Introduction Flashcards
What is the Overhead Squat Assessment
A dynamic/transitional posture Assessment that combines end-range shoulder flexion with a squat (sit-to-stand transfer).
Why the OHSA (Relevance)?
This assessment is designed to highlight deviations from ideal motion with the intent of informing intervention selection.
What the OHSA is Not:
diagnostic test.
valid measure of joint or muscle pathology,
catch-all” assessment that replaces all other assessments.
“Ideal Posture is defined as”
Ideal arthro- and osteo-kinematics maintained by optimal myofascial activity and length, as a result of accurate sensation, integration and activation by the nervous system – both statically and dynamically.
Postural Dysfunction” is
the absence of ideal posture as a result of maladaptation by one or multiple tissues within the human movement system.
Kinetic Chain Check point “Feet”
Feet: Hip width (2nd toe directly below the ASIS, i.e. hip joint width), feet are parallel to one another (2nd toe pointing forward), the medial longitudinal arch of the foot is maintained.
“Feet” Room for debate
Foot position is commonly cued as hip to shoulder width (slightly wider than hips), and feet parallel may refer to the first or second ray parallel (big toe, or second toe). Often, professionals will allow a significant amount of “turn out” during a squat, and defend the foot position, by quoting that “15° of foot/ankle external rotation is normal.” Howver, this is the malleolar angle without consideration of additional bone joint angles of the lower extremity, and does not account for the 25-45° seen practiced by some. 15° of foot/ankle “turn out” using the center of the foot as a starting position would only be enough “turn-out” to result in 1st ray pointing forward. Clinically, the stricter guidelines described above have proven more provocative/sensitive, and therefore, have resulted in more consistent and positive outcomes.
Knee Checkpoint
Underneath hips, knee caps face forward, patella tracks over second and third ray (toes).
Pelvis checkpoint
Normal lumbar curve, neutral pelvis (anterior superior iliac spine (ASIS) within an inch of level of the posterior superior iliac spine (PSIS)), no right to left asymmetry.
Tibia and torso
The tibia and the mid-axillary line should remain parallel to one another throughout the OHSA.
Shoulder Girdle
Shoulder blades down and back (upward rotation and posterior tipping without excessive elevation)
Arms
remain inline with torso with elbows locked, maintaining roughly 180º of flexion and 150º to 170º of abduction.
OHSA Set up instructions
Do your best not to indicate the objective of the assessment, or what signs you are looking for during the assessment. We do not want clients/patients attempting to assume “ideal posture” and altering the results of the OHSA.
Ask your patient/client to stand with feet hip width apart.
Because foot placement may be a bit random, and an individual may assume a range of comfortable foot positions, cue and manually adjust foot position so that the OHSA is started with ideal foot position (or as close a foot position as can be achieved).
Ask your patient/client to reach “straight up” over their head with elbows “locked”.
Ask your patient to “sit down” and “stand up” as many times as necessary to assess if the signs discussed below are present.
Helpful Tips:
For those who do not know how to squat or may be a falls risk, this can be done with a chair, and thought of as a “sit-to-stand transfer assessment”.
For advanced exercises and athletes who may “know what a squat should look like”, it may be helpful to have them close their eyes, reducing visual input and their ability to self-correct.
Common Mistakes:
Stick to the “Signs”: It is tempting to start noting every “deviation” based on a personal frame-of-reference of squat form. The only signs that have been correlated with dysfunction and successful intervention are the signs discussed below. Adding additional signs to the assessment, however well intentioned, may serve to invalidate the assessment, and/or reduce reliability.
Common signs of dysfunction
Feet flatten Feet turn-out Knees bow-in Knees bow-out Excessive lordosis (Anterior pelvic tilt) Excessive forward lean Arms fall Shoulder girdle elevation Asymmetrical weight shift
signs of dysfunction at the feet
Feet Flatten or turn out
