-blind, placebo-controlled study. PAIN®, 145(1-2), 96-104.</li>
</ol>
&nbsp;

Muscles that act to reduce or prevent movement at proximal joints to improve force transmission.
Example: The muscles of the core are important fixators; reducing motion of the spine/trunk to enhance force transmission between the extremities and environment.

An increase in joint stability via compressive forces resulting from muscular contraction and increased tension in fascial structures (1,2).
<ul>
 	<li>This term is most often used in reference to core intrinsic stabilizers, the thoracolumbar fascia and the sacroiliac joint; however, force closure and form closure have been mentioned in the literature referring to other joints.</li>
 	<li>Related term: Form closure</li>
</ul>
<ol>
 	<li>Andry Vleeming, Vert Mooney, Rob Stoeckart. Movement, Stability &amp; Lumbopelvic Pain: <a class="glossaryLink " title="Glossary: Integration" href="https://brentbrookbush.com/glossary/integration/" target="_blank" rel="noopener noreferrer" data-cmtooltip="&lt;div class=glossaryItemTitle&gt;Integration&lt;/div&gt;&lt;div class=glossaryItemBody&gt;Making a whole of parts.&lt;br /&gt;&lt;br /&gt;Example, The Brookbush Institute uses an integrative approach to explaining and addressing human movement.&lt;/div&gt;">Integration</a> of Research and Therapy. (c) 2007 Elsevier Limited</li>
 	<li id="gs_cit1" class="gs_citr" tabindex="0">Vleeming, A., Pool-Goudzwaard, A. L., Stoeckart, R., van Wingerden, J. P., &amp; Snijders, C. J. (1995). The Posterior Layer of the Thoracolumbar Fascia| Its Function in Load Transfer From Spine to Legs. Spine, 20(7), 753-758.</li>
</ol>

The relative contribution of joint shape and structure to the stability of a joint (1,2).
<ul>
 	<li>This term is most often used in reference to the "rough" articulating surfaces of the sacroiliac joint and the wedge shape of the sacrum; however, force closure and form closure have been mentioned in the literature referring to other joints.</li>
 	<li>Related term: Force closure</li>
</ul>
<ol>
 	<li>Andry Vleeming, Vert Mooney, Rob Stoeckart. Movement, Stability &amp; Lumbopelvic Pain: <a class="glossaryLink " title="Glossary: Integration" href="https://brentbrookbush.com/glossary/integration/" target="_blank" rel="noopener noreferrer" data-cmtooltip="&lt;div class=glossaryItemTitle&gt;Integration&lt;/div&gt;&lt;div class=glossaryItemBody&gt;Making a whole of parts.&lt;br /&gt;&lt;br /&gt;Example, The Brookbush Institute uses an integrative approach to explaining and addressing human movement.&lt;/div&gt;">Integration</a> of Research and Therapy. (c) 2007 Elsevier Limited</li>
 	<li id="gs_cit1" class="gs_citr" tabindex="0">Vleeming, A., Pool-Goudzwaard, A. L., Stoeckart, R., van Wingerden, J. P., &amp; Snijders, C. J. (1995). The Posterior Layer of the Thoracolumbar Fascia| Its Function in Load Transfer From Spine to Legs. Spine, 20(7), 753-758.</li>
</ol>

An arthrokinematic motion - linear motion across a joint surface parallel to the plane of the adjacent joint surface, just as your posterior moves relative to a "slide" in a park.

For example, the glide of facet joint in the spine during spinal flexion and extension, or the posterior glide of the humeral head that must accompany anterior roll to maintain congruence with glenoid fossa during shoulder horizontal adduction.

A plane joint (also called an arthrodial joint, gliding joint or plane articulation) is a synovial joint which allows only gliding movement in the plane of the articular surfaces. The opposed surfaces of the bones are flat or almost flat, with movement generally limited by tight capsules and ligaments. Plane joints are numerous, are most often small, and allow very little motion.  Examples include the carpal joints of the wrist, the tarsal joints of the ankle, and the facet joints of the spine.

"...refers to the measurement of angles, in particular the measurement of angles created at human joints by the bones of the body (1).

&nbsp;
<ol>
 	<li>Cynthia C. Norkin, D. Joyce White. Measurement of Joint Motion: A Guide to Goniometry 3rd Edition. Copyright (C) 2003 by F.A. Davis Company</li>
</ol>

Ground reaction force (GRF) - The force exerted by the ground on the body in contact with it.

