Week 4 Assessments CONOR HARRIS CSCS XPS CES
- Slides: 46
Week 4 - Assessments CONOR HARRIS – CSCS, XPS, CES, CPT
Learning Objectives Appreciate what each test is assessing for in terms of potential limitations Be able to determine what constitutes a given biomechanical pattern result Know what the general limitations are for each respiratory bias in a primary compensation Understand the importance of test/re-test protocols
If you are a strength coach or personal trainer, you are NOT a physical therapist Scope of Practice We cannot diagnose & treat, but we CAN give exercises to help people with their pain Use the right language to avoid potential legal trouble "Fitness exercises" "Warm up/cooldown exercises" “Reset drills"
RELAX. Tests are active, but need relaxation Clients will want to tense up
Ober's Test Goal: Knee drops to table without restriction Testing for: Pelvic IR/ADD/EXT Test is over when: • Back extends • Significant restriction is felt
Results Back Arches: Missing Hip Extension Halfway to Table: Missing IR, ADD All the way to table: Access to IR, ADD, EXT
Active Knee to Chest Goal: 120 degrees Testing for: • Pelvic ER, ABD, FLX • Counternutation on active leg, nutation on passive leg Test is over when: • Upper or lower leg isn’t straight anymore • Down leg comes off ground Source: Bill Hartman: https: //billhartmanpt. com/
Results 60 -100 Degrees: Pelvic IR bias 110 -130 Degrees: Can counternutate and re-access pelvic ER 130+ Degrees: Starting in excessive anterior pelvic tilt (passively cheating)
Straight Leg Raise Goal: 70 degrees Testing for: • Femoral IR • Nutation • Counter-nutation of spine Test is over when: • Knee bends • Other leg comes off floor • Pelvis rolls to one side Source: Alex Effer: https: //resilientedu. com/
The Screw-Home Mechanism Relative femoral internal rotation with tibial external rotation Tightens knee ligaments (ACL, MCL, PCL, etc)
Results 0 -45 Degrees: Compression of posterior pelvis (deep hip ER’s are tight) 45 -70 Degrees: Ability to nutate and IR, can’t re-counternutate lumbar spine 70 -80 Degrees: Can counter-nutate lumbar spine (aren’t stuck in lumbar extension) Source: Alex Effer: https: //resilientedu. com/
Squat Goal: Ass to grass Testing for: • Counter-nutation of sacrum • Pelvic expansion (ER, ABD, FLX) Test is over when: • Butt-wink occurs • Heels come off floor • Balance is lost
Results <60 Degrees: Can’t access nutation/IR mechanics 60 -100 Degrees: Ability to nutate and IR, can’t re-counternutate sacrum 100+ Degrees: Can counter-nutate sacrum
Toe-Touch Goal: Fingers to toes Testing for: • Full Limb-Arc Model • Location of ribcage compression Test is over when: • “Tent” occurs • Knees come forward Source: Alex Effer: https: //resilientedu. com/
Results Knees = Can’t nutate Mid-shin = Can nutate but not recounternutate Full = ER → IR → ER
Weird things you may see No posterior shift of weight or pelvis Flat back Palming the floor Leveraging compression in thorax (rectus strategy) and/or length of hamstrings to bypass pelvic mechanics Moving using orientation, not relative motion
UPPER BODY
Shoulder Internal Rotation Goal: 70 Degrees Testing for: • Anterior T 5 -7 Expansion Test is over when: • Posterior shoulder comes off ground • Back extends • Discomfort is felt
Results <70 Degrees = Lacking Anterior T 57 Expansion >70 Degrees = Access to Anterior T 5 -7 Expansion
Shoulder External Rotation Goal: 90 Degrees Testing for: • Posterior T 5 -7 Expansion Test is over when: • Posterior shoulder comes off ground • Back extends • Discomfort is felt
