Bulletproof Back Assess & Address

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2 Bulletproof Back Assess & Address Copyright 2010 by Eric Wong Training Systems All Rights Reserved. No part of this work may be reproduced or transmitted in any form or by any means without express written permission of Eric Wong Training Systems. Published by: Eric Wong Training Systems 484 Plains Rd. E PO Box L7T 4J8 eric@bulletproofback.com Web: Disclaimer There is always a risk of injury when performing any type of exercise. You must consult with your physician prior to beginning any exercise program or if you have any medical condition or injury that contraindicates physical activity. If you experience any lightheadedness, dizziness, or shortness of breath while exercising, stop the movement and consult a physician. The exercise information is not meant to provide any medical advice; it is for educational purposes only. No liability is assumed by Eric Wong Training Systems for any of the information contained herein.

3 How to Use This Guide By working through this guide, you ll discover 1. What condition you re likely to have that causes your back pain, if you ve never had a real diagnosis 2. If you have postural dysfunctions and what to do about them 3. If you have muscular imbalances and what to do about them 4. How flexible you are and what to do to improve your flexibility to reduce your pain 5. If your core muscles are working properly So let s get started! Just follow the 4 steps in this guide and you ll have completed the entire assessment and have an individualized plan to free yourself from back pain. Page 1

4 Step 1 - Symptoms and History Questionnaire The following questions will help you get a clear history of your back pain and identify some movements and/or tasks that bring about your back pain. 1) When did you first start having back pain (month, year): 2) How often do you usually get back pain (eg. once a month, once every 2 months)? 3) How long does your back pain usually last when you do get it? 4) If you ve been diagnosed with a condition, list it here: The pain table below will allow you to track your pain over time. The goal is to have a downward trend in the frequency, intensity and duration of your pain time until you re completely pain free. Scale: 1 = very slight pain, 5 = moderate pain, 10 = severe pain Date Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10 Week 11 Week 12 Week 13 Week 14 Week 15 Week 16 Month 5 Month 6 Pain Rating Page 2

5 Print this sheet off to complete so you can refer to the scoring chart on the next page. 1. I have numbness or tingling/pins and needle sensation or altered sensation (ie. burning sensation, decreased sensation) in my leg(s) and/or foot (feet). 2. It feels better when I stand, walk or move around compared to sitting. 3. My back pain started suddenly after lifting, bending over and/or twisting. 4. It feels better when I arch my back backwards while I m standing. 5. It hurts my back more when I cough or sneeze. 6. I have pain that goes into my buttocks sometimes. 7. I am over the age of 50, and my back has been progressively getting worse over the years. 8. I am stiffer in the morning; throughout the day my back seems to loosen up and feels better. 9. It feels better when I sit compared to when I am standing or walking. 10. My back pain is worse with activity and after activity but is usually not there if I am not doing anything. I also get low back muscle spasms sometimes. 11. My back pain started after a trauma (ie. motor vehicle accident, fall, etc.) 12. My back pain started for no reason that I can identify. 13. My back pain comes on randomly, but does not last a whole day and I cannot recall anything that caused it to start in the first place. 14. My back pain is constant and never goes away, not even at night in bed. 15. There have been recent changes in my bowel or bladder functions (i.e. I am unable to go to the bathroom when I feel I need to, or I need to go to the bathroom urgently, or I have accidents). 16. My sexual desire/performance has noticeably declined. 17. My inner thighs or groin area is numb (i.e. I cannot feel the toilet seat when I sit down like I used to) or there is altered sensation in that area. 18. I have lost weight without any explainable reason (unintentional weight loss). 19. Have you been diagnosed with osteoporosis, cancer, any connective tissue disease or any heart or lung conditions? 20. Have you had long term use of meds (i.e. corticosteroids), or are you currently on prescription medications (i.e. blood thinners, cholesterol medications)? Page 3

