0:05 This is Brent and in this video, it's our second video taking the overhead squat 0:10 assessment up a notch, going from recognizing just sign by sign 0:14 dysfunction to recognizing these common patterns, or these clusters of signs. So 0:20 in this video we're going to go over the cluster of signs that leads me to 0:24 believe somebody has the compensation pattern upper body dysfunction. I'm going 0:29 to have Melissa come out, she's going to help me demonstrate this. Now I'm going 0:33 to throw this out here right now guys, this is not Melissa's natural 0:37 compensation pattern, so she's going to face fake it a lot. I'm going to have her 0:41 dramatize stuff a lot. We will in the future do some case study videos where 0:46 you guys see very real compensation patterns. Alright so first things first 0:51 I'm going to set her up the same way, I know you guys can't see your feet but I want her 0:54 toes turned, second toe pointing forward, her feet hip-width underneath her ASIS, 0:59 she's going to throw her arms up. Now I mentioned this in the signs of 1:03 dysfunction video with arms fall, if somebody can't even get to their arms up 1:08 to in line with their torso, you check that box. If as soon as somebody throws 1:14 their arms up their shoulders elevate, you check that box. If they already have 1:20 an anterior pelvic tilt as soon as they throw their arms up, you check that box. 1:24 Now those are the three big signs that lead me to believe that somebody has 1:30 upper body dysfunction. The one problem we have and you can go ahead and do a 1:36 squat for us here, we would most most of the time we would see somebody's arms 1:40 fall either forward, or they do that like little mini lat pulldown thing or their 1:45 elbows bend, and they kind of come down this way, that happens right. So let me 1:50 have you a lateral view, then a lateral view we have this tendency to see arms 1:56 fall and then her lats sometimes pull her into an anterior pelvic tilt. Alright 2:03 and then in the posterior view, now this is super super rare, every once in a 2:09 while I'll see this, like one arm fall way farther than the other, and actually 2:14 get pulled into a little bit of an asymmetrical weight shift. So let's say 2:18 it's this arm the falls down a little further, and 2:21 she kind of does a weight shift this way, that's really rare that an asymmetrical 2:25 weight shift would come from upper body dysfunction, but it does happen. Alright 2:29 so the only thing I have to figure out about this dysfunction, what got me a 2:34 little boggled right now, is if Melissa presents with both arms fall forward and 2:39 an anterior pelvic tilt, both of those signs could come from over activity of 2:46 her latissimus dorsi. However her latissimus dorsi is involved in both 2:52 lumbo-pelvic hip complex dysfunction as well as upper body dysfunction. In order 2:59 for me to figure out a accurate effective corrective exercise strategy I 3:03 need to know which one I'm going to go after. Alright if the lats are coming 3:07 from upper body dysfunction, then it's going to be shoulder scapula thoracic 3:10 spine stuff i'm working on, maybe some cervical spine as opposed to if lats are 3:14 tight because of lumbo-pelvic hip complex dysfunction, I got to go after hip 3:18 flexors, lumbar extensors, hip, SI joint, lumbar spine are going to be involved. 3:23 How do I figure this out, well same thing we did with the other video we just did 3:28 with lower leg dysfunction, I do a squat with modification and see if the signs 3:34 go away. So actually for upper body dysfunction the only thing I really need 3:39 to see in modification, is hands on the hips and a lateral view. Now first things 3:46 first I'm going to have Melissa go ahead and just do a squat for me, and you guys 3:52 will see that her anterior pelvic tilt does not go away, that's coming from 3:56 lumbo-pelvic hip complex dysfunction; by putting her arms down I shortened her 4:02 lat, so it's not her lat pulling her into an anterior pelvic tilt it's 4:07 lumbo-pelvic hip complex dysfunction pulling her to an anterior pelvic tilt. 4:10 Now if she had true upper body dysfunction, her arms were falling 4:16 forward, she had an anterior pelvic tilt, and when she did this assessment that 4:20 anterior pelvic tilt went away, that's coming from upper body dysfunction. It is 4:25 actually her lats that are causing that dysfunctional pattern. Now the one 4:30 strange thing that you will often see with these people who have 4:34 true upper-body dysfunction, is do the lats being overactive, the