NASM Corrective Exercise Specialist

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What is the recommended verbal instruction when performing the cervical rotation test?

"Look over your right then left shoulder as far as you comfortably can."

Which instruction provided to a client would correctly assist them to perform static stretching of their right sternocleidomastoid (SCM)?

"Place your right arm to your side, rotate your head to the right, and then use your left hand to help side bend your neck to the left."

leg dominance

-weight shift to one side -strength differences between legs -Limb-to-limb asymmetries in neuromusculoskeletal control or muscle recruitment. cueing: "Maintain equal weight on both legs as you land." "Have your feet touch down softly at the same time when landing."

The Kendall kyphosis-lordosis posture presents with which of the following static position

Excessive lumbar lordosis, anterior tilted pelvis, flexed hips, and flexed/hyperextended knees

When screening the lumbo-pelvic hip complex, which tests should the fitness professional begin with?

Lumbar flexion and extension

Knee valgus and varus, an increased Q angle, poor quadriceps and hamstrings flexibility, poor eccentric deceleration capabilities, and playing on hard surfaces are all risk factors for developing what common knee injury?

Patellar tendinopathy

proximal row of bones in the hand

Proximal row: Pisiform, triquetrum, lunate, scaphoid

shoulder dynamic posture that would call for assistance

Scapular elevation Scapular winging

Tendinopathy

A broad term encompassing pain, swelling, and impaired performance occurring in and around tendons in response to overuse; commonly associated with the Achilles tendon.

Post-rehabilitation/return to play or performance

A client has completed treatment and has been cleared by their healthcare provider to return to exercise, using corrective programming to recondition and bridge the gap from rehab to fitness and/or performance.

Scheuermann's disease

A developmental dis-order of the spine that causes abnormal growth of usually the thoracic (upper back) vertebrae, but it can also be found in the lumbar vertebrae. Ankylosing spond

Neuromuscular stretching

A flexibility technique that incorporates varied combinations of isometric contraction and static stretching of the target muscle to create increases in range of motion. Also called proprioceptive neuromuscular facilitation (PNF).

Ankylosing spondylitis

A form of arthritis that primarily affects the spine, although other joints can become involved; causes inflammation of the spinal joints (vertebrae) that can lead to severe chronic pain and discomfort.

Muscular sling

A group of muscles that, when contracted, provide stability.

pes cavus

A high medial arch during weight-bearing.

Regenerate

Aspect of recovery that focuses on movement-based self-care strategies to optimize movement quality and minimize compensation. cumulative process of deloading workouts and pre- and post-training routines to maintain optimal movement efficiency and recover from repetitive posture and movements. Corrective exercise is the pillar of regeneration

postural sway

A measure of postural stability and control, often while standing. Refers to the amount of reflexive movement made by an individual around their center of gravity to remain balanced. subjects with increased postural sway have also been found to have up to seven times more ankle sprains than those subjects with better postural sway scores (McGuine et al., 2000; Tropp et al., 1985). Furthermore, fatigue in the knee and hip musculature (sagittal and frontal planes) creates even greater postural sway

Refuel

Aspect of recovery that focuses on nutrition and hydration habits prior to, during, and after activity. It is recommended to consume adequate levels of carbohydrate, protein, and fat to prepare for and support activity and provide the substrates needed for tissue repair and recovery.

Regional interdependence model

Assessment and intervention model used by clinicians based on the concept that the site of a patient's primary complaint or symptoms is impacted by dysfunction in remote musculoskeletal regions.

transitional movement assessment

Assessments that involve movement without a change in the base of support. examples: Overhead squat (OHSA) Modified overhead squat Single-leg squat (SLS) Split squat

muscle innervation

A muscle's point of connection to the nervous system.