6 Questionnaire Scoring Worksheet The links in this section are all clickable links, so if you see A) RED FLAGS - Get Screened by a Medical Professional If you answered YES to #11, you require screening from a medical professional to identify possible fracture, internal organ damage and/or other possible tissue damage, before beginning this program, which could make things worse. If you ve already had screening performed and are cleared to exercise, you can start this program. If you answered YES to one or more of #14, 15, 16, 17, 18, 19 or 20 get screening from a medical professional PROMPTLY to rule out serious pathology and to ensure this program is suitable. Do not follow advice in this program at this time. B) Sciatica If you answered YES to #1, 2, 3, 4 and 5, you have sciatica that is a result of a disc herniation/bulge, so refer to Page 6 to verify your symptoms. If your symptoms match the description, begin treatment. If you answered YES to #1 and 2, or 1, 2 and 6 (with NO for responses for 3, 4 and 5), then you likely have sciatica from a tight sciatic nerve or compression of the sciatic nerve from muscles such as the piriformis, so refer to Page 6 to verify your symptoms. If your symptoms match the description, begin treatment. C) Disc Herniation or Bulge (Flexion Dysfunction) If you are under 50 years of age and you answered YES to #3, 4, or 5 or any combination of them (eg. 3+4, 4+5, 3+4+5), you likely have a Disc Herniation, so refer to Page 8 to verify your symptoms. If your symptoms match the description, begin treatment. D) Degenerative Disc Disease If you answered YES to #7 and 8, you likely have Degenerative Disc Disease (DDD), so refer to Page 9 to verify your symptoms. If your symptoms match the description, begin treatment. E) Central Stenosis If you answered YES to #7 and 9, you likely have Central Stenosis, so refer to Page 10 to verify your symptoms. If your symptoms match the description, begin treatment. Page 4

7 F) Lateral Stenosis If you answered YES to only #1, you likely have Lateral Stenosis, so refer to Page 10 to verify your symptoms. If your symptoms match the description, begin treatment. G) Spondylolisthesis If you answered YES to #5 and 9, you likely have Spondylolisthesis, so refer to Page 11 to verify your symptoms. If your symptoms match the description, begin treatment. H) Low Back Muscle Sprain or Strain If you answered YES to #10, you likely have a Low Back Muscle sprain or strain, so refer to Page 12 to verify your symptoms. If your symptoms match the description, begin treatment. I) Core Function, Posture, Muscular Imbalances and/or Poor Movement Patterns If you only answered YES to only #12 and/or 13, you simply need to follow the customized plan that you ll create when you complete this guide and start the workouts in the Training Guide. Page 5

8 Sciatica Common Symptoms Low back pain Pain in the butt Pain in various parts of the leg and foot Numbness or muscular weakness or pins and needles/tingling in the leg/foot Background Information The sciatic nerve starts in the lower part of the lumbar spine (see 1 in diagram), and travels down the butt and the back of the thigh and then branches into two different, smaller nerves when it reaches the back of the knee (see 2 in diagram). The two branches run down the outer calf and into the outer edge of the foot (see 3 in diagram) and down the middle part of the calf (see 4 in diagram). That s why if you have sciatica, you may experience symptoms (pain, tingling, pins and needles, numbness or altered sensation) in any area where the sciatic nerve runs. Page 6

9 IMPORTANT POINT: Sciatica is not necessarily something you have, it s actually a term used to describe the symptoms of three different conditions. If you have sciatica, you ll have one (or more) of the following conditions: 1. Piriformis Syndrome Piriformis syndrome occurs when the sciatic nerve is compressed by a tight piriformis muscle. This can happen because the sciatic nerve lies very close to the piriformis, and in some people, the nerve actually runs through the piriformis.(see diagram 1 and point out where piriformis) 2. Tight Sciatic Nerve A tight and shortened sciatic nerve which can develop gradually over time if you are fairly sedentary and don t use the full range of motion of your lower body. If you have #1 or 2, you ll follow the treatment protocol below. 3. Sciatica as a Result of Disc Herniation/Bulge A disc herniation in the lumbar spine can compress or irritate the nerve root (where the nerve comes branches out from the spinal cord and exits the spine the start of the nerve) because the disc basically pushes on the nerve as it exits the spine. If you have this, you will follow the treatment outlined in the Disc Herniation section. If you have sciatica, do the following: For #1 and #2: Piriformis stretching Foam rolling on the piriformis Removing wallet from back pocket Sciatic nerve flossing Click Here to Watch these Videos For #3 See Disc Herniation treatment in the next section Page 7

