0:05 This is Brent and in this video we're taking our overhead squat assessment up 0:09 a notch. Now in our previous videos we went through sign by 0:14 sign. We discussed what each sign implicates as far as long and short 0:18 muscles. Which muscles are overactive an underactive. What you've already 0:22 started to notice is that you never get an overhead squat assessment where you 0:27 look down at your template, and you have one box checked, that's a nice thought. I 0:32 hope to meet that individual eventually where I get a very simple corrective 0:36 exercise program. But most of the time we start to see several boxes checked off. 0:41 If you've really been paying attention and you've really done a lot of overhead 0:46 squat assessments, what you've probably started to recognize that is that 0:50 there's a pattern to which boxes get checked off. Now these patterns develop 0:56 into clusters, these clusters start to implicate compensation patterns. Now in 1:02 this video we're going to go over the lower leg dysfunction compensation 1:08 pattern. So we're going to see certain signs packaged together, and you're going 1:13 to see this over and over and over again. So now we're taking our ability as 1:18 assessors, to go from seeing one sign to seeing the entire compensation 1:24 pattern package together. I'm going to have my friend Melissa come out, and 1:28 she's going to demonstrate what this looks like, which I know you guys have 1:31 seen a million times before. If I get her all set up, second toe pointing forward, 1:37 arms up over her head, her feet are hip-width or in line with her ASIS, and I 1:42 go okay, and she's going to exaggerate this for me. I go go ahead and squat, we watched 1:49 her feet turn out, her feet are flat and her knees kissed, how many times have you 1:55 guys seen that? You guys would have seen that a ton right, and then if you looked at 1:57 her from the lateral view, go ahead and turn, face that way for me. She does the 2:01 same thing right, knees kissed, feet turn out, feet flattened, but then you guys also 2:05 notice she has excessive forward lean, a little anterior pelvic tilt. And then 2:11 when we turned her around, she may or may not even have an asymmetrical weight 2:18 shift. How many of you guys have seen all of this package together. Well 2:23 mechanically we can describe this lower leg dysfunction. 2:27 I was going to say there was a route to lower leg dysfunction, lower leg 2:31 dysfunction starts with the inability to dorsiflex far enough. Alright remember 2:38 dorsiflexion is just not foot up this way, but the ability to translate the 2:42 knee forward. That ability to translate the knees forward, so go down into your 2:46 squat a little bit, it also keeps her center of mass, right we can think like 2:50 kind of in this core area, that's what keeps it over her base of support. So we 2:56 can already explain the excessive forward lean, if she can't dorsiflex far 3:00 enough, she has to, her butt ends up way out behind her, and she has to throw 3:04 her upper body mass over, creating that excessive forward lean, just to keep her 3:11 center of mass over her base of support. Let's get a little bit more technical 3:15 though, some you guys have heard of this concept of relative flexibility. So if I 3:20 have hypomobility a restriction at one joint, I start compensating with 3:24 hypermobility at other joints, she can't dorsiflex enough. So just for her body to 3:33 try to get some more motion, her feet flattened out, which is going to cause 3:37 problems, and then she steals even a little mobility from her knees by doing 3:44 this. Go ahead and go down in your squat, this little turnout thing all right. So 3:49 she can't dorsiflex here, she's stealing from here and here. Well hypomobility hyper 3:55 are sorry, hypermobility hypomobility, and then of course that leads to hip 4:00 dysfunction, because tibial external rotations, femoral internal rotation 4:03 which drives tightness in her tfl which is also a hip flexor; and that's going to 4:08 cause an anterior pelvic tilt. So I know I just said a lot these signs aren't 4:14 separate though, they're actually all mechanically linked as Melissa's body 4:20 here tries to figure out how to work around this one restriction that started 4:23 with an inability to dorsiflex. If you guys go back and look at all of your 4:29 solutions tables, you'll even notice that the muscles involved in like let's say 4:34 feet flattened, and feet turn out, both the lateral gastroc 4:39 will flatten the feet and turn out the feet, and