Intents of foam rolling

1. reduce the overactivity or tension in the targeted muscle . To do this, the user should roll the targeted muscle slowly to identify an uncomfortable spot and hold pressure. During this time, the user should be coached to breathe and relax for 30 to 60 seconds or until a reduction in discomfort is felt. 2.introducing active movements. Active movements involve moving the targeted limb on the myofascial roller. dorsiflexion while rolling the calves, knee extensions while rolling the hamstrings, hip flexion and abduction/adduction while rolling the piriformis, scapular retraction while rolling the pectorals, and shoulder flexion while rolling the latissimus dorsi Although no specific recommendations currently exist, performing four to six active movements, at a medium pace, may be easy for the individual to remember and execute effectively.

static stretching warm up recommendations

< 60 seconds per muscle group if participating in high-intensity exercise or athletic activity. No need to go to the point of discomfort or pain. Stretch major muscle groups and specific muscle groups to the activity. Focus on muscles identified as overactive/shortened during assessment stages.

Rest

Aspect of recovery that focuses on improving daily sleep amount and quality, limiting stress, and increasing physical and psychological relaxation. Individuals should aim to achieve a minimum of 8 hours of sleep per night and 60 minutes of accumulated psychological relaxation per day

Javier demonstrates knee valgus during his assessment. Which of the following muscles should be inhibited?

TFL

Which muscle is thought to be overactive/shortened if the client demonstrates hip abduction during the modified Thomas test?

TFL

Sacromere

The functional unit of a muscle made up of overlapping actin and myosin filaments.

dynamic valgus treatment

This movement deficit should be identified and corrected during training. In addition, individuals should be instructed to hold the landing (stabilize) of their horizontal jump test for 5 seconds, which forces the individual to gain and maintain dynamic knee control for a more prolonged period (Myer et al., 2005). The prolonged deep hold may facilitate feedback-driven lower extremity alignment adjustments and ultimately improve frontal plane alignment of the knee.

Static postural assessment

a visual observation of the client's posture when standing still. Proper static posture allows for optimal mobility and joint kinematics, whereas poor posture is indicative of either a structural problem or poor musculoskeletal recruitment patterns.

What best describes a closed-packed position of the shoulder?

The glenohumeral joint is at 90 degrees of abduction and full external rotation.

What is considered normal mobility in the cervical side bending test?

The head can tilt to a 45-degree angle.

Mennell's Four Basic Truisms

These four truisms are some of the reasons to perform inhibitory and lengthening techniques (first two phases of the Corrective Exercise Continuum) before isolated strengthening exercises. 1.When a joint is not free to move, the muscles that move it cannot be free to move it. 2.Muscles cannot be restored to normal if the joints that they move are not free to move. 3.Normal muscle function is dependent on normal joint movement. 4. Impaired muscle function perpetuates and may cause deterioration in abnormal joints.

At which joint might an increase in ROM serve as a preventative strategy by allowing the trunk to be more upright and minimizing shearing forces in the trunk?

ankle

if some sits a lot during work

are potentially prone to musculoskeletal adaptations such as a decrease in spinal posture and increase in musculoskeletal discomfort

what can happen if a joint looses normal function

the muscles around that joint may spasm and tighten to minimize the stress at the involved segment. Certain muscles become overactive/shortened to prevent movement and further injury. altered length-tension relationships altered normal force-couple relationships, which alters normal movement patterns and leads to structural and functional inefficiency

snyergist

the muscles that assist the prime mover but are not supposed to be the primary source of force production. For example, the triceps brachii are synergistic to the pectoralis major for pressing movements, while the hamstrings assist the gluteus maximus during hip extension.

If a client cannot complete a single-leg squat without difficulty, what modification provides more stability but also more insight into unilateral compensations?

split-squat

function of subscapularis muscle

stabilization, internal rotation and depression of the humeral head

What term describes a muscle acting to help support the joint or joints that permit movement from the primary mover?

stabilizer

Contract-relax technique in NMS

static stretching of the target muscle followed immediately by an isometric contraction of the stretched (target) muscle, followed with another stretch of the target muscle.