Results <90 degrees = Limited access to Posterior T 5 -7 Expansion 90 degrees = Access to Posterior T 5 -7 Expansion
Shoulder Abduction Goal: 30 Degrees Testing for: • Anterior and Posterior T 5 -7 Expansion Test is over when: • Posterior shoulder comes off ground • Back extends • Palm or forearm rotates • “Nerve” sensations
Results <30 Degrees = Limited T 5 -7 Anterior and/or Posterior Expansion 30+ Degrees = Access to T 5 -7 Anterior and Posterior Expansion
Shoulder Adduction Goal: 30 Degrees Testing for: • Anterior and Posterior T 2 -4 Expansion Test is over when: • Posterior shoulder comes off ground • Trunk “rolls” • Discomfort is felt
Results <30 Degrees = Limited T 2 -4 Anterior and/or Posterior Expansion 30+ Degrees = Access to T 5 -7 Anterior and Posterior Expansion
Shoulder Flexion Goal: 170 Degrees Testing for: • Full thorax expansion abilities • Scapulohumeral Rhythm Test is over when: • Back arches • Trunk “rolls” • Elbow deviates outward (abducts) • Head comes forward
Results 0 -90 Degrees: Compression in lower ribcage below T 8/scaps 90 -120 Degrees: Compression at T 5 -7 (mostly posteriorly, but also anteriorly) 120 -180 Degrees: Compression at T 2 -4 posteriorly
The side that is better, that is the side we are likely rotated to EXPECT TO SEE BETTER EXPANSION MEASUREMENTS ON THAT SIDE – ER, ABD, FLX
Expected Results: Narrow ISA Thorax HG IR: <70 Degrees HG ER: 90 Degrees Shoulder Flexion: 160+ Degrees Shoulder Abduction: 30+ Degrees Shoulder Adduction: <30 Degrees
Expected Results: Narrow ISA Pelvis Squat: Full Toe-Touch: Knees or Mid-Shin Supine Knee to Chest: 120 Degrees Straight Leg Raise: ~50 degrees Ober’s: Fail
Expected Results: Wide ISA Thorax HG IR: 70+ Degrees HG ER: <90 Degrees Shoulder Flexion: 100 -120 Degrees Shoulder Abduction: <30 Degrees Shoulder Adduction: <30 Degrees
Expected Results: Wide ISA Pelvis Squat: Parallel Toe-Touch: Mid-Shin Supine Knee to Chest: <110 Degrees Straight Leg Raise: 70 Degrees Ober’s: Pass
It's All Relative THE FOLLOWING EXPECTATIONS ARE ALL RELATIVE TO THE STARTING POINT OF RESPIRATORY BIASES
Results – Left AIC Ober’s: Left < Right Supine Knee to Chest: Left > Right Straight Leg Raise: Left < Right
Results – Right BC HG IR: Left > Right HG ER: Left < Right Shoulder Flexion: Left < Right Shoulder Abduction: Left < Right Shoulder Adduction: Left > Right
OPTIONAL TESTS
Internal Rotation External Rotation Femoral Rotation ER = 45 degrees ideal IR = 40 degrees ideal
Knee Extension Goal: Full extension at 180 degrees Testing for: Femoral IR, Tibial ER mechanics
Knee Flexion Goal: ~130 degrees Testing for: Femoral ER, Tibial IR mechanics
Test/Re-Test 1. Try a technique you feel is appropriate 2. Retest same assessment immediately after. Did it make meaningful change? If not, it wasn't coached well enough and/or they need a new exercise
Recommended: Online Assessments Toe Touch Squat Shoulder Flexion Supine Knee to Chest Straight Leg Raise HG IR/ER Humeral Abd/Adduction
Suggested “Quick Assessment” Toe-Touch to Squat Active Knee to Chest Shoulder Flexion
Assessment Sheet Linked in program materials on website
ASSESSMENT TIME!
Sources Postural Restoration Institute: https: //www. posturalrestoration. com/ Bill Hartman: https: //billhartmanpt. com/ Zac Cupples: https: //zaccupples. com/ Alex Effer: https: //www. resilientrehab. ca/
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