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Overhead Squat Assessment 15 - Sign Clusters: Asymmetrical Weight Shift

The Overhead Squat Assessment 15 - Sign Clusters: Asymmetrical Weight Shift is designed to identify abnormal weight-shifting patterns in the overhead squat. This assessment begins with the athlete in an erect standing posture with their feet shoulder-width apart and their arms fully extended above the head. The athlete will then proceed to perform a full depth overhead squat while keeping their arms above the head throughout the entire squat. Observers will watch to identify any unbalanced shifts from side to side

Transcript

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This is Brent and in this video we're going
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after a dysfunction that many of you
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have had questions about, that's the asymmetrical weight shift. But this video
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has been placed very purposely at the end of our signs contributing to
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clusters, contributing to compensation patterns, because the asymmetrical weight
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shift isn't just a sign of dysfunction it is actually a compensation pattern
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unto itself, and there are going to be several signs that contribute to it. So
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if we expect to be successful with our corrective exercise strategy, we're going
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to need to understand how several joints work together before we just check this
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box and think that we're going to get a real easy quick solution. So I'm going to
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have my friend Melissa come out, she's going to help me demonstrate what's
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going on here. Let's say for a second that I've seen Melissa squat, go ahead
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and throw your hands up, and I noticed right off the bat maybe I even noticed
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this when she was working out like doing squats or deadlifts out on the gym
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floor, that she squatted down and she had an asymmetrical weight shift. Alright so
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I've got that box checked off, the question is is where is that coming from,
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and I know a lot of you guys think that right here is where asymmetrical weight
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shift comes from. That's kind of what the solution tables out there have said that
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this is where asymmetrical weight shift has come from, but that's not necessarily
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the case. Asymmetrical weight shift can come from any one of our segments, so we
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talked about upper body in a video, we talked about lower leg, i'm going to talk
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about how that's probably the most common contributor to an asymmetrical
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weight shift, and it can also come from here. Alright so if I've seen or do an
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asymmetrical weight shift out there, I need to pay closer attention now. So i'm
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going to set her up, second toe pointing forward. I got her pants on her ASIS and PSIS,
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looking to see if those are within one inch of level, alright and I got our
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hands up elbows locked. Now when she squats, go ahead and squat down i'm going to key into
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every dysfunction I see, but what I'm really looking for is anything
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asymmetrical. So any sign that happens on the right or
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left only, or the right more than the left or left more than the right. So
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let's say for a second that Melissa does this squat, we know she has an
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asymmetrical weight shift but she squats down and her right foot turns out more
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than her left, that is something for you to look out for. You really want to key
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into that is worse than that side. Alright go ahead and stand up again, we
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want to see about the knees, does one knee bow out and one knee bow in. Alright so if
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she does an asymmetrical weight shift towards me. What that looks like to me
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guys, I don't know if you can see this, that's technically knee bow out on her left
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side and knee bow in on her right side. That's going to be real important. I'm
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going to mark that down, right so she does that again and I would say knee bow out
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left only, knee bow in right only. Good so let's go to lateral view, hands up squat
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down. Maybe I start to see some other lumbo-pelvic hip complex signs right. I
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know you guys have learned that asymmetrical weight shift is generally a
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lumbo-pelvic hip complex thing, there is definitely a lot going on there. I still
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see that excessive lordosis, I see an excessive forward lean. Alright go ahead
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and come back up, obviously those aren't going to be right or left only. Then
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let's see her upper body, let's see her arms alright. Go ahead and squat down,
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occasionally what you will see is this, alright where she has one side where
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the lat is really really geared up, if that was on the same side of her
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dysfunction I'm definitely geering into that, I'm definitely thinking okay there
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might be a connection there, where her lat on this side is pulling her
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right pelvis anteriorly, which is causing her to shift on that side.
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Good now the question is how I figure out where it's coming from, i just gave
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you a lot of reasons why maybe her right side being more dysfunctional
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than her left in lower leg could cause her to collapse and shift to that side.
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We talked a little bit about the lumbo-pelvic hip complex, maybe just
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right-sided knee bows in right, and then this side bows out, and then we also
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talked about how a lat could contribute to a right anterior pelvic tilt and a
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shift. So now we have to figure out some way to isolate, which just goes back to
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our squat with modifications. So what I'm going to probably do in this case is i
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won't do hands down and feet up at the same time, just to see if one at a time i
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can kind of knock things out. If i have her hands up, wait hands up high heels,
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all I'm doing now is try to differentiate between what's going on
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and whether it comes from her lower leg and ankle. If she squats down and her
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asymmetrical weight shift disappears, because I put her on high heels then the
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problem is not at the lumbo-pelvic hip complex it's at the tighter ankle.
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Basically what's happening there is go ahead and back off, this would be the
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equivalent of let's say she has a tight right ankle maybe she sprained her right
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ankle a year ago, if she can't dorsiflex on this side right she's going to
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squat down, not be able to go any further, and she's either going to collapse this way
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to try to get down, or she's going to collapse away from just like that
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rotate that way, either one's going to cause an asymmetrical weight shift. You could
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try to correct at her lumbo-pelvic hip complex all day, and if it's coming from
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here it will not get better. So once again I have her on high heels, hands up
