Paul Thawley BSc (Hons), MSc, Pg Dip Simple movement Patterns and dysfunction

This an extra Lecture You will not have a written paper on this However sports medicine uses and understands physical and functional movements

Movement dysfunction can be caused by a range of factors, including: Structural instability: which occurs when the body structure fails, usually as a result of a direct trauma Loss of Range of Motion (ROM): which can be due to joint stiffness, muscle tightness or motor patterning (acts performed with less skill and in which movement is stressed) Functional rigidity: which often develops if an athlete tries to cope with a higher balance or stability challenge than they are capable of Insufficient Control of Momentum: if an athlete can't control their momentum, their change in direction will be slow, or, alternatively, will throw them off balance

Poor balance: balance requires an interplay between your vision, inner ear and body's feedback Poor co-ordination: Most obvious in racket sports, and golf Timing: Poor stability is often related to timing problems Poor understanding of the movement required: Caused by a misunderstanding between the coach and athlete Poor training design: unsuitable training practices Stress: Stress from the mind can manifest itself in the body

Clinical Movement Analysis to Identify Muscle Imbalances and Guide Exercise MOVEMENT is an essential component of athletic performance. Human movement is influenced by an individual’s structural alignment, muscle flexibility, muscle strength, and nervous system coordination of muscle responses to a changing environment. (Padua 2007) The Overhead Squat Test can be used to qualitatively assess an individual’s overall movement patterns. The results of this test can then be related to goniometric measures (muscle flexibility) and manual muscle testing (muscle strength) to develop a comprehensive view of the individual’s movement characteristics. (Ford et al 2003)

Observable functional test can provide the basis for therapeutic exercise recommendations for stretching of potentially overactive and tight muscles and for strengthening of underactive and weak musculature. To optimize function, the individual should be progressed to an integrated functional exercise program. (Clark et al 2005)

The Overhead Squat Is used regularly in screening by medical teams It can help identify Common dysfunctional movement patterns. It can be linked to Muscle testing etc

After Padua 2007 Over head Squat Two legged squat with the arms raised overhead. The athlete is instructed to stand with feet hip-width to shoulder width apart with toes pointing straight ahead and arms raised above the head.

The athlete is instructed to squat down as if sitting in a chair. The observation is made from three views: anterior, lateral, and posterior. 5 Squats are preformed whilst the clinician observes from anterior view, lateral view posterior view (15 squats in total The clinician notes the movement pattern characteristics by recording whether or not a particular characteristic was identified during performance of the test. Method

Anterior View : Observations made from the anterior view of the overhead squat are focused at the feet and knees A common compensation at the feet is the foot turning outwardly When observing for the presence of toe out assess the position of the first metatarsophalangeal (MTP) joint in relation to that of the medial malleolus. The 1st MTP joint will align with the medial malleolus in a normal foot, whereas the first MTP joint will appear lateral to the medial malleolus with foot turn-out. This can identify potentially overactive/tight muscles and underactive/weak muscles Foot and Ankle

Anterior View Knee Inward movement of the patella over the first MTP joint during the squatting movement creates valgus stress at the knee

lumbo-pelvic hip complex (LPHC) and upper body positions. Lateral View Two common compensations are excessive forward leaning and arms falling forward. Trunk should remain parallel to the lower leg during the descent phase of the squat. If the two imaginary lines do not remain parallel, forward leaning is excessive (Figure 4).

Arms should be held over the head in an elbow-extended position parallel to the torso. If the arms move forward in relation to the torso, the observation is designated as “the arms falling forward”

Observations made from the posterior view include the positions of the feet and the lumbo-pelvic hip complex. The calcaneus should stay parallel with the lower leg A common compensation seen at the feet is pronation. During the descent phase of the Overhead Squat Test may observe flattening of the medial longitudinal arch with eversion of the calcaneus in the frontal plane Posterior View

Identifying possible causes of common movement dysfunction

Overactive? underactive?

Overactive? Underactive?

Single Leg Squat Increases demand and need for balance + control Can be specific to sport / running single stance Requires Rotational control