Name: Overhead Squat Assessment 5 - Feet Turn Out Breakdown
Uploaded: 2023-04-26T01:01:54.000Z
Duration: 5 min 18 s

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https://stream.mux.com/Mufj302zC00YHys1arrUteLi020202do7K9NJTxKDpdjisoM.m3u8

Learn how to identify and interpret the sign feet turn-out 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 evaluating foot placement, recognizing compensatory movement patterns, and understanding how altered foot and ankle mechanics influence knee alignment, hip function, and overall movement quality. Develop the skills needed to accurately assess the sign feet turn-out, to inform corrective exercise and mobility strategies, and improve movement efficiency. Perfect for clinicians, fitness professionals, and rehabilitation clients seeking to enhance movement assessment accuracy, optimize lower-extremity mechanics, and reduce injury risk.

Introduction to Overhead Squat Assessment

Identifying Foot Turnout Dysfunction

Understanding Muscle Imbalances and Joint Actions

Techniques for Addressing Overactive Muscles

Activating Underactive Muscles for Correction

The Role of Dorsiflexion in Lower Leg Dysfunction

Conclusion and Exercise Selection Guidance

Overhead Squat Assessment 5 - Feet Turn Out Breakdown

This is Brent coming at you with another overhead squat assessment video. In this video we're going to go after the dysfunction feet turn out. I'm going to have my friend Leanne come up and help demonstrate this. This is a fairly easy sign to see. I don't think you guys generally have a problem identifying this sign of dysfunction. If she starts off parallel with second toe pointing forward and she's in an anterior view, what we're going to see during the overhead squat is her feet turned out, and Leanne makes this look very easy because this is her natural compensation pattern. She's not just doing this to demonstrate for you guys, I know she's exaggerating a little bit. The only hard thing you guys might see is believe it or not guys, just going from second toe to first toe pointing forward is feet turn out, and as I've said in previous videos I know you guys are thinking, really that's dysfunction that little tiny bit. Look if you can gain performance from correcting that, if you can reduce the risk of injury by correcting that by even a little bit, go for it, what do you have to lose. Thank you Leanne for demonstrating that. Now the question is where do I go with this information. Great i have somebody with feet turn out, i have to go back to my five-step process of determining which muscles are short, which muscles are long. So feet turn out, what joint action does that imply? This is the tricky part. It actually implies tibial external rotation. Really at the ankle guys you don't have much of this turnout motion. Most of it happens at the knee as the tibia turns out this way. So now we have to ask ourselves this question what are my tibial external rotators? Well it's going to be my TFL, yes this muscle way up here actually turns out my tibia via my iliotibial band. Now invested in my iliotibial band which will also tighten the structure is my vastus lateralis, you guys can look at the TFL, VL, ITB as kind of like a little group. I know many of you guys have heard that thought of foam roll your iliotibial band, this doesn't exist. You're a iliotibial band isn't contractile tissue, it can't develop trigger points, it can't develop things that we need to release, so what we're going to go after is this group. You guys are still using the same technique, you're just actually affecting the tensor fascia lata and vastus lateralis that's underneath. The other structures we want to affect that are short and overactive here, is the biceps femoris and lateral gastroc. These together will drive that tibia outward if short and overactive. Once again if things are short and overactive we want to tone them down and lengthen them. To tone them down you guys are going to look towards those self-administer release and self-administered active release techniques that you guys can look up by muscle, and then you're going to lengthen them. Generally if we're doing corrective exercise strategies with static stretching, to be progressed into active and dynamic stretching later, but we're not done, we have to turn around and we have to get at those long structures. So if i do tibial external rotation then my tibial internal rotators are now long and under active. Right to list those muscles my tibial internal rotators would actually be my gracilis, my semi's that semitendinosus and semimembranosus, and my popliteus, as well as my medial gastroc. Now you guys notice a big bracket here, we're going to activate these as a group. You guys can find the activation video for this under tibial internal rotator activation, that's one exercise that affects all of these muscles. In order to activate the medial gastroc we don't actually have specific medial gastroc activation, what we have is posterior tib activation that would also include medial gastroc, and start to increase the activity of this muscle to help increase the firing rate, and then of course improve our dysfunction. Last segment with this, and I know this is kind of a complicated one, don't be surprised if what's driving this lower leg dysfunction is a lack of dorsiflexion. And as I went over in a previous video, a lack of dorsiflexion is going to be caused by tight plantarflexors, your calves and weak dorsi flexors being your anterior tib. If you think that that's occurring here what you would add to this list is then calf release and stretch, and tibialis anterior activation. I hope this breakdown helps you guys come up with better exercise selection. I hope that exercise selection produces great results. I'll look forward to seeing you guys in the next overhead squat breakdown.

