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This is Brent coming at you with another
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overhead squat assessment video. In this
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video we're going to go over the sign knees bow out. So I'm gonna have my
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friend Leanne come out, she's going to demonstrate knees bow out for us. I'm
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going talk to you guys about some of the details here. So first things first, i'm
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going to go ahead and have her set up with feet hip width. We know that her
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hips are just behind her ASIS here, so she can go a little wider than that, just a
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little bit. There you go, and then she's going to make sure her second toe is
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pointing forward. Ideally I know that the knees should track, so that the patella
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goes over the second and third toe. Now Leaane's going to throw her hands up over
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her head, and show us what knees bow out looks like, and she's doing a pretty good
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job demonstrating what you would commonly see here. You can see here her
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patella starts tracking over her pinky toe, or just passed her pinky toe. Now I
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know most of you guys are probably expecting to see more of a exaggerated
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knees bow out. Let's go ahead and show that. But the truth of the matter is
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that just doesn't happen all that often. Most of the time when you guys see the
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sign, it is going to be just a little bit of splaying out to the pinky toe, and i
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would say even more common than that is only on one side. So I'm going to have
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Leanne kind of bow out, try to show bow out just on the right side, and all I
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would do on my overhead squat assessment, as if I saw that, if it was only on the
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right side, i would just knees bow out 'r' circle right, to make sure I
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understood it was just the right side. If it was right side more than left but
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both of them did it it would be 'r' greater than left. Keep your
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documentation simple, easy for you to read, so that you can reproduce the same
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way every time. Thank you Leanne. Now let's analyze this dysfunction. Unfortunately
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this dysfunction is not as obvious as some of the other dysfunctions we've
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put up. So knees bow out, you would think towards abduction, but the truth of the
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matter is it's actually femoral external rotation, and then at the ankle that
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knees bow out is being driven by eversion. So you guys remember the joint
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action eversion is like this with my feet, unless
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its tibia on foot eversion, then if I did this with my feet and laid them back
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flat, my tibia would be pointed outward, so hopefully you guys can follow
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that. When we get into actually breaking down femoral external rotation, we have
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to add yet another layer. So some of you guys are already aware of this idea of
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agonists versus synergists, and this idea of synergistic dominance. In this
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dysfunction this all plays a role. So if I were to just throw my external
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rotators up there for the femur, I would end up with the glute max and the glute
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medius on my short and overactive side. I can honestly tell you guys an overactive
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glute max and glute medius almost never happens, these are what we call phasic
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muscles. They have a propensity to get really under active. What is actually
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happening in this dysfunction is that has happened .The glute max and the glute
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medius have definitely become inhibited and reduced in activity, and you have the
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takeover of the synergists for that, which are not quite as good as extension
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but better at external rotation. So we get displaying of the knees. Those three
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muscles are the piriformis, biceps femoris, and posterior head of the
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adductor Magnus. So those are going to be muscles you want to treat with release
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and stretching, and of course you guys know our eversion from previous videos of
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the fibularis and lateral gastrocnemius. So now what are we going to activate to improve
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this dysfunction, well my inhibited agonists, the muscles that are allowing
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the center just to become dominant. Once we release and stretch them and reduce
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their activity, we need to get the glute max and the glute medius involved again. So
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that's where you guys are going to do your glute max and glute medius activation,
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and then of course you're going to go after your inverters, being your
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posterior tib and your anterior tib to fix that dysfunction in the ankle. Now
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one small thing i will say about this dysfunction, this is one of our first
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dysfunctions within a dysfunction. Believe it or not if you guys started
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with knees bow out, corrected the dysfunction, and ended up with knees bow
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in, that's actually a step forward. I
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actually find that most people who have knees bow out, it's just knees bowing in
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disguise. We need to get past this synergistic dominance relationship and
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then once we do that, we go back to our knees bow in sign, and we start
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correcting that way. I hope you guys enjoyed this video. I hope you guys get