What makes up the knee joint?

two articulations: the tibiofemoral joint and the patellofemoral joint

elastic limit

stretching to the point of discomfort

Sensorimotor integration

the ability of the central nervous system to gather and interpret sensory information to execute the proper motor response An individual who trains with improper form delivers improper sensory information

Functional efficiency

the ability of the neuromuscular system to recruit correct muscle synergies, at the right time, with the appropriate amount of force to perform functional tasks with the least amount of energy and stress on the HMS.

local mechanism effects of foam rolling

the direct roller pressure may change the viscoelastic properties of the local myofascia by mechanisms such as causing thixotropy (reduced viscosity), reducing myofascial restriction, promoting fluid changes (fascial hydration), and stimulating cellular responses

motor behavior

the human movement systems response to internal and external environmental stimuli

mobility restriction

the inability to move a joint through what should be its full ROM. If a client has restricted mobility, it means that overactive/shortened muscles and soft tissues on the side contralateral (opposite) to the observed restricted movement are responsible for reducing how far that joint can continue to move.

where are mechanoreceptors

cutaneous, fascia, muscle, tendon, and joint receptors

produce symptoms in the LPHC

injury at a higher spinal ,L1-L3 level

According to the Screw-Home Mechanism, in an open-chain position and as the knee extends, what action best describes the motion of the tibia on the femur during the last 30 degrees?

external rotation

predominant substrate used during lower-intensity exercise

fats

client reports spending 4 hours watching TV per day between morning and evening

fitness professional works with the client to develop a plan, the client has options they can opt into, such as the following: Watching TV during a bus ride so that it does not interfere with health-enhancing behaviors Watching programming that educates on exercise, meditation or relaxation, or cooking skills for more nutritious meals Being more selective in the programs watched to reduce screen time and create more time for movement and sleep

Pes Planus Distortion Syndrome

flat feet with knee valgus

pes planus

flattened medial arch during weight-bearing may result from overactivity of the fibularis muscles (peroneals) and lateral gastrocnemius, underactivity of the anterior and posterior tibialis, and decreased joint motion of the first metatarsophalangeal (MTP) joint and talus (decreased posterior glide).

Which term best describes the normal extensibility of all soft tissues that allow for the full range of motion of a joint?

flexibility

Hanging effectively from a tree branch with an outstretched hand requires which full range of motion?

flexion

The recovery-enhancing principle of compression boots is to

flush out lactate accumulation in blood during high-intensity exercise through repeated vascular compression and subsequent release. In practice, compression boots have been found to have a clinically significant effect on recovery post-workout, but they are not meant to be performance-enhancing pre-workout

Sensory deprivation chambers benefits

flush out lactate accumulation in blood post-exercise but can also more rapidly transition the brain into a state of active rest and restoration

If an excessive anterior pelvic tilt is NOT improved with the hands on the hips, this indicates that

focuS on the LPHC

When client returns from low back pain

focus on enhancing stability and mobility around the LPHC. For stability, LPHC muscle stabilization exercises can benefit clients by helping to restore motor control and stability to the muscles that affect the sacroiliac joint (Pel et al., 2008; Wallden, 2014). For mobility, improving hip joint range of motion and enhancing flexibility of the hip flexors, quadriceps, adductor complex, and hamstrings complex may provide positive results for these clients

scapulothoracic joint

formed by the convex surface of the posterior thoracic cage and the concave surface of the anterior scapula important role in providing motion and shoulder girdle stability through the 17 muscles that attach to the scapula For every 2 degrees of glenohumeral elevation, there is 1 degree of scapulothoracic elevation

SUBTALAR JOINT

formed by the talus and calcaneus movements being inversion and eversion both in open- and closed-chain motions. It is the movements of the STJ that allow the rearfoot to alternate between what is called a mobile adaptor (or an unlocked foot) and a rigid lever (or a locked foot), allowing for energy transfer during dynamic movement. a locked STJ, can be associated with foot stability, or a position necessary to transfer energy at push off, whereas eversion (Figure 11-7), or an unlocked STJ, can be associated with foot mobility, or a position necessary to absorb impact forces.