you guys saw that. Feet turn 4:45 out knees bow in -lateral gastroc, biceps femoris, tfl. Knees bow in -lateral 4:51 gastroc, biceps femoris tfl and gluteus minimus. You see all of this 4:55 overlap, it's almost disingenuous for us to start the way we did, which is with 5:00 individual signs. It's actually these entire patterns that the body tries to 5:06 create. So going back to our overhead squat assessment now, you guys just took 5:13 yourselves up a notch by realizing that it's not individual signs, but clusters 5:18 of signs that we're looking for. The one thing we have to make sure we do now 5:23 though, is make sure that it is the ankle that is driving this dysfunction and not 5:28 the lumbo-pelvic hip complex. Some of you guys have already seen that squat with 5:34 modifications for further assessment, so stay with me here for a second. Sure 5:41 knees bow in can be driven by the fact that her feet turn out alright, so that's 5:47 tibial external rotation which causes relative femoral internal rotation, and 5:51 causes her knees to collapse as she goes down into a squat. But she can put her 5:58 feet back here, if she just had like an anterior pelvic tilt which was driving 6:03 over activity of her tfl, gluteus minimus and anterior adductors, that could also 6:11 drive her knees in. Go ahead and squat for me, but that would be coming from the 6:15 lumbo-pelvic hip complex. So before I start fixing here, I need to make sure 6:20 that the dysfunction is being driven here in her lower leg, versus being 6:25 driven by the lumbo-pelvic hip complex, and that's actually fairly easy to do. 6:28 All I have to do is take my ankle out of the movement. If i take my ankle out of 6:33 this and everything recklessly gets better, then i know that's where the 6:37 dysfunction comes from, and that's what I'm going to correct. So I'll 6:43 have her do her overhead squat and I'll do all of my signs alright, so let's go 6:48 ahead and see the the overhead squat hands over your head, 6:51 do your squat, we see feet turn out, we see knees bow in, that's our anterior 6:56 view. Alright lateral view hands up over her head, she squats down, I see an 7:01 excessive forward lean, an anterior pelvic tilt. Posterior view good and I 7:07 see a little asymmetrical weight shift to the left, great now what I'm going to 7:11 do is go okay where is this coming from. I'm going to have her get on high heels 7:16 so I'm gonna put her in a whole bunch of plantar flexion, so now that dorsiflexion 7:21 restriction is not an issue. I do get a lot of questions on how high this needs 7:25 to be, you guys need to pick a platform whether it's a couple weight plates, foam 7:30 a half foam roll, rolled up mats, the backs of someone's shoes, it does have to 7:34 be high enough so that they don't show their ankle signs, basically feet 7:38 flattened, and feet turn out. If they still feet turn out and feet flattened, 7:42 your platform here for their high heels isn't high enough. For this I think she's 7:49 going to be fine. So she's going to go ahead and throw her hands up over her 7:52 head and squat, you noticed that all of this stuff gets cleaned up. So we know 7:58 that her knee and her ankle signs of course were actually coming from lower 8:02 leg dysfunction. If I turn her sideways 8:10 she squats, notice how that excessive forward lean disappears, I know that was 8:15 coming from here. We do see something interesting with Melissa she still has 8:21 an anterior pelvic tilt all right, so that anterior pelvic tilt is probably 8:26 coming from a lumbo-pelvic hip complex dysfunction. I can even double 8:28 check if I have a put her hands on her hips, all right and go ahead and stand up. 8:33 Do one more for me, you still see that anterior pelvic tilt. So most of our 8:38 signs are coming from lower leg dysfunction, that's probably what I would 8:41 aim for first. But chances are i'm going to have to come back and look at the 8:44 lumbo-pelvic hip complex specifically, and write a program to fix this. If I go 8:48 posterior view, we said in the posterior view before we saw an asymmetrical 8:54 weight shift, she was faking it, but let's pretend that she thought we saw an 8:58 asymmetrical weight shift, and then we put her in high heels and shift went away. 9:01 A lot of you guys have been asking me for an asymmetrical weight 9:05 shift video, and I'm going to do just one specifically dedicated be asymmetrical 9:08 weight shift. But I do find a lot of people have an asymmetrical weight shift, 9:13 not because of something that's going on here, but