Name: Introduction to Overhead Squat Assessment
Uploaded: 2023-12-20T05:39:28.000Z
Duration: 9 min 58 s

English captions

https://stream.mux.com/7E8SaaSSm01uxyWzFVqppTRdTiu00E1weXuS7rzEMlYw00.m3u8

Learn how to properly perform and interpret the overhead squat assessment in this comprehensive step-by-step instructional video from the Brookbush Institute. This evidence-based video provides expert guidance on assessment setup, optimal viewing angles, and key movement checkpoints to accurately evaluate lower-extremity alignment, lumbopelvic control, core stability, and upper extremity motor patterns. Develop a foundational understanding of how to assess strength, flexibility, and movement quality through the legs, hips, trunk, and arms. Perfect for clinicians, fitness professionals, and rehabilitation clients seeking to improve movement assessment skills, identify compensations, and build a framework for corrective exercise and performance optimization.

Understanding Ideal Posture for Overhead Squat Assessment

Analyzing Lower Body Alignment: Feet and Knees

Evaluating Lumbo-Pelvic Hip Complex Positioning

Correct Shoulder Girdle and Head Positioning

Setting Up for an Effective Overhead Squat Assessment

Alternative Assessment Techniques and Considerations

Introduction to Overhead Squat Assessment

This is Brent coming at you with the overhead squat assessment. Now, this is going to be a series of videos by request. In this first video, we're going to go ahead and go over what is ideal posture? What is that ideal that we're judging our overhead squat assessment against? As well as how to setup the overhead squat assessment for your patient or client, so that you know you're getting an accurate read as we go into "signs and symptoms." So I'm going to have my friend come out. Leanne is going to show us exactly what good posture looks like. Now, you guys notice I have some key words written up here. These are the key segments, or joints, that I want to look at to make sure I have everything lined up ideally. Now we start with the feet. That's because everything stacks on top of the feet, so if I were to fix her head, fix her shoulders, fix her hips, and then try to fix her feet, there is a chance I can change all of that alignment back up.  We're going to go ahead and start bottom-up. Now with the feet, there's basically three things to think about. I want them parallel, hip-width, and I want to make sure that I have some sort of medial arch, which I'll explain in a second here. So first things first, feet parallel -  let's define that term. Feet parallel is going to be second toe pointing forward. If you guys just threw your hands out in front of you, you guys will notice that it's actually your index finger that points upward, and your thumb kind of points in, so if you thought about your feet doing the same thing, it's actually second toe pointing forward. Big toe's going to point in just a little bit. I know you guys are going to see a lot of this turnout. So the next thing is going to be hip-width. Now be careful. These are not Leanne's hips. These are Leanne's thighs. This is her vastus lateralis. Her hip joint is actually just underneath her ASIS. So her ASIS, for those of you guys who are familiar with your palpations, not a hard palpation to find. You're just going to go ahead and find what most people call their hips, the top of their ilium, palpate around. You guys will notice a notch right before it become soft tissue. So, we want to make sure that the feet are in line with that ASIS. Alright, her hip joint is right behind this point. Next, I want to make sure that she has some sort of medial arch. Now, it is very helpful when you guys do your overhead squat assessment, to have somebody take their shoes off. They can probably leave their socks on unless you guys are doing some more advanced assessments, but at least the shoes off will allow you to see this little space in here. I shouldn't say, I don't know if you guys are aware, where the first metatarsal-cuneiform joint is and cuneonavicular joint is, but these bones right here, in the middle of her foot, shouldn't be touching the floor. If you guys see those bones riding on the floor, that is going to be something we notice on our assessment as a dysfunction. I want to at least try to get them set up. "Hey, can you maintain that position?" Good. Alright, the next thing we're going go to is the knees. Now in static posture, we expect her knees to be in-line. But when she moves, "if you can give me a little dip here, and give me a little quarter squat," we're going to want to see her patella track over her second and third toe. So once again, if I go back to this position with my hands, this would be analogous to the middle of my hand I want my patella to track right through the middle of my foot. Now the lumbo-pelvic hip complex, as you guys can see here,  LPHC, has several things that we're looking at, or at least four or five things that I'm looking at right off the bat. "Leanna, you can go ahead and turn sideways."  I want to number one, make sure she's in neutral. "That's okay." So I had you guys palpate the ASIS here. If I were to put this part of her pants on her ASIS, palpate around her ilium, and found this other bony notch here, which "go ahead and turn your back to the camera. There you go." You guys can see these two bony notches, being her PSIS, are actually a lot closer together than the ASIS are, but if I go ahead and put the back of her pants up on her PSIS and then I line up her pants, that gives me a good idea of whether her pelvis is level, and that's the first thing I want to notice. "Is this level? Or is she turned in a little bit," which you guys might already know, is an anterior pelvic til.  