10 Disc Herniation / Bulge Common Symptoms Low back pain Pain or weakness/numbness/tingling/pins and needles in the leg or foot, usually in only one leg or foot Symptoms worsen with sitting (especially prolonged sitting and driving), getting up from sitting to standing position, bending down, coughing and sneezing Symptoms relieved with walking, standing, lying down Morning stiffness in the low back Background Information Herniate is a fancy term for protrude. In a herniated disc the nucleus of the disc (blue part of image) protrudes and compresses the nerve (yellow part in the inset). Remember our jelly donut analogy from the Master Manual? In a herniated disc, the jelly (nucleus) squirts out and irritates the nerve. Also, the tearing of the fibres of the disc (annulus) may produce an inflammatory response which can also cause low back pain. Because the brain wants to protect the disc from further damage, it causes your muscles to contract and go into spasm, preventing motion. A herniated disc typically happens to people between years old. It s often brought on by repetitive forward bending and/or twisting or less often by one big bend and/or twist. If you have back pain due to a disc herniation, do the following: Extension exercises 2-3 times daily, 10 reps (Standing extensions or Pressups) Click Here to Watch the Extension Exercises for Disc Herniation Avoid flexion of the lumbar spine and excessive posterior pelvic tilt o Decrease sitting and when you do sit, make sure to use a lumbar roll/towel o Lie on your stomach as much as you can tolerate o Eliminate / minimize bending and use proper lifting mechanics o Avoid sitting on soft or low seats such as a soft couch or low foot stool as they cause your lumbar spine to flex o Sleep on firmer mattress Avoid twisting the spine, instead, move the feet so that you don t have to twist Page 8

11 Degenerative Disc Disease Symptoms More pain when sitting for a long time, bending, lifting, or twisting Less pain when walking or running Less pain if you change positions frequently Less pain when you lie down If the nerves are compressed by bone spur growth, then you may feel numbness, tingling/pins and needles sensation, weakness or pain in the buttock or leg/foot Degenerative disc disease (DDD) is more of a condition than a disease. This condition is, as the name implies is a degenerative arthritic condition of the lumbar spine. For some people, it may be part of the aging process. The intervertebral discs become thinner, less flexible, less fluid, and lose their shock absorbing qualities. It s related to the principle of repetitive stress usually the individual with DDD has had back pain throughout their adult lives most likely due to disc herniations and bulges. Over time, the outer ring of the disc (annulus fibrosis) continues to take a beating due to movement habits and becomes brittle and can tear more easily, allowing the fluid (nucleus) to leak out of the disc. As the space between the vertebrae become smaller because of the thinning discs, bone spurs (also called osteophytes) start to develop as part of the degeneration process, which may put pressure on the spinal nerves. As well, ligaments in the spine become thicker to add support to the degenerating spine (see diagram). DDD is the permanent result of a lifetime of poor movement habits, but pain can be minimized because of it! The key is to minimize the stress you put on the spine by learning proper movement habits, which you ll do in this program. Risk Factors Being 50 years old or older An injury to the spine, which may start the degenerative process Smoking Doing heavy physical work (ie. repetitive lifting) Treatment Your customized plan and the Bulletproof Back Training Program! Page 9

