The BioMechanics Method

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Ada Russell
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1 The BioMechanics Method EXERCISE SOLUTIONS FOR CHRONIC PAIN The Fundamentals of Structural Assessment

2 End of Section Self-Check There are many things that can make conducting a structural assessment more confusing or stressful than necessary. Take a few minutes to consider the following problems one might encounter before, during or after an assessment. Indicate in the space next to each issue who would be affected by the issue and what you could do to rectify the problem. Potential Issue Client, Assessor or Both Possible Solution Assessor cannot remember all the information the client tells them during the verbal assessment process Client arrives 15 minutes late for their appointment because they could not find parking near the facility Client becomes irritated during the assessment process over what assessor is doing and why they need to do it Assessor cannot clearly see the structures or areas of the body they are trying to evaluate due to the client s clothing Client does not see the point in assessor conducting an entire body assessment when they only came in for a specific problem (e.g., knee pain) 10 Section 1 The Process of Structural Assessment 2010 The BioMechanics. All Rights Reserved.

3 End of Section Self-Check Assess the condition of your own feet and ankles to determine the state of your own foundation. Remove your shoes and socks and take a few minutes to check for the following signs of wear and tear: Do you have Yes No Where Bunions Tender or sore plantar fascia Hammer or claw toes Pain in and around the ankle joint Valgus position of big toe Calluses Abducted foot position Tight or sore calf muscles Now check to see whether you overpronate by using the Talus Bone Assessment described in this section. Do you overpronate? Use the Talus Bone Assessment to find a neutral position for your foot and ankle. Assess both sides until you feel confident that you can find the correct position. Can you find a neutral position for your feet and ankles? Once you are able to achieve a neutral position in your own feet and ankles, practice the assessment on someone else. 24 Section 2 Assessing the Feet and Ankles 2010 The BioMechanics. All Rights Reserved.

4 Assessment Skills Test Perform a complete foot and ankle assessment on another person. Record your findings below in the Client Assessment Diagram. CHECKLIST FEET AND ANKLES Y / N DETAILS Pain? Arthritis? Function? Aggravating Factors? Causal Links? Visual Irregularities? Pronated? Ab/Adducted? Condition of Toes? Plantar Fascia? Condition of Calves? Client Knows Neutral? 2010 The BioMechanics. All Rights Reserved. Section 2 Assessing the Feet and Ankles 25

5 End of Section Self-Check Since the function of the knee is directly affected by the structures above and below it, the condition of your knees can act as an early warning system to detect if there are structural issues or malalignments in the feet and ankles and/or the lumbo-pelvic hip girdle. Assess your own knees and see what kind of grade you would get on the following knee health report card. Impression Perfect working order Exceeds expectations As expected Have some problems Need help Description Patella aligned over middle of second toe when standing, small medial movement when squatting, no pain or popping or grinding during any movement Patella nearly aligned over middle of second toe when standing, moderate amount of inward movement of knee when squatting, little or no pain, popping or grinding during flexion/extension is minimal Patella not aligned over second toe when standing, but can be when in neutral foot/ankle position, a little too much inward movement of knee when squatting, occasional pain, slight popping or grinding during flexion/extension Patella not aligned over second toe when standing, find it difficult to bring it into alignment/achieve/maintain neutral foot and ankle position, patella is noticeably shifted toward the middle of body when standing still and squatting, frequent or persistent pain, popping or grinding during movement Patella not aligned over second toe when standing, unable to bring it into alignment/achieve/maintain neutral foot and ankle position, valgus position of the knee standing and even worse when squatting, swelling, constant or persistent pain Grade ( X which category describes you) 36 Section 3 Assessing the Knees 2010 The BioMechanics. All Rights Reserved.

6 Assessment Skills Test Perform a complete knee assessment on another person. Record your findings below in the Client Assessment Diagram. CHECKLIST KNEES Y / N DETAILS Pain? Arthritis? Function? Causal Links? Aggravating Factors? Visual Irregularities? Single Leg Squat? Patella Tracking? Client Knows Neutral? 2010 The BioMechanics. All Rights Reserved. Section 3 Assessing the Knees 37

7 End of Section Self-Check Since the pelvis is where the upper body and lower body connect, everything above and below it are affected by deviations in this area. Stand in front of a mirror and practice trying to posteriorly tilt your pelvis to achieve a neutral position for your pelvis (either against the wall or with the palms on pelvis technique). As you bring your pelvis and lumbar spine into alignment, look for any movements or compensations that occur in other parts of your body. Examine each part of your body and write down what you see happen in the spaces below. For example, as you try to posteriorly tilt your pelvis to decrease the arch in your lower back, you might notice that your shoulders come forward away from the wall. This may happen because your body is used to pulling your shoulders back to the wall by excessively arching your lower back. However, when you take away this compensation pattern by decreasing the arch in your lower back, you may find that your shoulders can no longer stay against the wall. Area of Body What I Noticed Happened Foot Ankle Knee Lower Back Upper Back/Shoulders Neck/Head 50 Section 4 Assessing the Lumbo-Pelvic Hip Girdle 2010 The BioMechanics. All Rights Reserved.