TALOCRURAL (ANKLE) JOINT

formed by the tibia, fibula, and talus movement in sagittal plane, dorsiflexion and plantar flexion Dorsiflexion + Abduction = Unlocked or loading position of the ankle Plantar flexion + Adduction = Locked or unloading position of the ankle

Which of the following describes the ability of different muscles in the body to work together to allow coordination of global and refined movements?

intermuscular coordination

Peter, a Corrective Exercise Specialist, has completed his assessment of a new client who demonstrated non-neutral wrist during her assessment. He's completed Phases 1-3 of the Corrective Exercise Continuum, what should be his next exercise with his client?

inverted rows

prime mover of elbow flexion

brachialis

main substrate used during moderate- to high-intensity exercise

carbs

the three bones in the elbow

humerus, ulna (pinky side), and radius (thumb side)

Benefits of static stretching

- can be preformed by just the indidvuals -improves fluid flow, heat dissipation, and elasticity of tissue. -it is thought that static stretching causes an acute viscoelastic stress relaxation response, allowing for an immediate increase in ROM -can inhibit or relax the muscle by muscle spindle disfacilitation (reduced discharge frequency of the nuclear bag and chain fibers)

test for dynamic valgus

horizontal jump test appears when taking off from a jump rather than landing.

contradictions for isolated strength training

-Acute injury or muscle strain or tear of the muscle being strengthened -Acute rheumatoid arthritis of the affected joint -Impaired joint motion -Pain produced during the movement

Improvements in joint ROM are always due to several factors such as:

-Mechanical (muscle and tendon factors affecting compliance or stiffness) -Neural (inhibition of the central nervous system to help the muscle relax) -Psycho-physiological (stretch tolerance)

basic hydration rule

500 mL (16.9 oz) before bed and within the hour prior to exercise will satisfy the hydration needs for most exercisers.

precautions for isolated strength training

-Special populations -Neuromuscular disorders -Clients with poor core stabilization strength

Populations that are considered to take precautions for stretching

-Special populations (e.g., pregnant women, osteoarthritis, and rheumatoid arthritis) -Seniors -Hypertensive patients -Neuromuscular disorders -Joint replacements -Fibromyalgia -Marfan syndrome

neuromuscular stretching stages

-Taking the target muscle to its end-range ROM (point of joint compensation) and holding for 10 seconds -Actively contracting the target muscle to be stretched (5- to 10-second submaximal intensity contraction) -Passively (or actively) elongating the target muscle to a new end-range -Statically holding the new position for 20 to 30 seconds and repeating the contract-relax cycle up to a total of three times

sets of isolated strength training

1-2

what happens after injury

1-inflamation 2-muscle spasm 3-adhesions 4-altered neuromuscular control 5-muscle imbalance

scientific rationale for foam rolling

1. To affect local myofascial tissue dysfunction 2. To influence the autonomic nervous system

weight of head when there is no tilt

10-12lbs

A Corrective Exercise Specialist is looking to integrate short foot into the programming of a client with an over-pronated foot type. How many repetitions are best to include?

10 to 15 reps under control

reps for isolated strength training

10-15

weight of head when there is a 15 degree tilt

27lbs

Intervertebral discs make up what percentage of the height of a healthy spine?

25%

How many grams of lean protein are recommended for a pre-exercise meal for strength training athletes?

20-30g

The head weighs approximately 10 to 12 pounds. However, when the neck is flexed 60 degrees, such as when looking down at a cell phone, how many pounds of stress does this place on the neck?

60 pounds

Acute Training Variables for Integrated Dynamic Movement

3 to 5 days per week 1 to 3 10 to 15 Controlled

Frequency of isolated strength training

3-5 days a week

What percentage of the U.S. population reports reduced activity due to chronic back conditions?

35%

weight of head when there is a 60 degree tilt

60 lbs

duration of reps

4/2/1 4 seconds eccentric 2 seconds isometric hold at end-range 1 second concentric

Hyperkyphosis is present when the normal thoracic kyphosis range exceeds what degree?

40

weight of head when there is a 30 degree tilt

40lbs

What is considered normal mobility during the seated hip internal and external rotation test?