Usually what comes with that, is now we see that there's this excessive curve. We wanted a neutral curve, which we saw Leanne started with, and then as we go through the overhead squat assessment, we'll talk about something called an "excessive forward lean," and I also want to make sure that Leanne, even just standing there, has a little bit of abdominal tone. I know you guys have seen, "hate to have you do this Leanne, but go ahead and totally relax out your TVA." Alright, so you guys see those people who have like, they have no abdominal tone whatsoever. You know, they got that little, like beer belly thing going on. Like, we want just a little bit of beach belly. That should be kind of normal as were standing there. Now, next thing we're going to look at is shoulder girdle. When I sit here and I got Leanne,  "you can go ahead and face the camera." When I have Leanne getting set-up, we know that a lot of individuals have a propensity to get here with their shoulders. So I want to make sure I at least cue "shoulders down and back" to start, see if she can even get to this position. Now this is going to be a little interesting when we go into an overhead squat because I'm actually going to actually have Leanne throw her arms in the air.  Right. Elbows locked.  She's just going to go straight up, and what I want to make sure is she did exactly what she did, which is her shoulders kind of stayed down, as opposed to raising her arms like this, where you see shoulders come up to her ears, as I kind of manhandle Leanne here. The last thing I want to look for is the head, guys. "Let me have you go ahead and turn sideways." I know a lot of you guys see this forward head tilt, and we see this like, protruding chin. We want to make sure that Leanne's ear kind of lines up with her shoulder assuming that I just put her shoulder into optimal posture by cueing her down and back. Now, when you get somebody set up for this overhead squat assessment, this is what you start with. "Alright, so go ahead and turn straight." But with all that being said, you don't want to go heavy, heavy, heavy, on the cues. I don't want to cue Leanne into a million positions that she's not used to being in. I don't want to give her a million instructions. I want to get a clean assessment. So basically what I'm going to do is I'm going to set up her feet, make sure she starts with her feet parallel. I'm going to make, I'm going to kind of, check out her pelvis. I might adjust her pants so it's easier for me to see whether her pants level or not. I'm not necessarily saying anything to her. Of course, ask permission if you're going to palpate. I'm going to go ahead and say "arms up." All right, we'll check to make sure that her head's straight. Then, just go ahead and have her sit. You guys notice I didn't use a whole lot of words. It's like, "okay, feet parallel. Good. Hands up, and go ahead and sit back for me." About all the cues I want to give. Alright.  So, once we get into the next video and I talk about common postural dysfunctions and the common signs we'll see, we'll talk about how we're going to notate all this stuff. Now, a couple things you do have to be aware of. These things can destroy your squat assessment. Somebody has to be able to keep their heels on the floor. Every once in awhile, "let me go ahead and you turn sideways." You'll see somebody, "can you squat and let your heels come up?" Have you ever seen that? Right? Every once in awhile, you guys will see this, and someone's heels will come up off the floor as they're squatting. That is going to destroy your assessment. You might be able to guess that they have tight calves from that, but unfortunately, because they've lifted their ankle off, you really don't know how that's affecting the rest of their kinetic chain. Alright, the other thing we want to make sure is they're not faking it. Alright, I know a lot of fitness professionals out there, a lot of athletes out there, they've been taught how to do a squat. So if you have to, here's the trick I use. Rather than having them do an overhead squat assessment, I'll have them do a sit and stand assessment. Now they don't necessarily know it's an exercise, but you guys, as professionals doing your assessment, know that there is no difference between sitting and standing, and your overhead squat.  So I could say, "go ahead put your hands up over your head. Stand up. Good. Sit back down. Stand up. Good. Can you sit down with only touching your butt to the chair and getting back up? Good."  So you guys can see, this is the exact same thing. This is also a wonderful regression if you guys have maybe, a less well conditioned, or an older population, who can't do an overhead squat to begin with. You could break it down, not do the overhead part. You could have them put their hands on their waist to start or hands over their head to start, or maybe break it apart, and do this part as one part of the assessment, sitting as the other. But if I go ahead and take just about anybody and go, "Ok. Let me just have you sit and stand." I know from here, at least here, down, that's the exact same assessment,  and I can get almost anybody to do that. Alright, so there you guys go. We have optimal posture, which is going to be reviewing real quick, feet parallel, hip-width, with a mild medial arch. Knees in line with the second and third toe. That's patella in line with the second and third toe. Lumbo-pelvic hip complex -  I'm going to go ahead and set somebody's pants up so that I can see if her lumbopelvic hip complex is in neutral. Shoulder girdle. Shoulders down and back. That includes, even when I put my arms up, shoulder girdle is down and back. And then head, I'm going to at least look to try to start in neutral position. I hope that this gives you guys a good foundation for what is going to happen in the overhead squat video series, as we start pulling this thing apart sign by sign. Thanks again. That was long. That was 10 minutes.

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 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.

Introduction to Overhead Squat Assessment

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