8 Assessment Skills Test Perform a complete lumbo-pelvic hip girdle assessment on another person. Record your findings below in the Client Assessment Diagram. CHECKLIST LUMBO-PELVIC HIP GIRDLE Y / N DETAILS Pain? Arthritis? Function? Causal Links? Aggravating Factors? Visual Irregularities? Excessive Lordosis? Anterior Rotation? Client Knows Neutral? 2010 The BioMechanics. All Rights Reserved. Section 4 Assessing the Lumbo-Pelvic Hip Girdle 51

9 End of Section Self-Check You should now be very aware that poor alignment of the thoracic spine can impair movements of the thoracic spine and the entire shoulder girdle region. To further demonstrate how excessive thoracic kyphosis can have an effect on the correct functioning of various joints and muscles is these areas, perform the movements detailed below. Try each movement first with your upper back rounded. Then correct your posture and repeat the same movement. Make a note of the quality and the range of motion of you achieve when you perform each movement in both the bad posture trial (A) and the corrected good posture trial (B). MOVEMENT #1 Trial A: Round your upper back and shoulders. Try to lift your arms over your head and back toward your ears while still keeping your upper back and shoulders rounded forward. Make a note of how high you can lift your arms back to your ears. Trail B: Now correct your posture in your thoracic spine and shoulder girdle and try to lift your arms again. You will notice that your arms can lift much higher and further back to your ears when your thoracic spine and shoulder girdle are in alignment. MOVEMENT #2 Trial A: Round your upper back and shoulders. Try to rotate your torso to the right and then to the left while still keeping your upper back and shoulders rounded forward. Make a note of how far you can rotate to the right and to the left. Trail B: Now correct your posture in your thoracic spine and shoulder girdle and try to rotate your torso to the right and then to the left again. You will notice that you can rotate much further when your thoracic spine and shoulder girdle are in alignment. MOVEMENT #3 Trial A: Round your upper back and try to rotate your arms outward and behind you so that the palms of your hands rotate away from your body. Be sure to keep your upper back and shoulders rounded forward as you perform the movement. Make a note of how far your arms and shoulders rotate back. Trail B: Now correct your posture in your thoracic spine and shoulder girdle and try the same movement again. You will notice that you can rotate your arms and hands much further back when your thoracic spine and shoulder girdle are in alignment The BioMechanics. All Rights Reserved. Section 5 Assessing the Thoracic Spine and Shoulder Girdle 65

10 Assessment Skills Test Perform a complete thoracic spine and shoulder girdle assessment on another person. Record your findings below in the Client Assessment Diagram. THORACIC SPINE AND SHOULDER GIRDLE Pain? Arthritis? Function? Causal Links? Aggravating Factors? Excessive Kyphosis? Protracted/Elevated Scapula? Internally Rotated Arms? Muscle Tension? Client Knows Neutral? CHECKLIST Y / N DETAILS 66 Section 5 Assessing the Thoracic Spine and Shoulder Girdle 2010 The BioMechanics. All Rights Reserved.

11 End of Section Self-Check You now know all the techniques for achieving a neutral position for your feet and ankles, knees, lumbo-pelvic hip girdle, thoracic spine and shoulder girdle, and neck and head when standing. Take a few minutes to try them all out together to see if you can achieve a neutral standing position from your feet to your head. Write down any information regarding your experience to help you better understand where your own structural deviations exist. For example, if you feel the muscles in your feet working very hard to maintain a neutral foot position, it may indicate that you overpronate and the muscles of your feet are deconditioned as a result. Alternatively, when you try to pull your shoulders back to the wall to achieve a neutral thoracic spine and shoulder girdle position, you may feel your lower back arch excessively. This may be indicative of the fact that the muscles of your thoracic spine and shoulders are weak and you have to compensate by overusing your lower back to cheat your shoulders back to the wall The BioMechanics. All Rights Reserved. Section 6 Assessing the Neck and Head 75

12 Assessment Skills Test Perform a complete neck and head assessment on another person. Record your findings below in the Client Assessment Diagram. CHECKLIST NECK AND HEAD Y / N DETAILS Pain? Arthritis? Function? Causal links? Aggravating factors? Visual irregularities? Forward head? Excessive curvature? Client knows neutral? 76 Section 6 Assessing the Neck and Head 2010 The BioMechanics. All Rights Reserved.

WHY BASIC HIP FLEXOR STRETCHES DON'T ALWAYS WORK

WHY BASIC HIP FLEXOR STRETCHES DON'T ALWAYS WORK Do you do a daily stretching routine only to find that your muscles tighten back up throughout the day? Do you continue to stretch your hamstrings but still