Kinetic chain checkpoints Observations: Foot/ankle Knee Lumbo-Pelvic-Hip-Complex (LPHC) Shoulder and Cervical Spine (upper body) Each joint region has a specific and optimal motion based on its structure and function. Deviation from a normal path is indicative of compensation, and can be used to presume movement impairment.
Anterior view (5 reps): Feet turn out Knees move inwards Knees move outwards Lateral view (5 reps) Excessive forward lean Low back arches Low back rounds Arms fall forwards Posterior view (5 reps) Feet flatten Heels raise Asymmetrical weight shift Observations
FEET: turn out Turned Out Straight Normal Abnormal Note: the second MTPs of each foot should be parallel to one another as if standing on snow skis. When turned out the toes will appear lateral to the medial malleolus and the ankle externally rotated relative to the lower leg.
Overactive Muscles Lateral Gastrocnemius Soleus TFL (via ITB) Biceps Femoris (short head)
Underactive Muscles Medial Gastrocnemius Medial Hamstrings Popliteus Also: gluteus medius/maximus, gracilis, sartorius
FEET: flatten Arch Drops Normal Abnormal Note: the arch will drop or appear to flatten and the lateral border may also appear to raise. Collectively, this will usually cause an adducted appearance of the crease at the junction between the foot and lower leg.
Overactive Muscles Peroneus Longus Lateral Gastrocnemius TFL (via ITB) Biceps Femoris (short head)
Underactive Muscles Medial Gastrocnemius Posterior Tibialis Also: gluteus medius Anterior Tibialis
KNEES: move inwards Normal Abnormal Note: The knee would be observed to move inward if the patella (knee cap) moves over the 1 st MTP joint (big toe) towards the midline of the body.
Overactive Muscles Adductor Complex TFL (and IT band) Also: lateral gastroc, vastus lateralis Biceps Femoris (short head)
Underactive Muscles Gluteus Medius Gluteus Maximus Also: medial gastroc, medial hamstring, vastus medialis
KNEES: move outward Normal Abnormal Note: This compensation consists of femoral abduction (external rotation) and/or tibial adduction (internal rotation)
Overactive Muscles Gluteus Medius TFL (and IT band) Also: gluteus minimus, piriformis Biceps Femoris (short head)
Underactive Muscles Adductor Complex Medial Hamstrings Gluteus Maximus
Excessive forward lean Normal Abnormal Note: Imaginary lines that are created by the lower leg and torso of the client if extended out should remain parallel. If the clients torso moves forward and causes these imaginary lines to cross than it would be observed as excessive forward lean.
Overactive Muscles Gastrocnemius Soleus Hip Flexor Complex Also: abdominal complex
Underactive Muscles Gluteus Maximus Erector Spinae Also: tibialis anterior
Low back arches Normal Abnormal Note: The low back should remain in a neutral curve (lordosis). It would be considered an arch if the lumbar spine moves into excessive extension.
Overactive Muscles Hip Flexor Complex Erector Spinae Latissimus Dorsi
Underactive Muscles Core Stabilizers Gluteus Maximus Hamstrings
Low back rounds Normal Abnormal Note: The low back should remain in a neutral curve (lordosis). It would be considered to round if the buttocks appear to move under the body into a posterior pelvic tilt throughout the entire squat descent.
Overactive Muscles Hamstrings Adductor Magnus Also: external obliques Abdominal Complex
Underactive Muscles Gluteus Maximus Hip Flexor Complex Erector Spinae Intrinsic Core Stabilizers
UPPER BODY: arms fall forward Normal Abnormal Note: In normal movement the arms should be in line with the torso. If the arms move forward in relationship to the torso it would be observed as arms fall forward
Overactive Muscles Latissimus Dorsi Pectoralis Major Also: coracobrachialis Pectoralis Minor
Underactive Muscles Rhomboids Middle & Lower Trapezius Also: posterior deltoid, rotator cuff
LPHC: asymmetrical weight shift Normal Abnormal Note: The spine and pelvis should remain centered over the knees and feet in the frontal plane. It would be considered an asymmetrical weight shift if the pelvis appears to move toward one side more so in the frontal plane.
Over/Underactive Muscles LEFT SIDE Overactive: Piriformis Biceps Femoris Gluteus Medius Gastroc/soleus Underactive: Adductor Complex Anterior tibialis RIGHT SIDE Overactive: Adductor Complex TFL Underactive: Gluteus Medius