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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