Name: Overhead Squat Assessment 13 - Sign Clusters: Upper Body Dysfunction
Uploaded: 2023-04-26T01:02:06.000Z
Duration: 9 min 11 s

English captions

https://stream.mux.com/u2AU01AH3102CBH00wM3F1iGMwYXVKEKCih6dYWqdzgdVc.m3u8

Learn how to identify and assess upper body dysfunction using the overhead squat assessment in this comprehensive step-by-step instructional video from the Brookbush Institute. This evidence-based video provides expert guidance on recognizing common upper body sign clusters, interpreting compensations of the shoulders, thoracic spine, and upper extremities, and understanding how these patterns contribute to pain and movement inefficiency. Develop the skills needed to trace observed dysfunctions back to their potential root causes and inform corrective exercise strategies. Perfect for clinicians, fitness professionals, and rehabilitation clients seeking to enhance movement assessment skills, improve upper body analysis, and optimize performance while reducing injury risk.

Understanding Upper Body Dysfunction Patterns

Identifying Key Indicators of Dysfunction

Modifications to Assess Dysfunction

Effects of Latissimus Dorsi on Pelvic Tilt

Integration of Corrective Exercise Strategies

Enhancing Assessment and Correction Techniques

Overhead Squat Assessment 13 - Sign Clusters: Upper Body Dysfunction

This is Brent and in this video, it's our second video taking the overhead squat assessment up a notch, going from recognizing just sign by sign dysfunction to recognizing these common patterns, or these clusters of signs. So in this video we're going to go over the cluster of signs that leads me to believe somebody has the compensation pattern upper body dysfunction. I'm going to have Melissa come out, she's going to help me demonstrate this. Now I'm going to throw this out here right now guys, this is not Melissa's natural compensation pattern, so she's going to face fake it a lot. I'm going to have her dramatize stuff a lot. We will in the future do some case study videos where you guys see very real compensation patterns. Alright so first things first I'm going to set her up the same way, I know you guys can't see your feet but I want her toes turned, second toe pointing forward, her feet hip-width underneath her ASIS, she's going to throw her arms up. Now I mentioned this in the signs of dysfunction video with arms fall, if somebody can't even get to their arms up to in line with their torso, you check that box. If as soon as somebody throws their arms up their shoulders elevate, you check that box. If they already have an anterior pelvic tilt as soon as they throw their arms up, you check that box. Now those are the three big signs that lead me to believe that somebody has upper body dysfunction. The one problem we have and you can go ahead and do a squat for us here, we would most most of the time we would see somebody's arms fall either forward, or they do that like little mini lat pulldown thing or their elbows bend, and they kind of come down this way, that happens right. So let me have you a lateral view, then a lateral view we have this tendency to see arms fall and then her lats sometimes pull her into an anterior pelvic tilt. Alright and then in the posterior view, now this is super super rare, every once in a while I'll see this, like one arm fall way farther than the other, and actually get pulled into a little bit of an asymmetrical weight shift. So let's say it's this arm the falls down a little further, and she kind of does a weight shift this way, that's really rare that an asymmetrical weight shift would come from upper body dysfunction, but it does happen. Alright so the only thing I have to figure out about this dysfunction, what got me a little boggled right now, is if Melissa presents with both arms fall forward and an anterior pelvic tilt, both of those signs could come from over activity of her latissimus dorsi. However her latissimus dorsi is involved in both lumbo-pelvic hip complex dysfunction as well as upper body dysfunction. In order for me to figure out a accurate effective corrective exercise strategy I need to know which one I'm going to go after. Alright if the lats are coming from upper body dysfunction, then it's going to be shoulder scapula thoracic spine stuff i'm working on, maybe some cervical spine as opposed to if lats are tight because of lumbo-pelvic hip complex dysfunction, I got to go after hip flexors, lumbar extensors, hip, SI joint, lumbar spine are going to be involved. How do I figure this out, well same thing we did with the other video we just did with lower leg dysfunction, I do a squat with modification and see if the signs go away. So actually for upper body dysfunction the only thing I really need to see in modification, is hands on the hips and a lateral view. Now first things first I'm going to have Melissa go ahead and just do a squat for me, and you guys will see that her anterior pelvic tilt does not go away, that's coming from lumbo-pelvic hip complex dysfunction; by putting her arms down I shortened her lat, so it's not her lat pulling her into an anterior pelvic tilt it's lumbo-pelvic hip complex dysfunction pulling her to an anterior pelvic tilt. Now if she had true upper body dysfunction, her arms were falling forward, she had an anterior pelvic tilt, and when she did this assessment that anterior pelvic tilt went away, that's coming from upper body dysfunction. It is actually her lats that are causing that dysfunctional pattern. Now the one strange thing that you will often see with these people who have true upper-body dysfunction, is do the lats being overactive, the global stabilizers becoming synergistically dominant at the core, once I take the lats out of the movement, and I'm going to have Melissa try to demonstrate this, they'll squat and collapse in the upper body, they'll go into a further excessive forward lean or you'll actually see trunk flexion, or rounding of the back here, guys that's still upper body dysfunction. I know it looks like a totally different set of signs, it's just kind of how this whole dysfunctional pattern works out. That the intrinsic stabilizers shut down, lats and anterior oblique subsystem become overactive. So when I take the lats out of it, the anterior oblique subsystem takes over and either crunches them for forward, or crunches their lumbar spine and thoracic spine. Thank you Melissa. So hopefully you guys got how this cluster of signs work. The one thing I wanted to mention is the shoulder girdle elevation guys, that -this thing that I went over in a previous video, that is an upper body dysfunction sign. You don't have to do a squat with modifications to find out if that's an upper body dysfunction sign, that is only related to upper body dysfunction; however more often than not you will see if somebody's arms fall that with modification it truly comes from upper body that this is included. Now just like our previous video, I know this looks like a lot of signs to try to figure out, but really when you smash out all the stuff together you realize there's a lot of overlap, and rather than getting a huge corrective exercise strategy you get a corrective exercise strategy that's a few muscles longer but way more effective. So you can see here on the overactive side, actually all I've done is take this overactive scapulae muscles and add them to the overactive shoulder muscles all right. Subscapularis should be up there as well guys that's my apology, and you guys will notice that I have anterior oblique subsystem because now that I've started to look that this is a cluster of signs, as I started to look at the entire upper body, I get to investigate some of those more interesting relationships, where you have the lats into the thoracolumbar fascia, and the thoracolumbar fascia is also integrated into the intrinsic stabilization subsystem; and we get to consider all of that once we get to look at multiple joints. So in this particular dysfunction we have a AOS overactive. That's going to play a role in like if I know that this is overactive, maybe somebody who has upper body dysfunction probably shouldn't be doing crunches. Maybe planks are kind of off the menu until we get this more corrected. Under- active, external rotators, lower traps, serratus anterior, and then this crunching forward comes from that intrinsic stabilization subsystem taken out, due to global muscular dominance, and to get them straightened back out and then start integrating that posterior oblique subsystem. Once again this is stuff that I get to look at because I'm integrating all of these signs together. Now there is an article at brentbrookbush.com under postural dysfunction and movement impairment on upward up per body dysfunction, and you guys can see me rip this thing apart and go into arthrokinematics, and go into all of the muscles, and all of the muscles are hyperlinked to muscular articles, and those articles have techniques for each muscle that you would use based on the activity of length of all of these structures. I think what you guys are going to find by taking the jump from signs to patterns, is all of a sudden you are going to get much better correction in one session. You're going to have that person who arms fell forward, shoulders elevate, anterior pelvic tilt, once you do all of this they do a squat and feel a lot better in one session. I think you're going to see your outcomes get better, your carryover from session to session get a lot better, and I know that's something that all of us are working on. We don't just want somebody to get better, but then the next time they come back to us they still have 50 or 75 percent of the changes we made from the previous session, so that we can keep taking steps forward. I hope you guys enjoyed this video, I hope you take a huge step in your assessment capabilities, and that has a huge impact on your program, talk to you soon.