For example, when a runner's foot strikes the ground with a force equal to the mass of the individual times their acceleration due to gravity, momentum and muscular exertion, the ground exerts an equal and opposite force on the runner's foot.
<ul>
 	<li>GRF is often measured in research studies using force plates as a means of quantitatively measuring the force generated by an individual.</li>
</ul>

H-Band - Refers to the central zone of a sarcomere that looks lighter under a microscope.  This area of the sarcomere is a lighter portion of the A-band where there is no overlap between the thinner filaments (actin), and the thicker filaments (myosin).
<ul>
 	<li>Example, when a muscle contracts, actin and myosin cross-bridging occurs in the region of the A-band until the H-band is reached where no overlap occurs.</li>
</ul>
<ol>
 	<li>Saladin, K. (2014). Anatomy &amp; physiology: The unity of form and function. McGraw-Hill Higher Education, New York. ISBN: 9780073403717</li>
</ol>

A hinge joint (also called a ginglymus) is a synovial joint in which the articular surfaces fit one another in a way that only permits motion in one plane. Examples include the elbow, the knee (unless considered a condyloid joint) and the interphalangeal joints.

Holism (holistic) (biological holism) - (from Greek holos "all, whole, entire") is the idea that systems and their properties should be viewed as wholes, not just as a collection of parts.
<ul>
 	<li>Summarized by Aristotle in his "Metaphysics": "The whole is more than the sum of its parts". However, the term "holism" was introduced into language by the South African statesman Jan Smuts as recently as 1926. (Smuts J. C. 1987 [1926]. Holism and evolution. Cape Town: N &amp; S Press.)</li>
</ul>
Example: The Brookbush Institute promotes a holistic approach to human movement science, in which the muscular, fascial, articular and neural systems are not viewed as separable and all proximal segments are considered.

Hormone: Chemical messengers produced by the endocrine system, transported via tissue fluids such as blood, to stimulate cells to "act."
<ul>
 	<li>Example: Growth hormone is secreted by the pituitary gland in the brain; stimulating growth, cell reproduction and cell regeneration in certain types of cells</li>
</ul>
The English physician E. H. Starling discovered in collaboration with the physiologist W. M. Bayliss secretin, the first hormone, in 1902. (1).
<ol>
 	<li>Henriksen, J. H., &amp; de Muckadell, O. S. (2000). Secretin, its discovery, and the introduction of the hormone concept. Scandinavian journal of clinical and laboratory investigation, 60(6), 463-472.</li>
</ol>

A range of motion achieved by the patient/client that is more than normal.
<ul>
 	<li>Note: Both hyper-mobility and hypo-mobility may adversely affect motion and may lead to deleterious effects on joints and soft tissue over time. There is no evidence to suggest that more or less flexibility than normal is beneficial.</li>
</ul>
Example: If an individual can place their forehead on their knees they are likely hypermobile at one, if not several joints

Example 2: 110° of shoulder external rotation would be considered hyper-mobile.

Hyperplasia is an increase in organic tissue size due to an adaptive increase in the number of cells per organ.
<ul>
 	<li>Although muscle hyperplasia has been noted in some animals, human muscle tissue does not seem to have this adaptive ability.</li>
</ul>

A condition of excessive tone of the skeletal muscles; increased resistance of muscle to passive stretching.  May be related to increased neural drive, synergistic dominance, trigger points, reflexive over-activity, and/or muscle length.
Example:  Individuals who exhibit ankle eversion and abduction during an overhead squat assessment likely have hypertonic fibularis (peroneal) muscles.

Muscular hypertrophy is an increase in muscle mass/size due to increase in the volume and cross-sectional area (CSA) of individual muscle cells. The increase in cross-sectional area can be attributed to an an increase in contractile proteins and structural elements (myofibrillar hypertophy), as well as an increase in glycogen storage and elements related to metabolism (sarcoplasmic hypertophy). Hypertrophy is an adaptation of both cardiac and skeletal muscle fibers in response to progressive increases in workload.
<ul>
 	<li>Note: Hypertrophy is not hyperplasia. Hyperplasia is an increase in muscle size due to an adaptive increase in the number of muscle fibers/cells per muscle. This type of adaptation does not occur in human muscle tissue.</li>
</ul>

A range of motion achieved by a patient/client that is less than normal.
<ul>
 	<li>Note: Both hyper-mobility and hypo-mobility may adversely affect motion and may lead to deleterious effects on joints and soft tissue over time. There is no evidence to suggest that more or less flexibility than normal is beneficial.</li>
</ul>
Example: If the end range of shoulder external rotation is reached and measured as 75° during goniometric assessment, the client/patient is exhibiting hypomobility of the glenohumeral joint (shoulder).