because they actually had one 9:16 calf or one ankle, or one sided lower leg dysfunction, that when they squatted down 9:23 was forcing them over. You're not going to correct this then, even though it's an 9:29 asymmetrical weight shift I wouldn't go after this. I would go after the tighter 9:32 side of their lower leg dysfunction. Thank You Melissa. So big step guys, you 9:41 just took a huge huge huge step. We just went from looking at signs of 9:46 dysfunction to what the body actually really tries to do, which is create a 9:50 compensation pattern. Now before you freak out and go oh my goodness that is 9:56 a lot of stuff I have to correct, it's actually not that bad, and you start 10:00 looking at how overlapping the muscles and those signs were, how mechanically 10:05 linked those joint signs were. 10:12 You start realizing it's not a very long list at all. Despite all of the stuff we 10:19 just saw, it only comes down to lateral gastroc, soleus, fibularis, biceps femoris, 10:24 TFL VL, ITB complex and gluteus minimus. That's six release techniques. If you go 10:29 back and look at some of the stretching videos, the lateral gastroc, soleus and 10:33 fibularis muscles get stretched together in that modified slant board 10:37 stretch I've shown. So we're already condensing down pretty quick. This gets 10:42 its own stretch. The gluteus minimus, tfl gets stretched together. Tibialis 10:48 posterior, medial gastroc get activated together. So that still only leaves us, let's see here, five 10:55 activation techniques, and then we have our integration techniques. Even when we 11:00 get really really complicated it doesn't amount to more than 20 techniques let's 11:05 say, 25 techniques. Or even if you're really really sophisticated you can do all 11:09 this different manual stuff 30 techniques. Try to keep in mind this 11:12 isn't like resistance training, I'm not having them do multiple sets of this 11:16 stuff over and over again. I'm going through each muscle doing what I need to 11:20 do one set a piece, people do not get rest between sets. I guarantee at the 11:25 minimum let's say this takes 16 or 17 techniques to correct, everything from 11:30 ankle all the way up to here, I can get somebody to do that in 20 minutes. It 11:36 might take two or three sessions before they can get through it in 20 minutes, 11:39 but eventually that's one minute per technique, and they're just rocking 11:44 through it; and you're fixing the entire compensation pattern which makes sure you 11:49 leave a lot less behind, so that your outcomes are a lot better, your carryover 11:55 from session to session is a lot better, and this is what gets really cool. So I 12:00 want you guys to look up this article on brentbrookbush.com that I wrote, it's 12:04 under postural dysfunction and movement impairment, called lower leg dysfunction. 12:08 You'll be able to see where I start combining these signs, and it starts 12:13 implicating all of this other cool stuff. Like we can start looking at subsystem 12:18 activation. In this dysfunctional pattern we see that the deep longitudinal 12:23 subsystem and anterior oblique subsystem become 12:26 overactive, but the posterior oblique subsystem and lateral subsystem become 12:30 under active. You can't really even look at that stuff though until you see the 12:35 entire package. Everybody's talking about fascia, everybody's talking about it. But 12:41 we know fascia isn't a single joint, a single sign thing, it spans several 12:46 joints, it connects lots of muscles. Well once we're looking at several joints we 12:51 do start to see a little bit of that fascial connection. We see the TFL VL ITB 12:56 complex come in. Alright we see the tibial internal rotators which have this 13:02 this tendinous fascial connection at the medial knee come in, lots of stuff going 13:09 on here. If you guys look back at the deep longitudinal subsystem you'll see 13:13 that that's actually a huge fascial system, including the sacrotuberous 13:16 ligament, and the deep layers of the thoracolumbar fascia. So we're taking a 13:21 big step guys. I know we're taking a huge step going from signs to patterns, to 13:26 integrated functional anatomy, and some really sophisticated exercise techniques 13:32 and routine design, but that gives us a whole lot more to work with. I think you 13:38 guys are going to have a whole lot of fun with it. It's basically unending what 13:42 you could possibly do with all of this information. I hope you guys have fun. I 13:46 look forward to hearing about your outcomes. 13:56