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if her asymmetrical weight shift disappears it's coming from lower leg.
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What if it doesn't disappear, well now I'm down to two options; is it coming
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from upper body or is it coming from lumbo-pelvic hip complex.
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Let's say here she still did it, so we're weight shift right right towards
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me good and now all that's that's still there. Alright so let's try arms down
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and now the asymmetrical weight shift disappears, well then I know where the
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problem is, the problem is on whatever side is more dysfunctional in her upper
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body, and I'm going to address that side and that side only in my corrective
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strategy. Now i have to admit of all of the possibilities i'm talking about here,
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upper body dysfunction contributing to lumbo-pelvic hip complex asymmetry is
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fairly rare, but it does happen. Now if i've taken her ankle out of it and i've
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taken her upper body out of it, she squats and she still has an asymmetrical
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weight shift, that's an asymmetrical weight shift coming from the
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lumbo-pelvic hip complex. Alright and actually I kind of keyed into how you
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solve this problem a few minutes ago. Notice very carefully how this is
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actually bowing in this knee, and this is bowing out, there is the solution. Right
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in that sign is the key to how you get somebody out of this asymmetrical
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pattern. Alright so thank you Melissa, much appreciated. Let's go to our graphs
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and talk about what this ends up looking like. Number one, if it came from the
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lower leg you're going to go back to the lower leg dysfunction video, use the
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lower leg dysfunction solution which you guys can get from my website
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brentbrookbush.com at the overhead squat assessment under the assessments
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category. Or you could go to lower leg dysfunction under postural dysfunctions
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and movement impairment. If it came from upper body same thing you're only
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going to fix the one upper side, upper body dysfunction, and again you can find
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the upper body dysfunction article under postural dysfunction of movement
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impairment, or you can go to the solution tables under overhead
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squat assessment. If it just so happens that it is coming from the lumbo-pelvic
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hip complex here's the solution. What you end up having is knee bow in on one side,
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knee bow out on the other. So the knee bow in side i'm going to go after all of my femoral
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internal rotators- TFL, gluteus minimus, adductors, short head of the biceps
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femoris, alright that's femoral internal rotation via relative tibial external
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rotation; and then on the knee bows out side I'm going to do external
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rotators those overactive synergists piriformis, adductor Magnus is an
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external rotator, and biceps femoris long head. And then from an activation
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standpoint I'm going to go after my glute max and my glute medius on the side
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of the shift. So once I've released and stretched these overactive muscles, or
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released and lengthen these overactive muscles, I'm going to activate the glute
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on this side to help push me back to centre, be careful though you want to
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start here, make sure you clean this up. I find more often than not as soon as I
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clean this up all of a sudden out of nowhere that next layer of the onion is
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one of their feet flattens. A very common occurrence is we have this thing
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going on and I end up having to fix the internal rotation of this femur, and foot
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flat on that side, so foot flat was over activity of the everters and under
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activity of the inverters. So you just go back to your solutions table, fix this
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side for lower leg dysfunction, fix this side for knee bows in dysfunction. If you
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got that far and for whatever reason you still didn't fix this dysfunction,
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there is a dysfunction within this dysfunction that's fairly common which
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is sacroiliac joint dysfunction. Most often these individuals need some sort
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of mobilization for either the lumbar spine or sacrum, which means my personal
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trainers you're going to have to refer out and this is not a bad thing, this is
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an opportunity for you to create a connection with somebody who could be
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referring back to you right, they might need some sort of manual mobilization or
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manual manipulation. Alright for all of my PT's and ATC's my DC's, if this is the
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muscular model you guys are the ones that if you see an asymmetrical weight
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shift are going to need to go into those further assessments for the sacrum,
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further assessments for the lumbar spine, and probably further assessments for the
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hip, as well to see what sort of arthrokinematic dysfunction exists within this.
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I know this is a little complicated guys, I hope you start figuring out how it's
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actually one asymmetrical compensation pattern. So like lower leg
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dysfunction on one side, or really just lumbo-pelvic hip complex dysfunction
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on one side, contributing to this asymmetry, and the muddied water start to
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clear. If you practice this I think you will actually find that it is not a more
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complicated dysfunction than any other dysfunction we've been over, it just
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happens to have that weird thing that somehow we all mess up, which is right
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and left. We can all memorize our origins and insertions and all of these
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muscles and learn all these great techniques, but then you throw right and
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left into it like Melissa had right sided asymmetrical weight shift, so
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that would be right side knee bows in, she'd do release and stretch here, left
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side knees bow out she'd do here, and then she'd only do glute max and glute
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meius on the right side, and somehow just because I said right left that made this
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graph more complicated, Take your time, take a second practice it. Grab a few
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people who maybe are your colleagues that you have seen with a little bit of
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asymmetrical weight shift, try to solve for it and get some practice before you
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throw it at a client or patient. I look forward to hearing about your outcomes
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guys. I think you guys will have great success with this, and those of you those
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people who have asymmetry that you do correct, you're going to watch their
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performance go through the roof. I look forward to talking to you guys soon.