Hypothesis - a proposed explanation for a phenomenon; "scientific hypotheses" are generally constructed in a way that is testable or falsifiable.
<ul>
 	<li>Example: The hypothesis, "excessive knee valgus may be correlated with future knee pain and injury," has been the subject of several studies published over the last decade.</li>
</ul>

Diminished tone of skeletal muscles; diminished resistance of muscles to passive stretching.   May be related to inhibition, reciprocal inhibition, arthrokinematics inhibition and/or  increased resting length of muscle.
Example:  If your knees cave (hip adduction) during a squat or leg-press it is likely that your gluteus medius is hypotonic.

I-Band - Refers to the part of the muscle cell that looks lighter under a microscope.  This area of the cell is lighter due to parallel arrangement of thinner filaments (actin), and no overlap with the thicker filaments (myosin).
<ul>
 	<li>As a muscle contracts, the I-bands will decrease in width and move closer to one another.</li>
</ul>
<ol>
 	<li>Saladin, K. (2014). Anatomy &amp; physiology: The unity of form and function. McGraw-Hill Higher Education, New York. ISBN: 9780073403717</li>
</ol>

Independent variable - in research, this is the variable or phenomenon being manipulated in the study.
<ul>
 	<li>Example, in the study by Ghanbari et al. (1), the independent variable is "knee joint mobilization", the dependent variable is "quadriceps muscle strength."</li>
</ul>
<ol>
 	<li><a href="https://brentbrookbush.com/articles/research-corner/effect-knee-joint-mobilization-quadriceps-muscle-strength/" target="_blank" rel="noopener noreferrer">Ghanbari A. and Kamalgharibi S. (2013). Effect of knee joint mobilization on quadriceps muscle strength. International Journal of Health and Rehabilitation Sciences. 2(4): 186-191</a></li>
</ol>

An anatomical direction; toward the bottom (below)

Example, the mouth is inferior to the eyes

A reduction in neural drive, muscular activity, and or force output due to altered neuromuscular reflex.  Alterations in neuromuscular reflex may occur due to increases in muscle length (hypothesis: increased excitation threshold), altered reciprocal inhibition in response to increased antagonist tone, and or alterations in joint motion (arthrokinematics inhibition).

Making a whole of parts.

Example, The Brookbush Institute uses an integrative approach to explaining and addressing human movement.

Intermuscular Coordination - Optimal timing and motor unit recruitment of agonists, antagonists, synergists, neutralizers, stabilizers and fixators.

