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Overhead Squat Assessment 13 - Sign Clusters: Upper Body Dysfunction

Overhead Squat Assessment 13 - Sign Clusters: Upper Body Dysfunction is a tool used to detect movement irregularities in the shoulder, thoracic spine, and trunk that may be causing pain or limiting performance. This assessment is quick and easy to perform and results in a score which can be used to give an analysis of the body's overall function while performing the overhead squat. In addition, the Sign Clusters of Upper Body Dysfunction component can provide insight into how the shoulder, thor

Transcript

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