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Overhead Squat Assessment 13 - Sign Clusters: Upper Body Dysfunction

This video teaches you how to identify and assess upper body dysfunction during an overhead squat. We cover common sign clusters and how to use them to find the root cause of your pain. Learn the basics of overhead squat assessments today!

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00:05 - 00:10This is Brent and in this video, it's our second video taking the overhead squat
00:10 - 00:14assessment up a notch, going from recognizing just sign by sign
00:14 - 00:20dysfunction to recognizing these common patterns, or these clusters of signs. So
00:20 - 00:24in this video we're going to go over the cluster of signs that leads me to
00:24 - 00:29believe somebody has the compensation pattern upper body dysfunction. I'm going
00:29 - 00:33to have Melissa come out, she's going to help me demonstrate this. Now I'm going
00:33 - 00:37to throw this out here right now guys, this is not Melissa's natural
00:37 - 00:41compensation pattern, so she's going to face fake it a lot. I'm going to have her
00:41 - 00:46dramatize stuff a lot. We will in the future do some case study videos where
00:46 - 00:51you guys see very real compensation patterns. Alright so first things first
00:51 - 00:54I'm going to set her up the same way, I know you guys can't see your feet but I want her
00:54 - 00:59toes turned, second toe pointing forward, her feet hip-width underneath her ASIS,
00:59 - 01:03she's going to throw her arms up. Now I mentioned this in the signs of
01:03 - 01:08dysfunction video with arms fall, if somebody can't even get to their arms up
01:08 - 01:14to in line with their torso, you check that box. If as soon as somebody throws
01:14 - 01:20their arms up their shoulders elevate, you check that box. If they already have
01:20 - 01:24an anterior pelvic tilt as soon as they throw their arms up, you check that box.
01:24 - 01:30Now those are the three big signs that lead me to believe that somebody has
01:30 - 01:36upper body dysfunction. The one problem we have and you can go ahead and do a
01:36 - 01:40squat for us here, we would most most of the time we would see somebody's arms
01:40 - 01:45fall either forward, or they do that like little mini lat pulldown thing or their
01:45 - 01:50elbows bend, and they kind of come down this way, that happens right. So let me
01:50 - 01:56have you a lateral view, then a lateral view we have this tendency to see arms
01:56 - 02:03fall and then her lats sometimes pull her into an anterior pelvic tilt. Alright
02:03 - 02:09and then in the posterior view, now this is super super rare, every once in a
02:09 - 02:14while I'll see this, like one arm fall way farther than the other, and actually
02:14 - 02:18get pulled into a little bit of an asymmetrical weight shift. So let's say
02:18 - 02:21it's this arm the falls down a little further, and
02:21 - 02:25she kind of does a weight shift this way, that's really rare that an asymmetrical
02:25 - 02:29weight shift would come from upper body dysfunction, but it does happen. Alright
02:29 - 02:34so the only thing I have to figure out about this dysfunction, what got me a
02:34 - 02:39little boggled right now, is if Melissa presents with both arms fall forward and
02:39 - 02:46an anterior pelvic tilt, both of those signs could come from over activity of
02:46 - 02:52her latissimus dorsi. However her latissimus dorsi is involved in both
02:52 - 02:59lumbo-pelvic hip complex dysfunction as well as upper body dysfunction. In order
02:59 - 03:03for me to figure out a accurate effective corrective exercise strategy I
03:03 - 03:07need to know which one I'm going to go after. Alright if the lats are coming
03:07 - 03:10from upper body dysfunction, then it's going to be shoulder scapula thoracic
03:10 - 03:14spine stuff i'm working on, maybe some cervical spine as opposed to if lats are
03:14 - 03:18tight because of lumbo-pelvic hip complex dysfunction, I got to go after hip
03:18 - 03:23flexors, lumbar extensors, hip, SI joint, lumbar spine are going to be involved.
03:23 - 03:28How do I figure this out, well same thing we did with the other video we just did
03:28 - 03:34with lower leg dysfunction, I do a squat with modification and see if the signs
03:34 - 03:39go away. So actually for upper body dysfunction the only thing I really need
03:39 - 03:46to see in modification, is hands on the hips and a lateral view. Now first things
03:46 - 03:52first I'm going to have Melissa go ahead and just do a squat for me, and you guys
03:52 - 03:56will see that her anterior pelvic tilt does not go away, that's coming from
03:56 - 04:02lumbo-pelvic hip complex dysfunction; by putting her arms down I shortened her
04:02 - 04:07lat, so it's not her lat pulling her into an anterior pelvic tilt it's
04:07 - 04:10lumbo-pelvic hip complex dysfunction pulling her to an anterior pelvic tilt.
04:10 - 04:16Now if she had true upper body dysfunction, her arms were falling
04:16 - 04:20forward, she had an anterior pelvic tilt, and when she did this assessment that
04:20 - 04:25anterior pelvic tilt went away, that's coming from upper body dysfunction. It is
04:25 - 04:30actually her lats that are causing that dysfunctional pattern. Now the one