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An explanation of common groupings of movement compensation signs ("clusters") in the overhead squat assessment (OHSA) and OHSA w/ modification. Solutions tables for lower leg, upper body, lumbopelvic hip complex, posterior pelvic tilt (posterior pelvis), and sacroiliac joint dysfunction (including asymmetrical weight shift). A breakdown of related joint actions and the overactive and underactive muscles.

Overhead Squat Assessment: Sign Clusters and Compensation Patterns

Excessive lordosis (Anterior pelvic tilt)

 . The "OHSA with Modification" is used to differentiate between these two compensation patterns.

OHSA with Modification - Arms Down (Hands on Hips)

Perform OHSA as described in the article 

Carefully note all "signs" as described in the courses 

Overhead Squat Assessment: Signs of Dysfunction

Ask the patient/client to place their hands on their hips (arms down).

Perform the OHSA again with "modification" ("arms down"), carefully noting all "signs" still present.

Note: For most cases, the OHSA with Modification can be performed once, with both "heel rise" and "arms down", to determine what signs are still present and originating from 

 . For most, "heel rise" will not have an impact on upper body signs, and conversely, "arms down" will not have an impact on lower extremity signs.

Squat with Modification - Arms Down (Hands on Hips)

Arms Down (Hands on Hips) Rationale: If the 

 is short/over-active it may contribute to an 

 over-activity may originate from either dysfunction. By placing the hands on the hips (

 are placed in a "shortened" positioned reducing their capacity to contribute to the OHSA and the observed dysfunction.

 is present during the OHSA, but not present during the OHSA with Arms Down, 

 we may assume that dysfunction originates from 

 is present during the OHSA, and still present during the OHSA with Arms Down, 

 improves but is still present during the OHSA with Arms Down, 

 we may assume that dysfunction originates from both 

Note: The OHSA with Arms Down Modification may produce an additional sign "Trunk Flexion" and/or an increase in 

 . It has been our experience that these signs are related to 

 and can be best explained by dominance of the 

Overhead Squat Assessment 13 - Sign Clusters: Upper Body Dysfunction

Overhead Squat Assessment 16 - Sign Clusters: Posterior Pelvic Tilt ("Butt Wink") and Inadequate Forward Lean Breakdown

Overhead Squat Assessment 15 - Sign Clusters: Asymmetrical Weight Shift

Overhead Squat Assessment 14 - Sign Clusters: Lumbo Pelvic Hip Complex Dysfunction

Overhead Squat Assessment 12 - Sign Clusters: Lower Leg Dysfunction

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