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This is Brent coming at you with
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another overhead squat assessment video.
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In this video we're going to go over the sign knees bow in. So I'm going to have
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my friend Mike Tierney come out. Mike Tierney is going to demonstrate this
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dysfunction for us. Just a couple little things to watch out for, I think you guys
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kind of know what this sign is supposed to look like. I'm going to set him up so
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the second toes pointing forward, feet underneath his hips. He's going to go
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ahead and throw his hands up, perfect and what you guys are watching for, is does
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this patella track over a second or third toe, or does it start to bow in
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towards this big toe, or maybe even closer than that. Actually Mike let me
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have you do us a little favor here, can you tuck these shorts into your
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compression shorts. It is helpful to be able to see somebody's kneecaps, you can
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have somebody roll with their pants if you have to. Alright so let's go ahead
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and go knees bow in, and this is pretty typical you can see Mike's knees
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starting to kind of track in this way, just medial to his big toe, alright
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good. A sign that's a little less obvious but I know you've all seen it before,
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maybe you've wondered what to do with it, is the wobbly knee thing right. Can you
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show us that Mike. This isn't his natural dysfunction, natural compensation pattern,
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so he's going to act for us a little bit, good back up. That wobbling knee thing is
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usually, usually knees bow in waiting to happen. So if you guys are cleaning up
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somebody's dysfunction, you happen to notice that, it might be worth throwing
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in some of those corrective techniques for knees bow in to try to solve that,
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before it becomes, let's go ahead and go back to the first sign knees bow in,
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before it becomes this. The only other thing I want you guys to watch out for
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is occasionally what ends up happening, is the only time somebody's knees bow in,
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and you can go ahead and go back up, the only time somebody's knees bow in, is at
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the hardest part of the movement, which is that turn around between eccentric
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and concentric. In other words they bounced into adduction at the bottom.
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Can you show us what that looks like,
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good. So you guys can see in this part of dysfunction, if this is how
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they're going to show it, that you're going to have to watch all the way
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through their squat pattern. Don't just look at them going down and go, oh yeah
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knees you're fine, and then move on to the next sign. You need to watch the knees
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through an entire rep, to ensure that you don't have knees wobble, the knees don't
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bow in on the eccentric phase, they also don't bow in in that amortisation phase
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of the turn around from eccentric to concentric. Thank you Mike. Now breaking
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that down, now we just have to figure out what joint actions are occurring, what
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joint actions correlate with knees bow in. And I know a lot of you guys have
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probably been taught adduction, and while adduction is not wrong, you're going to
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see the adductors come back up in our graph, there are a couple joint actions
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that correlate better. So if knees bow in if we thought of it is, my tibia are
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trying to turn out, while my femurs are trying to bow in right. So this whole
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this bowing in, and this bowing out is actually collapsing the knee inward. That
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has a much better correlation with what muscles are short, and what muscles are
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long. So what I want you guys to memorize for now and start to try to think about,
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is knees bow in equals tibial external rotation, and femoral internal rotation.
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Now in the feet turn out video you guys saw who the tibial external rotators are,
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so that's going to be TFL, VL, ITB complex we talked about a little bit, the biceps
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femoris short head, all right so that short head does not actually cross the
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hip, and then lateral gastroc will also rotate my tibia outward. My femoral
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internal rotators some of these muscles you guys are going to recognize because
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they're very nasty, they like to get really tight, they like to get really
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short right. You have TFL, you have TFL's nasty cousin, the glute min, and then your
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anterior adductors. I know at some point every one of you has released or
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stretched one of those three muscles. Now on the flip side we got to go back to
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our tibial internal rotators, and our femoral external rotators. Now before I
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kind of talk to you guys when we did that feet turn out video,
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the tibial internal rotators are activated as a group, so we'll leave that
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tibial internal rotators, even though that's the semis, and the gracilis, and
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the popliteus. The medial gastroc is going to be activated with our post tib.
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Now I'm not saying that my post tib crosses my knee and contributes to this
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dysfunction, what I am saying is the exercises that we use for post tib would
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include medial gastroc activity, so we're going to use that as a little cheat. And
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then of course our femoral external rotators guys, the muscles that love to
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get underactive, but the muscles we love to work and try to hypertrophy, and try
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to get strong which of course are our glute complex, being the glute max in the glute
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medius. I hope seeing the signs of dysfunction, noting some of the details
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and dysfunction. The breakdown and the discussion of how we would create
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exercise from this graph, helps you create more powerful corrective
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strategies, including rehab and performance enhancement. I look forward