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.