12 Stenosis Symptoms Low back pain, which is often better with sitting or forward bending of the back (like reaching for your toes) Pain radiating into the buttocks and legs, which is often worse with walking and better with rest Numbness or tingling feeling in the back or legs Weakness in one or both legs In rare, severe cases, loss of bowel or bladder control or loss of sexual function Spinal stenosis is a narrowing of the spine in an area that causes pressure on the spinal cord or the nerve roots as they leave the spinal cord. Central stenosis is when the pressure is on the spinal cord itself. Lateral stenosis is when the pressure is on the nerve roots. Stenosis is more likely to affect those over the age of 50. Do the following if you have symptoms in BOTH sides of the butt, both legs and/or both feet: If you have pain, sit down and hug your thighs by wrapping your arms around them for seconds x 2-3 repetitions to see if it helps decrease symptoms Sleep on your back with 1 or 2 pillows under your knees Avoid sleeping on your stomach or lying on stomach Sit when symptoms get worse When you need to stand for long periods of time, put one foot on a stool Do the following if you have symptoms in only ONE butt, leg and/or foot Follow the Disc Herniation protocol Page 10

13 Spondylolisthesis The main thing to note if you have Spondylolisthesis is that whenever your lumbar spine is that extension (backwards bending) brings on pain while flexion or forward bending (think toe touch) helps reduce pain. Positions like standing and lying on your stomach put your spine into extension, so you ll want to minimize these positions. Symptoms Postural ache, worse when standing Usually worse with activity, may feel worse the day after the activity due to inflammation of tissues during activity to try to support spine Increasing lumbosacral ache when the extremes of movement are sustained for seconds Pain with activities requiring lumbar extension Often bilateral pain radiating into the back of the thighs Pain may decrease with lumbar flexion, posterior pelvic tilt, sitting Tenderness in the low back area which is pretty specific Normally the vertebrae (bones of the back) are stacked neatly on top of one another (see diagram). With a spondylolisthesis, the alignment of the spine is altered due to one vertebrae slipping forward on the vertebrae below. This condition can occur because of genetic malformations in the spine.it can also occur In younger people due to a stress fracture. Sports that include repeated backwards arching such as gymnastics and heavy contact sports such as football are often contributing factors in younger people. If you have back pain due to a spondylolisthesis, do the following: Perform Deep Core Activation exercises in a posterior pelvic tilt by removing your hand from your lumbar spine (you ll see the first example in the Corrective Phase Mobility and Developmental Exercise videos) - DAILY Perform lunge stretches with your foot on the ground and on the ball DAILY CLICK HERE to watch the Spondylolisthesis videos If you have pain, sit down and hug your thighs by wrapping your arms around them for seconds x 2-3 repetitions to see if it helps decrease symptoms Standing causes spine extension, so If your pain is due to standing for a long period of time sit down or put one foot up on a stool if you must stand Avoid lying on your stomach or sleeping on your stomach Ice the area after activity Avoid contact sports until after completing the Corrective Phase of the Bulletproof Back training program Page 11

14 Low Back Muscle Strain or Sprain Symptoms Low back pain Pain in the butt Low back muscle spasm Pain with activity, pain usually relieved with rest Background Information A low back muscle strain occurs when the muscle fibres of a low back muscle are stretched or torn. The low back has four large groups of muscles and any of these groups may become strained. A low back sprain occurs when the ligaments (bands that are attached from one bone to another and provide stability) are stretched or torn. The low back has a handful of ligaments that provide stability for the lumbar spine and any of them can become sprained. Symptoms and treatment for both a muscle strain or ligament sprain are similar. Initial Treatment Rest initially (1-2 days only); this will allow for the muscles to relax if they are in spasm from the injury and allow for inflammation to settle down Avoid any lifting, bending, twisting and other aggravating movements or any sports/exercise that causes pain during or after the activity Ice initially (up to 1 week if needed; see ice/heat section) Correct lifting biomechanics and posture and ergonomics (see the Fundamentals videos) Pain meds, anti-inflammatory meds and muscle relaxants may help you go about your day, BUT, the points above are the priority Pain meds must be minimized as outlined in the Myths and Misconceptions section in the Master Manual. Page 12

