Chapter 8 - Static Assessments Flashcards
Pattern overload
Occurs when a segment of the body is repeatedly moved or chronically held in the same way, leading to a state of muscle overactivity
Static positions of Lower crossed syndrome
Head: Neutral to forward Cervical spine: Normal to extended Thoracic spine: Normal to rounded Shoulders: Neutral to rounded Lumbar spine: Neutral to excessive lordosis, possible lateral shift Pelvis: Anterior tilt Hip joints: Flexed or neutral Knee joints: Flexed or hyperextended Ankle joints: Neutral or plantar flexed
What is the CES Assessment flow?
Client intake ->
Static Postural Assessment->
OHSA and modified OHSA->
S/L squat and/or split squat assessment ->
Dynamic (optional) and/or loaded(optional) -> Mobility Assessments ->
Corrective Exercise Programming
Muscles prone to imbalance: LPHC and Lower Body
Overactive/shortened: Gastrocnemius, Hamstrings, Hip adductors, Piriformis, Psoas, Quadratus lumborum, Rectus femoris, Soleus, Tensor fascia latae
Underactive/lengthened: Gluteus maximus and medius,
Fibularis (peroneal) muscles, Rectus abdominis,
Tibialis anterior and posterior, Transverse abdominis
Vastus medialis and lateralis
Upper-crossed syndrome
Forward head, hyperextended cervical spine, rounded shoulders
Lordotic posture
Excessive lumbar lordosis & anterior pelvic tilt
Lateral lumbar shift, lateral leg rotation, and knees slightly flexed or hyperextended
5 kinetic chain check points:
- Foot and ankle
- Knee
- Lumbo-pelvic-hip complex (LPHC)
- Shoulders and thoracic spine
- Head and cervical spine
Kyphosis
Natural curvature of the thoracic spine toward the back of the body
Muscle Activity of Upper crossed syndrome
Overactive/shortened: Cervical extensors, Pectorals (major and minor), Upper trapezius,
Levator scapulae
Underactive/lengthened: Deep neck flexors,
Rhomboids, middle/lower trapezius, Serratus anterior
Posterior view
Foot and ankle: Heels are straight and parallel, not overly pronated (flattened)
Knees: Neutral position, neither valgus nor varus
LPHC: Pelvis level to the horizon
Shoulders/scapulae: Level, not elevated nor rounded forward
Head: Neutral position, neither tilted nor rotated
Pes planus distortion syndrome
A postural distortion pattern characterized by flat feet, knee valgus, and an anterior pelvic tilt.
Muscle Activity of Lower crossed syndrome
Overactive/shortened: Hip flexors, Lumbar extensors, Gastrocnemius/soleus
Underactive/lengthened: Abdominals, Gluteus maximus and medius, Hamstrings
Pes Planus static positions
Pelvis: Anterior tilt
Hip joints: Internally rotated
Knee joints: Valgus, flexed
Ankle joints: Pronated (flattened, pes planus)
Muscle activity of lordotic posture
Overactive/shortened:
Hip flexors, Internal obliques (upper),
Lumbar extensors
Underactive/lengthened: Abdominals (external obliques) Hip extensors (hamstrings)
Postural distortion
Malalignments of bodily segments that place undue stress on the joints; for example, poor posture at one or more of the kinetic chain checkpoints
Lateral view
Foot and ankle: Neutral position, leg vertical at a right angle to the sole of foot
Knees: Neutral position, not flexed nor hyperextended
LPHC: Pelvis in neutral position, not anteriorly nor posteriorly rotated
Shoulders: In line with the hips and ears
Head: Neutral position, not in cervical extension (jutting forward)
Muscle Activity of lordotic posture
Overactive/shortened: Cervical extensors, Pectoralis minor, Shoulder adductors, Upper trapezius and levator scapulae, Anterior abdominals and intercostals, Internal obliques (upper and lateral fibers), Hip extensors (hamstrings)
Underactive/lengthened:
Cervical flexors, Thoracic extensors, Trapezius (middle and lower), Lumbar extensors, Hip flexors (iliopsoas)
Muscle Activity for kyphosis-lordosis
Overactive/shortened:
Cervical extensors,
Upper trapezius and levator scapulae,
Shoulder adductors, Intercostals, Pectoralis minor
Internal obliques (upper and lateral), Hip flexors (iliopsoas), Lumbar extensors
Underactive/lengthened: Cervical flexors, Thoracic extensors, Trapezius (middle and lower), Anterior abdominals (external obliques), Hip extensors (hamstrings)