Example: Role of Muscles during Hip Extension
<ul>
 	<li><a class="glossaryLink " style="box-sizing: border-box; font-family: roboto; color: #000000 !important; font-size: 15px; outline: none; background: transparent; border-bottom: 1px dotted #000000 !important; text-decoration: none;" title="Glossary: Prime Mover" href="https://brentbrookbush.com/glossary/prime-mover/" target="_blank" rel="noopener" data-cmtooltip="&lt;div class=glossaryItemTitle&gt;Prime Mover&lt;/div&gt;The muscle most responsible for a joint action under load -&lt;br /&gt;&lt;br /&gt;That is, the muscle that can produce the most force for a given joint action. Often this term is used synonymously with the term agonist. The prime mover as defined above, may or may not be the most active muscle for a joint action during activities of daily living.&lt;br /&gt;&lt;br /&gt;Example: the gluteus maximus is the most powerful hip extensor and therefore the prime mover; however, the hamstrings are likely the most active hip extensors during low level activities like walking or standing.">Prime Mover</a>:  <a href="https://player.vimeo.com/external/82855344.hd.mp4?s=54c3e7d98fb9d4e0af8d282c85ba9b3e">Gluteus maximus</a></li>
 	<li><a class="glossaryLink " style="box-sizing: border-box; font-family: roboto; color: #000000 !important; font-size: 15px; outline: none; background: transparent; border-bottom: 1px dotted #000000 !important; text-decoration: none;" title="Glossary: Synergists" href="https://brentbrookbush.com/glossary/synergists/" target="_blank" rel="noopener" data-cmtooltip="&lt;div class=glossaryItemTitle&gt;Synergists&lt;/div&gt;Muscles that assist the prime mover in performing a joint action.&lt;br /&gt;&lt;br /&gt;That is, all muscles that can perform a joint action that are not the prime mover, are termed synergists.&lt;br /&gt;Example: The rectus abdominis is the prime mover of spinal flexion. All other muscles that can perform spinal flexion are synergists including – external obliques, internal obliques and psoas.">Synergists</a>: <a href="https://brentbrookbush.com/articles/muscular-anatomy/biceps-femoris/">Biceps femoris (long head)</a>, <a href="https://brentbrookbush.com/articles/muscular-anatomy/semitendinosus-and-semimembranosus/">semitendinosus, semimembranosus</a>, <a href="https://brentbrookbush.com/articles/muscular-anatomy/adductors/">posterior head of adductor magnus</a></li>
 	<li><a class="glossaryLink " style="box-sizing: border-box; font-family: roboto; color: #000000 !important; font-size: 15px; outline: none; background: transparent; border-bottom: 1px dotted #000000 !important; text-decoration: none;" title="Glossary: Antagonist" href="https://brentbrookbush.com/glossary/antagonists/" target="_blank" rel="noopener" data-cmtooltip="&lt;div class=glossaryItemTitle&gt;Antagonist&lt;/div&gt;Muscles that oppose the prime mover and synergists for a given joint action.&lt;br /&gt;&lt;br /&gt;That is, all the muscles that can perform the opposing joint action.&lt;br /&gt;&lt;br /&gt;Example: The triceps and anconeus are antagonists during elbow flexion.">Antagonists</a>: <a href="https://brentbrookbush.com/articles/muscular-anatomy/psoas/">Psoas</a>, <a href="https://brentbrookbush.com/articles/muscular-anatomy/iliacus/">iliacus</a>, <a href="https://brentbrookbush.com/articles/muscular-anatomy/tensor-fascia-latae-tfl/">tensor fascia latae</a> (TFL),<a href="https://brentbrookbush.com/articles/muscular-anatomy/rectus-femoris/"> rectus femoris</a>, <a href="https://brentbrookbush.com/articles/muscular-anatomy/adductors/">anterior adductors (especially pectineus)</a>, <a href="https://brentbrookbush.com/articles/muscular-anatomy/sartorius/">sartorius</a></li>
 	<li><a class="glossaryLink " style="box-sizing: border-box; font-family: roboto; color: #000000 !important; font-size: 15px; outline: none; background: transparent; border-bottom: 1px dotted #000000 !important; text-decoration: none;" title="Glossary: Neutralizer" href="https://brentbrookbush.com/glossary/neutralizers/" target="_blank" rel="noopener" data-cmtooltip="&lt;div class=glossaryItemTitle&gt;Neutralizer&lt;/div&gt;Muscles that oppose unwanted joint motions created by the prime mover and/or synergists, and/or muscles that prevent unwanted ancillary motion.&lt;br /&gt;Example: The teres minor and infraspinatus neutralize the internal rotation force created by the pectoralis major during horizontal adduction of the shoulder.">Neutralizers</a>: <a href="https://brentbrookbush.com/articles/muscular-anatomy/gluteus-minimus/">Gluteus minimus</a> and <a href="https://brentbrookbush.com/articles/muscular-anatomy/gluteus-medius/">anterior fibers of gluteus medius</a> neutralize external rotation force of <a href="https://brentbrookbush.com/articles/muscular-anatomy/gluteus-maximus/">gluteus maximus</a></li>
 	<li><a class="glossaryLink " style="box-sizing: border-box; font-family: roboto; color: #000000 !important; font-size: 15px; outline: none; background: transparent; border-bottom: 1px dotted #000000 !important; text-decoration: none;" title="Glossary: Stabilizer" href="https://brentbrookbush.com/glossary/stabilizers/" target="_blank" rel="noopener" data-cmtooltip="&lt;div class=glossaryItemTitle&gt;Stabilizer&lt;/div&gt;Muscles whose primary role is to improve arthrokinematics by maintaining optimal alignment of joint surfaces.&lt;br /&gt;&lt;br /&gt;Most often these muscles are the most intrinsic muscles of a joint, have a larger percentage of Type I muscle fibers and are rich in proprioceptors.&lt;br /&gt;Example: The muscles of the rotator cuff act as stabilizers for most shoulder motions.">Stabilizers</a>: <a href="https://brentbrookbush.com/articles/muscular-anatomy/deep-rotators-of-the-hip/">Deep rotators of hip</a></li>
 	<li><a class="glossaryLink " style="box-sizing: border-box; font-family: roboto; color: #000000 !important; font-size: 15px; outline: none; background: transparent; border-bottom: 1px dotted #000000 !important; text-decoration: none;" title="Glossary: Fixator" href="https://brentbrookbush.com/glossary/fixators/" target="_blank" rel="noopener" data-cmtooltip="&lt;div class=glossaryItemTitle&gt;Fixator&lt;/div&gt;Muscles that act to reduce or prevent movement at proximal joints to improve force transmission.&lt;br /&gt;Example: The muscles of the core are important fixators; reducing motion of the spine/trunk to enhance force transmission between the extremities and environment.">Fixators</a>: <a href="https://brentbrookbush.com/articles/core-subsystems/intrinsic-stabilization-subsystem/">Intrinsic stabilization subsystem</a>, <a href="https://brentbrookbush.com/articles/muscular-anatomy/rectus-abdominis/">rectus abdominis</a>, <a href="https://brentbrookbush.com/articles/muscular-anatomy/internal-obliques/">internal</a> and <a href="https://brentbrookbush.com/articles/muscular-anatomy/external-obliques/">external obliques</a>, <a href="https://brentbrookbush.com/articles/muscular-anatomy/quadratus-lumborum/">quadratus lumborum</a>, <a href="https://brentbrookbush.com/articles/muscular-anatomy/erector-spinae/">erector spinae</a></li>
</ul>
&nbsp;