15 Step 2 Physical Assessment The Physical Assessment is composed of 2 parts: the Assessment Video and Postural Photo Assessment. There are 3 main components you will be testing: 1. Posture and Muscular Imbalances Muscular imbalances and posture give you an idea of the length of your muscles relative to each other. This is a very important area to address because if your body is out of balance, you ll put more load and wear on the joints where the imbalance lies. Think of it like your car if your wheels are out of alignment, your tires will wear out a lot faster. Plus, in day-to-day activities, exercise and sport, if you re out of balance, you ll be using more energy compared to a body that is in proper alignment, so you ll also improve your performance by correcting any dysfunctions that you have. 2. Absolute Range of Motion Absolute range of motion is the measure of the total range of motion or flexibility of certain muscles. While muscular imbalances cause more wear on the joints on a day-to-day basis, limited absolute range of motion is potentially damaging when you need to use the full range of motion, like squatting down to pick something heavy up off the floor. You ll be guided through the measurement of the most important areas to address when it comes to absolute range of motion: the hamstrings and the hip flexors. Page 13

16 3. Core Muscle Activation, Strength and Endurance If you re ever to be free of back pain, you need to first be able to activate all of the core muscles, then, you must build their strength and endurance. These tests will show you how to measure your current level and what where you need to be to achieve bulletproof levels of core fitness. Although there is a lot of information to gather here, just work through it step-by-step, and soon, you ll have performed a comprehensive assessment on yourself in under 30 minutes, and you ll have clear actions to take to correct any problems you may have. I don t know if you read those Choose Your Own Adventure books where you had to make a choice that brought you to either Page 35 or 57 when you were a kid, but I definitely did, and you this will be exactly like that. Page 14

17 Self-Assessment For this assessment, we ll be working through the Assessment Videos and the 2 photos you took standing to assess posture. Go through the Assessment Videos first, which are located here: Print this page so you can complete the tests and record your results easily. Flexibility Tests - for positive tests, stretch once 1-2x daily, 2 reps x 30 s hold each Test Positive? Action L or R tighter? 1) Shoulder girdle (Pencil test) Internal rotation set L / R 2) Psoas length/balance Lunge stretch L / R 3) Quads length/balance Lunge stretch SB L / R 4) Piriformis length/balance Piriformis stretch L / R 5) Pec length/balance Chest stretch L / R 6) Hamstring balance (Waiter s bow) ~ Hamstring stretch L / R 7) Position of Pelvis (Wall test) Anterior / Posterior Anterior or Posterior Pelvic Tilt Set Strength Tests retest every 4 weeks to track your progress Test Time (s) Grade 1) Lower ab coordination n/a Level 1 Level 2 Level 3 2) Lower ab strength n/a Poor Fair Good Excellent L: 3a) Side bridge endurance Poor Fair Good Excellent R: 3b) Side bridge balance n/a Difference > 5%? 4) Prone cobra endurance Poor Fair Good Excellent 5) Prone bridge endurance Poor Fair Good Excellent Posture Tests - for positive tests, stretch once 1-2x daily, 2 reps x 30 s hold each Test Positive? Exercises 1) Head / Neck Chin tuck, Neck side stretch L / R, Wall lean 3 x 20 s hold 2) Torso Torso side stretch L / R 3) Shoulders Thoracic mobilizations (4 segments x 5 s hold) Page 15

18 Flexibility Tests 1. Shoulder Girdle Position Test Instructions 1. Grab 2 pencils or pens and wrap your hands around them so the ends are sticking out the top of your hand 2. Stand naturally with your arms at your sides 3. Without moving your arms, look at where the pencils are pointing POSITIVE: If the pencils point in towards each other as shown in the picture below, perform the Shoulder Internal Rotation stretch set (Lat stretch, Chest stretch, Prone Cobra exercise) daily, performing 2 reps of each exercise holding 30 sec each rep for the stretches and 3 reps x sec hold for the Prone cobra Click Here to Watch the Shoulder Internal Rotation set If one side is rotated in more than the other, perform the stretches on this side two times for every one stretch on the other side. Page 16

