Upper Body Dysfunction (UBD)

Upper Body Dysfunction (UBD) is an edit and update of previous postural dysfunction models (e.g. Upper-crossed Syndrome, Rounded Shoulder Posture, Protracted Shoulder Girdle, etc.). It is important to recognize that in these models the term "posture" is being used as an analogy for "ideal alignment". Similarly, when movement professionals refer to upper body posture, good posture, poor posture, better posture, etc. they are referring to this analogy of ideal alignment; not the rigid positioning implied by the colloquial use of the term "posture."

Postural dysfunction and movement impairment syndromes are likely the beginning of "modeling". Modeling has significant potential to aid in refining clinical decision-making, intervention selection, program design, and improve the reliability and effect size of outcomes. It is particularly helpful for aiding in the interpretation of multi-variant problems, which is how all clients and patients present. The Brookbush Institute recommends that all sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.) consider these models to aid in refining decision-making in practice.

Additional Models:

• Lumbo Pelvic Hip Complex Dysfunction (LPHCD)
• Lower Extremity Dysfunction (LED)

Definitions:

• Posture: Arthro- and osteo-kinematics alignment maintained by optimal myofascial activity and length, as a result of sensation, integration, and activation by the nervous system - both statically and dynamically.
• Postural Dysfunction: The absence of ideal posture as a result of maladaptation by one or multiple tissues within the human movement system.
  • Brookbush Institute Modern Definition: Modeling patterns of movement impairment correlated with orthopedic dysfunction, based on all available evidence, with the intent of predicting best-practice assessments and techniques, to optimize measured outcomes.

Summary:

Altered Mobility and Activity

Overactive (Release and Stretch):

• Pectoralis Minor
• Levator Scapulae
• Rhomboids
• Latissimus Dorsi
• Teres Major
• Subscapularis
• Posterior Deltoid
• Upper Traps
• Coracobrachialis
• Biceps Brachii
• Anterior Oblique Subsystem

Underactive (Activate and Integrate):

• Lower Traps
• Serratus Anterior
• Infraspinatus
• Teres Minor
• Long Head of Triceps
• Intrinsic Stabilization Subsystem
• Posterior Oblique Subsystem

Fascia (Reduction in Extensibility)

• Clavipectoral Fascia
• Cervicothoracic fascia
• Thoracolumbar fascia
• Abdominal fascia

Arthrokinematics

• Anterior Tipping: SC joint, AC Joint & Scapula
• Excessive Kyphosis: Thoracic Spine and Costal Joints
• Hypo or Hypermobility: Glenohumeral Joint
• Forward Head Posture: Cervical Dysfunction
• Elevation and Stiffness: First and Second Rib

Signs of Dysfunction

Overhead Squat Assessment :

• Arms Adduct (Arms Fall)
• Arms Fall Forward (Arms Fall)
• Scapula Elevate
• Anterior Pelvic Tilt (Excessive Lordosis)
• Spine/Trunk Flexion during "Overhead Squat with Modification: Arms Down"
• Asymmetrical Weight Shift (Unilateral Upper Body Dysfunction is rarely the cause of an asymmetrical weight shift, but it does occur. It is more likely that an asymmetrical weight shift is caused by LPHC Dysfunction, Sacroiliac Joint Dysfunction , or unilateral Lower Leg Dysfunction )

Goniometric Assessment

• Shoulder Flexion < 180-190°
• Shoulder Extension < 20-25°
• Shoulder Internal Rotation < 70°
• Shoulder External Rotation < 95-100°
• Cervical < 35-45°

Muscle Length Tests

• Lat Length Test
  • External Rotation Goniometry for Differentiation

Manual Muscle Tests

• Deep Cervical Flexors
• Shoulder External Rotators
• Lower Trapezius
• Serratus Anterior

Correlated Injuries, Pathologies, and Pain

• Impingement Syndrome
• Thoracic Outlet Syndrome
• DDD in cervical and thoracic spine
• Facet joint dysfunction in cervical and thoracic spine
• Sternocostal dysfunction
• Radiculopathy
• Neuritis (median, ulnar, radial nerve distributions)
• Chronic Glenohumeral Instability
• Adhesive Capsulitis
• Glenohumeral Osteoarthritis
• Hyperkyphosis
• Scapular Winging
• Supraspinatus and biceps tendonitis
• Subacromial bursitis
• Suprascapular trigger point
• Mid thoracic trigger points
• Epicondylitis
• Pain:
  • Shoulder
  • Neck
  • Thoracic Spine
  • Low Back
  • Elbow
  • SC or Sternocostal joint