Static positions of Upper crossed syndrome
Head: Forward Cervical spine: Extended Thoracic spine: Excessive kyphosis Shoulders: Rounded, elevated (scapular winging) Lumbar spine: Normal curve or extended Pelvis: Neutral Hip joints: Neutral or slightly flexed Knee joints: Neutral or slightly flexed Ankle joints: Neutral
Main factors related to postural imbalance
Chronic suboptimal postures Habitual repetitive movements Acute injuries Recovery from surgery Incompletely rehabilitated past injuries
Muscles prone to imbalance: Upper Body
Overactive/shortened: Cervical extensors, Latissimus dorsi, Levator scapulae, Pectorals (major and minor), Scalenes, Sternocleidomastoid, Upper trapezius
Underactive/lengthened: Deep cervical flexors (longus coli and capitis), Middle and lower trapezius, Rhomboids, Serratus anterior
Phases of CES
Phase 1: Inhibit
Phase 2: Activate
Phase 3: Lengthen
Phase 4: Integrate
Static positions for Kyphosis-lordosis posture
Head: Forward Cervical spine: Extended Thoracic spine: Excessive kyphosis Shoulders: Rounded, elevated Lumbar spine: Excessive lordosis, possible lateral shift Pelvis: Anterior tilt Hip joints: Flexed Knee joints: Flexed or hyperextended Ankle joints: Neutral or plantar flexed
Muscle activity of layered crossed syndrome
Overactive/shortened:
Cervical extensors,
Pectorals (major and minor), Upper trapezius,
Levator scapulae, Hip flexors, Lumbar extensors,
Gastrocnemius/soleus
Underactive/lengthened: Deep neck flexors, Rhomboids, middle/lower trapezius, Serratus anterior, Anterior abdominals, Hip extensors (hamstrings), Gluteus maximus and medius
Altered length-tension relationships
Occur when the resting length of a muscle is too short or too long to generate optimal force.
Lordosis
Natural curvature of the lumbar or cervical spine toward the front of the body.
Muscle Activity for Sway back posture
Overactive/shortened:
Cervical extensors,
Upper trapezius and levator scapulae,
Pectoralis minor, Intercostals, Abdominals (upper fibers),
Internal obliques (upper fibers), Hip extensors (hamstrings)
Underactive/lengthened:
Cervical flexors, Thoracic extensors, Trapezius (middle and lower), Abdominals (external obliques),
Hip flexors (iliopsoas)
Muscle Activity for Pes planus
Overactive/shortened:
Gastrocnemius and soleus, Peroneals, Adductors,
Iliotibial band, Iliopsoas, Hamstrings
Underactive/lengthened: Posterior and anterior tibialis, Vastus medialis Gluteus maximus and medius, Hip external rotators, Hip flexors, Thoracolumbar paraspinals
Static positions of layered crossed syndrome
Head: Forward Cervical spine: Extended Thoracic spine: Excessive kyphosis Shoulders: Rounded, elevated, possible scapular winging Lumbar spine: Excessive lordosis, possible lateral shift Pelvis: Anterior tilt Hip joints: Flexed Knee joints: Flexed or hyperextended Ankle joints: Neutral or plantar flexed
Anterior view
Foot and ankle: Straight and parallel, not flattened or externally rotated
Knees: In line with the second and third toes, not valgus or varus
LPHC: Pelvis level to the horizon
Shoulders: Level, not elevated or rounded
Head: Neutral position, neither tilted nor rotated
Sway-back posture: static positions
Head: Forward Cervical spine: Extended Thoracic spine: Excessive kyphosis with posterior displacement Lumbar spine: Reduced lordosis (flattening) Pelvis: Posterior tilt Hip joints: Extended Knee joints: Hyperextended Ankle joints: Neutral
Static positions of flat-back posture
Head: Forward Cervical spine: Extended Thoracic spine: Excessive kyphosis (upper region), flat (lower region) Lumbar spine: Reduced lordosis or flat Pelvis: Posterior tilt Hip joints: Extended Knee joints: Hyperextended Ankle joints: Neural or plantar flexed
Static positions of lordotic posture
Head: Neutral position Cervical spine: Normal curve Thoracic spine: Normal curve Lumbar spine: Excessive lordosis Pelvis: Anteriorly tilted Hip joints: Flexed Knee joints: Slightly flexed or hyperextended Ankle joints: Slightly plantar flexed
