Week 4 Assessments CONOR HARRIS CSCS XPS CES

  • Slides: 46
Download presentation
Week 4 - Assessments CONOR HARRIS – CSCS, XPS, CES, CPT

Week 4 - Assessments CONOR HARRIS – CSCS, XPS, CES, CPT

Learning Objectives Appreciate what each test is assessing for in terms of potential limitations

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

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

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

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

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

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

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 •

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

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

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

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

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

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 =

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

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

UPPER BODY

Shoulder Internal Rotation Goal: 70 Degrees Testing for: • Anterior T 5 -7 Expansion

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

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

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

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

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

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

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

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

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:

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

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

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

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

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

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

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 >

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

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

OPTIONAL TESTS

Internal Rotation External Rotation Femoral Rotation ER = 45 degrees ideal IR = 40

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

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

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

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

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

Suggested “Quick Assessment” Toe-Touch to Squat Active Knee to Chest Shoulder Flexion

Assessment Sheet Linked in program materials on website

Assessment Sheet Linked in program materials on website

ASSESSMENT TIME!

ASSESSMENT TIME!

Sources Postural Restoration Institute: https: //www. posturalrestoration. com/ Bill Hartman: https: //billhartmanpt. com/ Zac

Sources Postural Restoration Institute: https: //www. posturalrestoration. com/ Bill Hartman: https: //billhartmanpt. com/ Zac Cupples: https: //zaccupples. com/ Alex Effer: https: //www. resilientrehab. ca/

ARTICLES/VIDEOS: Suggested Reading Thoughts on the Adduction Drop Test Interpreting Lower Body Assessments Range

ARTICLES/VIDEOS: Suggested Reading Thoughts on the Adduction Drop Test Interpreting Lower Body Assessments Range of motion interpretation mistakes