global 4:40 stabilizers becoming synergistically dominant at the core, once I take the 4:45 lats out of the movement, and I'm going to have Melissa try to demonstrate this, 4:48 they'll squat and collapse in the upper body, they'll go into a further excessive 4:54 forward lean or you'll actually see trunk flexion, or rounding of the 4:58 back here, guys that's still upper body dysfunction. I know it looks like a 5:02 totally different set of signs, it's just kind of how this whole dysfunctional 5:06 pattern works out. That the intrinsic stabilizers shut down, lats and anterior 5:13 oblique subsystem become overactive. So when I take the lats out of it, the 5:16 anterior oblique subsystem takes over and either crunches them for forward, or 5:20 crunches their lumbar spine and thoracic spine. Thank you Melissa. So hopefully you 5:26 guys got how this cluster of signs work. The one thing I wanted to mention is the 5:31 shoulder girdle elevation guys, that -this thing that I went over in a previous 5:36 video, that is an upper body dysfunction sign. You don't have to do a squat with 5:41 modifications to find out if that's an upper body dysfunction sign, that is only 5:45 related to upper body dysfunction; however more often than not you will see 5:49 if somebody's arms fall that with modification it truly comes from upper 5:54 body that this is included. Now just like our previous video, I know this looks 6:00 like a lot of signs to try to figure out, but really when you smash out all the 6:04 stuff together you realize there's a lot of overlap, and rather than getting a 6:09 huge corrective exercise strategy you get a corrective exercise strategy 6:14 that's a few muscles longer but way more effective. So you can see here on the 6:22 overactive side, actually all I've done is take this overactive scapulae muscles 6:26 and add them to the overactive shoulder muscles all right. Subscapularis should 6:34 be up there as well guys that's my apology, 6:43 and you guys will notice that I have anterior oblique subsystem because now 6:49 that I've started to look that this is a cluster of signs, as I started to look at 6:53 the entire upper body, I get to investigate some of those more 6:57 interesting relationships, where you have the lats into the thoracolumbar fascia, 7:01 and the thoracolumbar fascia is also integrated into the intrinsic 7:06 stabilization subsystem; and we get to consider all of that once we get to look 7:10 at multiple joints. So in this particular dysfunction we have a AOS overactive. 7:15 That's going to play a role in like if I know that this is overactive, maybe 7:19 somebody who has upper body dysfunction probably shouldn't be doing crunches. 7:22 Maybe planks are kind of off the menu until we get this more corrected. Under- 7:22 active, external rotators, lower traps, serratus anterior, and then this 7:32 crunching forward comes from that intrinsic stabilization subsystem taken 7:37 out, due to global muscular dominance, and to get them straightened back out and 7:41 then start integrating that posterior oblique subsystem. Once again this is 7:45 stuff that I get to look at because I'm integrating all of these signs together. 7:49 Now there is an article at brentbrookbush.com under postural dysfunction and 7:54 movement impairment on upward up per body dysfunction, and you guys can see me rip 7:59 this thing apart and go into arthrokinematics, and go into all of the 8:03 muscles, and all of the muscles are hyperlinked to muscular articles, and 8:07 those articles have techniques for each muscle that you would use based on the 8:11 activity of length of all of these structures. I think what you guys are 8:15 going to find by taking the jump from signs to patterns, is all of a sudden you 8:20 are going to get much better correction in one session. You're going to have that 8:25 person who arms fell forward, shoulders elevate, anterior pelvic tilt, once you do 8:29 all of this they do a squat and feel a lot better in one session. I think you're 8:34 going to see your outcomes get better, your carryover from session to session 8:37 get a lot better, and I know that's something that all of us are working on. 8:41 We don't just want somebody to get better, but then the next time they come 8:44 back to us they still have 50 or 75 percent of the changes we made from the 8:50 previous session, so that we can keep taking steps forward. I hope you guys 8:54 enjoyed this video, I hope you take a huge step in your 8:56 assessment capabilities, and that has a huge impact on your program, talk to you 9:00 soon.