19 2. Psoas Length/Balance Test Instructions 1. Get into the position pictured below: 2. Look at the angle of the hip that has the knee on the ground POSITIVE: If you can t get into the position without flexion of the hips, you have a tight psoas muscle so perform the Lunge stretch with foot on ground and on Swiss Ball daily, performing 2 reps holding 30 sec each rep for each exercise. Click Here to See the Corrective Lunge Stretches If one hip flexor is tighter than the other, stretch it two times for every one stretch on the other side. Page 17

20 3. Quadriceps Length/Balance Test Instructions 1. Lie on your stomach and grab your right ankle with your right hand 2. Keeping your body flat and left leg straight, pull your heel towards your butt POSITIVE: If you cannot touch your heel to your bum without flexion (forward bending) of the hips, perform the Lunge stretch on Swiss Ball daily, performing 2 reps holding 30 sec each rep. Click Here to See the Corrective Lunge Stretch on SB If one side is tighter than the other, stretch it two times for every one stretch on the other side. Page 18

21 4. Piriformis Length/Balance Test Instructions 1. Lie on your back and put one foot up on a Swiss ball 2. Cross your other ankle across the knee that s on the ball 3. Pull the ball in while pushing the knee down 4. Make sure to keep your hips on the floor POSITIVE: If your knee points up at an angle, your piriformis is tight so perform the Piriformis stretch performing 2 reps holding 30 sec each rep. Click Here to See the Corrective Piriformis Stretch If one muscle is tighter than the other, stretch it two times for every one stretch on the other side. Page 19

22 5. Chest Length/Balance Test Instructions 1. Lie flat on your back 2. Place your hands under your head like you re chillin out POSITIVE: If the elbows are off the ground, perform the Chest stretch on Swiss Ball performing 2 reps holding 30 sec each rep. Click Here to See the Corrective Chest Stretch on SB If one side is tighter than the other, stretch it two times for every one stretch on the other side. Page 20

23 6. Hamstring Balance Test: Waiter s Bow Instructions 1. Stand with your feet together, knees straight 2. Tilt your body over at the hips only 3. Keep your back straight the whole time POSITIVE: If one hamstring is tighter than the other, stretch it two times for every one stretch on the other side. Click Here to See the Corrective Hamstring Wall Stretch Page 21

24 7. Position of Pelvis: Wall Test Instructions 1. Stand with your heels, butt, shoulders and head against a wall 2. Slide one hand flat into the small of your back ANTERIOR TILT: If your hand fits with lots of room you have an anterior pelvic tilt and/or excessive lumbar curve. Perform the Anterior Pelvic Tilt set. Click Here to See the Anterior Pelvic Tilt Set POSTERIOR TILT: If your hand doesn t fit or only the fingers fit you have a posterior pelvic tilt and/or flat lumbar spine. Perform the Posterior Pelvic Tilt set. Click Here to See the Posterior Pelvic Tilt Set Page 22

25 Strength Tests 1. Lower abdominal coordination Instructions 1. Lie on your back with your knees bent and hands under the small of your back 2. Apply pressure on your hands by slightly drawing the belly button down towards the floor 3. Maintain this pressure as you alternate raising one leg at a time for 3 reps per leg 4. Rest briefly, then do the same raising both legs at a time for 3 reps Level 1 can put pressure down on the hands Level 2 can maintain pressure on the hands during alternating leg raises Level 3 can maintain pressure on the hands during the two leg raise Page 23

26 2. Lower abdominal strength NOTE: skip this test if your back hurts right now, you can come back to it in the future. Instructions 1. Lie on your back with your legs straight and hands in the small of your back 2. Raise your legs up as high as you can with straight knees, keeping the hips on the floor 3. While maintaining pressure on your hands and knees straight, lower your legs to the floor under control Grading System Poor = lose pressure at 75º Fair = lose pressure at 45º Good = lose pressure at 15º Excellent = maintain pressure all the way to the floor Page 24