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Overhead Squat Assessment: Signs of Dysfunction

 to indicate the objective of the assessment or the signs you are attempting to identify. We do not want the client/patient attempting to "fix" their alignment.

Ask your patient/client to stand with feet hip-width apart.

Because a patient/client may assume a range of comfortable foot positions, it may be necessary to cue and manually adjust foot position so that the OHSA is started with the ideal foot position (or as close to the ideal foot position as can be achieved).

Ask your patient/client to reach "straight up over their head" with "elbows locked".

Ask your patient to "sit down" and "stand up" as many times as necessary to assess for the "signs of dysfunction".

 For those who do not know how to squat or may be at risk of falls, this can be done with a chair, and thought of as a "sit-to-stand transfer assessment".

 For advanced exercises and athletes who may "know what a squat should look like", it may be helpful to have them close their eyes, reducing visual input and their ability to self-correct

 It is tempting to start noting every "deviation" based on a personal frame-of-reference of squat form. The only signs that have been correlated with dysfunction and successful intervention are the signs discussed below. Adding additional signs to the assessment, however well-intentioned, may serve to invalidate the assessment, reduce assessment reliability, or reduce the relative efficacy of the implied interventions.

As mentioned above, this assessment is designed to highlight deviations from ideal motion with the intent of informing intervention selection. It may be helpful to review the definition (discussed above) of 

Evidence-based Ideal Posture/Alignment Definition:

 A mean range of segment alignment (bone, joint, muscle, nerve) that is absent of signs correlated with dysfunction, pain, or an increased risk of injury.

The ideal alignment described here is similar to what may be anticipated during a static postural assessment or gait assessment. However, additional details have been added to aid in differentiating between ideal motion and the deviations discussed below.

 Ideal alignment includes feet parallel (2nd metatarsal and toe pointing forward), hip width, and the medial longitudinal arch maintained. That is, the 2nd metatarsals (center of the foot) are parallel, in alignment with the hip joints which are inferior to the anterior superior iliac spine (ASIS), and significant inferior motion of the navicular tubercle is not observed.

Although the neck of the femur extends the greater trochanter laterally and gives the appearance that the hip joints extend to the lateral thigh, the hip joints are only about 7" apart (6). This is about the same width as the ASIS, and the hip joints are in fact, just inferior and in near alignment with the ASIS. Because the hip joints cannot be palpated, the ASIS are used as the reference for hip width.

 The knees should maintain alignment with the hip joint and ankle joint. If optimal foot position is maintained, the anterior and posterior motion of the patella during the squat should align with the 2nd and 3rd metatarsals.

 Ideal alignment includes an optimal lumbar curve, ASIS just inferior to the level of the posterior superior iliac spine (PSIS) (within 2 cm), and the right and left iliac crest level.

During the lateral view of the OHSA, the intersection of the mid-axillary line, and a line between the ASIS and PSIS should be near 90º.

 The tibia and the mid-axillary line should maintain near-parallel alignment during a squat.

 Ideal alignment includes depression and retraction of the scapula. Shoulder flexion should be achieved via upward rotation and posterior tipping of the scapula.

 Ideal alignment is maintaining the arms in alignment with the torso with elbows at terminal extension. That is, 180º of shoulder flexion should be maintained.

Overhead Squat Assessment 5 - Feet Turn Out Breakdown

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

Overhead Squat Assessment 11 - Shoulders Elevate

Overhead Squat Assessment 10 - Arms Fall

Overhead Squat Assessment 9 - Anterior Pelvic Tilt (Excessive Lordosis)

Anterior Pelvic Tilt Break Down (Workshop Snippet)

Overhead Squat Assessment 8 - Excessive Forward Lean

Overhead Squat Assessment 7 - Knees Bow Out

Overhead Squat Assessment 6 - Knees Bow In Breakdown

"Feet Turn Out" Breakdown

Overhead Squat Assessment 4 - Feet Flat Breakdown

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