Name: Overhead Squat Assessment 8 - Excessive Forward Lean
Uploaded: 2023-04-26T01:03:06.000Z
Duration: 5 min 20 s

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https://stream.mux.com/WmfMp02BEDTnCzO9m02f1eoBzTGPJr21EVG4zlSqFiJtY.m3u8

Learn how to identify and interpret excessive forward lean 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 trunk positioning, hip flexion mechanics, and lumbopelvic control during the squat. Develop the skills needed to recognize compensatory forward trunk displacement associated with mobility and stability impairments of the ankles, hips, and core. Inform corrective exercise and manual therapy strategies to improve squat mechanics, postural control, and movement efficiency. Perfect for clinicians, fitness professionals, and rehabilitation clients seeking to enhance movement assessment accuracy, optimize trunk stability, and reduce injury risk.

Understanding Excessive Forward Lean in Overhead Squats

Identifying Causes Behind Forward Lean During Squats

Muscle Imbalances and Activation Techniques

Corrective Strategies for Excessive Forward Lean

Overhead Squat Assessment 8 - Excessive Forward Lean

This is Brent coming at you with yet another overhead squat assessment video. In this video we're going to go over the excessive forward lean, a very very common sign which I'm sure you've all seen before. I'm gonna have my friend Leanne step out. Leanne is going to help us demonstrate an excessive forward lean. The first things you're going to notice is that Leanne actually steps so we can see sideways, right. This is one of those signs we see from a lateral view. I'm still going to set her up the same way, second toe pointing forward, two feet underneath her hips, and her arms are up over her head, and then when she does that I'm going to go ahead and have her squat. Now an excessive forward lean is based on the tibia torso angle. Her tibia and torso should line up parallel to one another. Now to help you guys visualize, I'm going to go ahead and line these dowels up. So there's her tibia anglem there's her torso angle, and as you guys can see, those two lines meet. So by definition they're not parallel, and Leanne has a excessive forward lean. So very very common impairment. I think you guys are going to see often. Thank you Leanne for demonstrating. Sometimes you guys will see something far worse than that, where people almost look like they're pancaking over, and sometimes it won't be that bad, and maybe you are going to have to break out a couple dowels or broom sticks, or whatever you guys got at your club, to kind of help you see whether that excessive forward lean is coming out. Now this isn't a terribly hard dysfunction to start correcting, it's not a terribly hard dysfunction to analyze, as soon as you know what's driving it. Now I know most of you guys are probably thinking excessive forward lean, well that's excessive hip flexion, but we actually have to take one more step back from that. What's actually driving that hip flexion is the inability of my knees to track forward. Now the inability of my knees to track forward is a lack of dorsiflexion. So the same joint action that causes my feet to come up, alright is the joint action that allows my tibias to come this way, so dorsiflexion foot on tibia, dorsiflexion tibia on foot. Since I can't track my knees forward, here's what happens. I can't track my knees forward, which means as I squat my backside gets further and further behind me, which is where my center of mass is located right. My core, once it goes past my base of support, I end up having to throw all of my upper body mass forward to maintain balance over my feet, so that's what's actually driving this dysfunction, is that lack of dorsiflexion, which then causes the excessive hip flexion. Now a lack of dorsiflexion is the same thing as excessive plantar flexion for our analysis purposes. So now we're right back to the same five steps that we've been going through on every video, Excessive forward lean equals excessive hip flexion, and excessive plantar flexion. You guys know your hip flexors, TFL, psoas and iliacus, rectus femoris, adductors. You're going to release these muscles. Save the psoas, we don't want to try self-administered release techniques on the psoas, but we'll release all of our other hip flexors. Then we'll start doing our hip flexor stretches, plantar flexors. You guys know your plantar flexors, your plantar flexors are your calves. Make sure you stretch calves in these individuals, all right you want to release and stretch. You see an excessive forward lean first thing you want to put them on is softball on those calves, as well as maybe a slant board. As far as what's under active, this gets a little tricky we're going back to some of this synergistic dominance. You guys probably have heard this phrase before this idea, before in excessive forward lean, you have hip extensors as long and under active, they're on this side of the graph, but once you get past the glutes and the semis you end up with two muscles that take on this weird relationship. They become long, but they get overactive. What that means is you can release these muscles for their over activity, but you don't want to stretch them just because they're overactive. You don't want to just go ahead and stretch and lengthen them because they're overactive. You also don't want to activate them. If you guys get somebody in an excessive forward lean big muscle to think about is actually the glute max. So you guys can kind of forget the other muscles that will extend the hip. If you're trying to correct this dysfunction and keep going after the glute macx with your isolated activation techniques, dorsiflexion of course is a huge important thing to gain back. You guys are going to want to continue to go after the tibialis anterior, and if you don't know some good tibialis anterior activation by now, I would definitely recommend you guys looking up those videos putting them in your repertoire, because you can definitely correct a lot of these lower leg dysfunction problems, by learning how to get this guy going. I hope you guys learned a lot from this video. I hope you guys understand excessive forward lean and get great outcomes, thank you.

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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 8 - Excessive Forward Lean

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 7 - Knees Bow Out

Overhead Squat Assessment 6 - Knees Bow In Breakdown

Overhead Squat Assessment 5 - Feet Turn Out Breakdown

"Feet Turn Out" Breakdown

Overhead Squat Assessment 4 - Feet Flat Breakdown

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