27 3. Side bridge endurance & balance Instructions 1. Lie on your elbow on your side 2. Stack your feet one on top of the other 3. Bridge your hips up, keeping your body straight 4. Keep breathing while you re holding and time how long you can hold it 5. Stop the test when you can t maintain good form 6. Rest 1-2 minutes then repeat on the other side Grading System Poor < 30 s Fair = s Good = s Excellent = 120 s + If there is more than a 10 second difference between sides, perform 2 sets of side bridges on the weaker side vs. 1 set on the stronger side during the Corrective phase Day 2 workouts and retest after 2 weeks. Page 25

28 4. Prone cobra endurance Instructions 1. Lie on your stomach 2. Stabilize your core by gently drawing in then bracing and squeezing your glutes 3. Raise your chest just off the floor 4. Raise your hands up off the floor and externally rotate the palms out so the backs of the hands are facing each other 5. Keep your eyes looking straight down towards the floor 6. Imagine you re trying to touch the backs of your hands together 7. Squeeze your shoulder blades down and back together Grading System Poor < 30 s Fair = s Good = s Excellent = 120 s + Page 26

29 5. Prone bridge endurance Instructions 1. Go on your elbows and forearms and on your toes 2. Keep your spine in neutral position as you raise up 3. Make sure your chin is tucked and your shoulder blades are down towards your butt 4. If you lose the ability to stay in neutral OR feel your back working more than your abs, stop the test Grading System Poor < 30 s Fair = s Good = s Excellent = 120 s + Page 27

30 Step 3 Postural Photo Assessment The photo assessments will verify some of the data you gathered during the video assessment and will provide us with a few additional details regarding your posture. Take 2 pictures of yourself, one from the front and one from the side like the examples given below. Once you ve got these pictures taken, it s best to print them out (quality doesn t matter, as long as you can see your posture) so you can draw on them and refer back and forth as you re going through the assessment. Here are the keys to taking proper photos: Set the camera on a level surface or tripod at approximately chest height Use the self-timer instead of having someone hold it for you, as they ll probably be off centre and shaky Make sure your body fills up most of the picture Stand against a plain background Use a flash and/or good lighting Don t try to stand perfectly stand naturally and relaxed Men: tight boxers/underwear are ideal (or your tightie whities) Women: tight shorts and a sports bra are ideal And here are a couple of example photos to model: Page 28

31 Front View Photo Assessment 1. Find the center point between your heels 2. Draw a straight vertical line from this point up 3. Draw a straight horizontal line across the picture at shoulders and hips 4. Remember the right side of the photo is the left side of your body, and vice versa! Head / Neck Are your eyes uneven? If so, circle the lower side: L / R ACTION: Neck side stretch for the circled side 2 reps x 30 s hold Page 29

32 Torso Are the shoulders uneven? If so, circle the lower side: L / R Are the hips uneven? If so, circle the higher side: L / R POSITIVE: If only the shoulders or hips weren t level or you circled the same side twice, perform the Torso side stretch for the side you circled - 2 reps x 30 sec hold. ACTION: If you circled 2 different sides, then you must get checked for a leg length discrepancy and investigate using a shoe lift. Page 30

33 Side View Photo Assessment Head 1. Draw a straight vertical line straight up from the centre of the ankle 2. Put a dot in the center of the shoulder and the ear canal Is the ear dot in front of the line? POSITIVE: Chin tuck stretch 2 x 30 s and Wall lean exercise 3 reps x 20 s hold Page 31

34 Shoulders Is the shoulder dot in front of the line? POSITIVE: Thoracic mobilizations 1 set = mobilizations over 4 segments, 3-5 sec hold in the bottom position Click Here to Watch all of the Corrective Posture Stretches and Exercises Page 32

35 Step 4 Follow Your Customized Plan Now that you ve gone through the entire assessment, if you were following along with Page 15, you now have a custom flexibility routine to perform Plus, it s more comprehensive than getting an assessment from 95% of rehab professionals out there! So stick to the routine daily or twice daily and retest in 4 weeks to see how far you ve come. Page 33