Example from: <a href="https://brentbrookbush.com/articles/anatomy-articles/introduction-to-functional-anatomy/kinesiology-of-the-hip/" target="_blank" rel="noopener">Introduction to Functional Anatomy: Kinesiology of the Hip</a>

Intramuscular coordination refers to the coordinated recruitment of motor units within a single muscle. This concept is used to explain increases in maximal strength and power; however, the coordinated and sequential recruitment of motor units is also essential to strength endurance and smooth coordinated motion.  Related terminology may include; motor unit recruitment, preferential recruitment, rate coding, sequence, etc..

Example: It is hypothesized that the "shaking" noted during a novice exercisers attempt at an activity like the <a href="https://brentbrookbush.com/vimeo_videos/ball-crunch-and-progressions/" target="_blank">stability ball crunch</a> may be due to relatively poor intramuscular coordination. Rather than smooth, sequential firing of rectus abdominis motor units, groups of motor units turn on and off in an uncoordinated manner.

Pertaining to the same side

Example, the quadratus lumborum performs ipsilateral flexion; lateral flexion toward the same side as the muscle.

An isoform, or variant, is a member of a set of similar proteins, that originate from the same gene, or gene family.
<ul>
 	<li>Example, the variations in myosin heavy chain proteins (MHC I, MHC IIA, MHC IIB/X) that contribute to the characteristic differences between muscle fiber types.</li>
</ul>

“The Prime Assumption”
Everything crossing a joint will influence joint motion during every joint action.

A concept that has expanded over the past several decades to describe the integration of 4 body systems (muscle, joints, fascia and nerves), as well as, the coordinated function of various body segments (e.g. hip, knee and ankle) to produce motion. Kinetic referring to motion, and chain being an analogy for the interdependent link between systems.

Example, the posterior kinetic chain, refers to the integrated function of nerves, muscles, fascia and joints on the posterior side of the body.

The concept of the kinetic chain was originally adapted from the work of a mechanical engineer named Franz Reuleaux (Kinematics of Machinery (1875)) by Dr. Arthur Steindler in 1955 (Steindler A: Kinesiology of the Human Body. Springfield, IL, Charles C. Thomas Co.. 1955).

Latent Trigger Point - A myofascial trigger point that is not painful at rest, only painful when palpated, and may or may not exhibit a characteristic referral pain pattern when palpated.  Latent trigger points do result in an acute point of sensitivity, in a taut band of muscle, and may restrict range of motion (1).