04:30 - 04:34strange thing that you will often see with these people who have
04:34 - 04:40true upper-body dysfunction, is do the lats being overactive, the global
04:40 - 04:45stabilizers becoming synergistically dominant at the core, once I take the
04:45 - 04:48lats out of the movement, and I'm going to have Melissa try to demonstrate this,
04:48 - 04:54they'll squat and collapse in the upper body, they'll go into a further excessive
04:54 - 04:58forward lean or you'll actually see trunk flexion, or rounding of the
04:58 - 05:02back here, guys that's still upper body dysfunction. I know it looks like a
05:02 - 05:06totally different set of signs, it's just kind of how this whole dysfunctional
05:06 - 05:13pattern works out. That the intrinsic stabilizers shut down, lats and anterior
05:13 - 05:16oblique subsystem become overactive. So when I take the lats out of it, the
05:16 - 05:20anterior oblique subsystem takes over and either crunches them for forward, or
05:20 - 05:26crunches their lumbar spine and thoracic spine. Thank you Melissa. So hopefully you
05:26 - 05:31guys got how this cluster of signs work. The one thing I wanted to mention is the
05:31 - 05:36shoulder girdle elevation guys, that -this thing that I went over in a previous
05:36 - 05:41video, that is an upper body dysfunction sign. You don't have to do a squat with
05:41 - 05:45modifications to find out if that's an upper body dysfunction sign, that is only
05:45 - 05:49related to upper body dysfunction; however more often than not you will see
05:49 - 05:54if somebody's arms fall that with modification it truly comes from upper
05:54 - 06:00body that this is included. Now just like our previous video, I know this looks
06:00 - 06:04like a lot of signs to try to figure out, but really when you smash out all the
06:04 - 06:09stuff together you realize there's a lot of overlap, and rather than getting a
06:09 - 06:14huge corrective exercise strategy you get a corrective exercise strategy
06:14 - 06:22that's a few muscles longer but way more effective. So you can see here on the
06:22 - 06:26overactive side, actually all I've done is take this overactive scapulae muscles
06:26 - 06:34and add them to the overactive shoulder muscles all right. Subscapularis should
06:34 - 06:39be up there as well guys that's my apology,
06:43 - 06:49and you guys will notice that I have anterior oblique subsystem because now
06:49 - 06:53that I've started to look that this is a cluster of signs, as I started to look at
06:53 - 06:57the entire upper body, I get to investigate some of those more
06:57 - 07:01interesting relationships, where you have the lats into the thoracolumbar fascia,
07:01 - 07:06and the thoracolumbar fascia is also integrated into the intrinsic
07:06 - 07:10stabilization subsystem; and we get to consider all of that once we get to look
07:10 - 07:15at multiple joints. So in this particular dysfunction we have a AOS overactive.
07:15 - 07:19That's going to play a role in like if I know that this is overactive, maybe
07:19 - 07:22somebody who has upper body dysfunction probably shouldn't be doing crunches.
07:22 - 07:22Maybe planks are kind of off the menu until we get this more corrected. Under-
07:22 - 07:27active, external rotators, lower traps, serratus anterior, and then this
07:32 - 07:37crunching forward comes from that intrinsic stabilization subsystem taken
07:37 - 07:41out, due to global muscular dominance, and to get them straightened back out and
07:41 - 07:45then start integrating that posterior oblique subsystem. Once again this is
07:45 - 07:49stuff that I get to look at because I'm integrating all of these signs together.
07:49 - 07:54Now there is an article at brentbrookbush.com under postural dysfunction and
07:54 - 07:59movement impairment on upward up per body dysfunction, and you guys can see me rip
07:59 - 08:03this thing apart and go into arthrokinematics, and go into all of the
08:03 - 08:07muscles, and all of the muscles are hyperlinked to muscular articles, and
08:07 - 08:11those articles have techniques for each muscle that you would use based on the
08:11 - 08:15activity of length of all of these structures. I think what you guys are
08:15 - 08:20going to find by taking the jump from signs to patterns, is all of a sudden you
08:20 - 08:25are going to get much better correction in one session. You're going to have that
08:25 - 08:29person who arms fell forward, shoulders elevate, anterior pelvic tilt, once you do
08:29 - 08:34all of this they do a squat and feel a lot better in one session. I think you're
08:34 - 08:37going to see your outcomes get better, your carryover from session to session
08:37 - 08:41get a lot better, and I know that's something that all of us are working on.
08:41 - 08:44We don't just want somebody to get better, but then the next time they come
08:44 - 08:50back to us they still have 50 or 75 percent of the changes we made from the
08:50 - 08:54previous session, so that we can keep taking steps forward. I hope you guys
08:54 - 08:56enjoyed this video, I hope you take a huge step in your
08:56 - 09:00assessment capabilities, and that has a huge impact on your program, talk to you
09:00 - 09:02soon.

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