Note: Based on the clinical experience, the Brookbush Institute suggests that latent trigger points (sometimes refereed to as Tender Points) are more common than active trigger points. Further, they are likely addressed more often than trigger points; being the intended target of many soft-tissue mobility techniques.
<ol>
 	<li>David G. Simons, Janet Travell, Lois S. Simons, Travell &amp; Simmons’ Myofascial Pain and Dysfunction, The Trigger Point Manual, Volume 1. Upper Half of Body: Second Edition,© 1999 Williams and Wilkens</li>
</ol>

An anatomical direction; further from the midline

Example, the anterior deltoid is lateral to the pectoralis major

Length/Tension Relationship - The amount of force generated by a muscle is dependent on sarcomere length.
<ul>
 	<li>The ability of sarcomere to maximally produce force occurs when sarcomere length results in optimal overlap between actin and myosin. Stretching a sarcomere decreases overlap between actin and myosin filaments and reduces force production (1-3). When length is less than optimal, actin from opposite ends overlap and interfere with cross-bridging, and myosin filament are compressed as they contact the the Z-disk also reducing force (4)</li>
</ul>
<ol>
 	<li>Gordon, A. M., Huxley, A. F., &amp; Julian, F. J. (1966). The variation in isometric tension with sarcomere length in vertebrate muscle fibres. The Journal of physiology, 184(1), 170-192.</li>
 	<li>Edman, K. A. P. (1966). The relation between sarcomere length and active tension in isolated semitendinosus fibres of the frog. The Journal of Physiology, 183(2), 407-417.</li>
 	<li>Lieber, R. L., Loren, G. J., &amp; Friden, J. (1994). In vivo measurement of human wrist extensor muscle sarcomere length changes. Journal of neurophysiology, 71(3), 874-881.</li>
 	<li>Lieber, R. L. (2002). Skeletal muscle structure, function, and plasticity. Lippincott Williams &amp; Wilkins.</li>
</ol>
&nbsp;

Levels of Evidence - Relative to evidence-based practice, levels of evidence are an attempt to describe the strength of the results measured in a clinical trial or research study.  Note: levels of evidence do not supersede the critical evaluation of an experienced professional, and should be viewed as guidelines - a meta-analysis may be poorly constructed (Level IA), and a comparative study (Level III) may employ new technologies and a strong methodology.


The Levels of Evidence used by the Brookbush Institute, as described by Shekelle et al.(1):
<ul>
 	<li class="p1">IA - Evidence from meta-analysis of randomized controlled trials</li>
 	<li class="p1">IB - Evidence from at least one randomized controlled trial</li>
 	<li class="p1">IIA - Evidence from at least one controlled study without randomization</li>
 	<li class="p1">IIB - Evidence from at least one other type of quasi-experimental study</li>
 	<li class="p1">III - Evidence from non-experimental descriptive studies, such as comparative studies, correlation studies, and case-control studies</li>
 	<li class="p1">IV - Evidence from expert committee reports or opinions or clinical experience of respected authorities, or both</li>
</ul>
<ol>
 	<li>Shekelle, P. G., Woolf, S. H., Eccles, M., &amp; Grimshaw, J. (1999). Developing clinical guidelines. Western Journal of Medicine, 170(6), 348.</li>
</ol>

Likelihood Ratios - Likilihood ratios are used for assessing the value of performing a diagnostic test. They use sensitivity and specificity to determine whether a test result usefully changes the practitioner's chance (probability) of reaching the correct assessment. Calculation of likelihood ratios is based on Baye's theorem.
<ul>
 	<li>Positive Likelihood Ratio (LR+) - The ratio of a positive test result in people with the pathology to a positive test result in people without the pathology.</li>
 	<li>Negative Likelihood Ratio (LR-) - The ratio of a negative test result in people with the pathology to a negative test result in people without the pathology.</li>
</ul>

Longitudinal Study - a research design that involves observing the same variables, several times over a period of time.
<ul>
 	<li>Example, the study by Hewett et al. (1) is a type of longitudinal study called a "cohort study." This study investigated whether excessive knee valgus during landing was a predictor of knee injury risk in adolescent females over the course of a season.</li>
</ul>
<ol>
 	<li><a href="https://brentbrookbush.com/articles/research-corner/knee/research-review-increased-valgus-during-landing-predicts-acl-injury-in-adolescent-female-athletes/" target="_blank" rel="noopener noreferrer">Hewett, T. E., Myer, G. D., Ford, K. R., Heidt, R. S., Colosimo, A. J., McLean, S. G., &amp; Succop, P. (2005). Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes A prospective study. The American journal of sports medicine, 33(4), 492-501</a></li>
</ol>

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