45

weight of head when there is a 45 degree tilt

49lbs

task specific warm up recommendations

5 to 15 minutes. Practice movements that are associated with the sport or task at velocities close to the actual movement. This may include exercises performed during the Activate and Integrate phases of the Corrective Exercise Continuum.

What percent of ACL ruptures occur during single-foot contact in physical activity secondary to uncontrolled lower extremity biomechanics?

70%

myofasical rolling for warm up recommendations

90 seconds to 2 minutes of myofascial rolling per muscle group to increase muscle temperatures, decrease tissue viscoelasticity, increase inhibition, and other factors.

screw home mechanism

A phenomenon that increases knee joint stability by locking the femur on the tibia (or vice-versa) when the knee is fully extended.

sensations

A process by which sensory information is received by the receptor and transferred either to the spinal cord for reflexive motor behavior, to higher cortical areas for processing, or both.

facet joints

A set of synovial, plane joints located between and behind adjacent vertebrae.

Hyperkyphosis

A spinal disorder in which an excessive outward curve of the spine results in an abnormal rounding of the upper back. places the head into a forward head position and causes anterior rounding of the shoulders

Supination

A triplanar motion that is associated with force production.

Pronation

A triplanar movement that is associated with force reduction.

myofascial flossing

Method intended to increase flexibility by wrapping an elastic band around a region of the body and performing movements.

Injuries Below the Cervical Spine Associated with Cervical Spine Impairment

AC impingement Anterior pelvic tilt/low-back pain Dysfunctional breathing Sacroiliac joint dysfunction Scapulothoracic dysfunction Thoracic outlet syndrome Upper extremity pain/weakness

Programming by the fitness professional that focuses on improving movement dysfunction such as excessive knee valgus, knee rotation, hip adduction and hip rotation; improving single-leg neuromuscular balance; and improving muscle strength can help reduce the risk of what severe knee injury?

ACL tear/rupture

Key Muscles Associated with the LPHC

Abdominal core complex Adductor complex Erector spinae Gastrocnemius/soleus Gluteus maximus and medius Hamstrings complex Hip flexors (psoas, rectus femoris) Intrinsic core stabilizers Latissimus dorsi Tensor fascia latae (TFL)/IT-band

lower cross syndrome underactive/ lengthened muscles

Abdominals Gluteus maximus and medius Hamstrings

underactive/lengthened muscles in lordotic posture

Abdominals (external obliques) Hip extensors (hamstrings)

dynamic stabilization

Ability of the human movement system to control and minimize unwanted joint motions during movement

Spinal remodeling

Abnormal reshaping of the spine's physiologic curvatures due to sustained abnormal posture.

Which tendon is the largest and strongest tendon in the human body?

Achilles

Populations that are considered contridictory for stretching

Acute injury or muscle strain or tear of the muscle being stretched Recent musculoskeletal surgery or treatment (i.e., shoulder dislocations, ligament repairs, or fractures) Acute rheumatoid arthritis of the affected joint Osteoporosis

contradictions for integrated dynamic movement

Acute injury or muscle strain or tear of the muscle being worked Acute rheumatoid arthritis of the affected joint Position of exercise (prone, supine, or decline position) relative to the client's condition (pregnancy, coronary heart disease, etc.) Acute injury to joint involved during movement Pain

Key Muscles Associated with the Knee

Adductor complex Gastrocnemius/soleus Gluteus maximus and medius Medial and lateral hamstrings complexes Quadriceps Tensor fascia latae (TFL)/IT-band

muscle imbalance

Alteration of muscle length surrounding a joint

When to Avoid Dynamic Assessments

Although very helpful in uncovering movement deficiencies, dynamic movement assessments may not be appropriate for all populations. Subjective assessments, static posture, and transitional movement assessments are important to perform before dynamic assessments, because successful completion of those first steps are what qualifies the client to perform dynamic assessments. For example, if an individual has difficulty performing the single-leg squat assessment, the depth jump assessment would not be appropriate for that individual. Or, if a client exhibits poor scapular stability during the pushing assessment, the Davies test should be avoided until that client can push under load with efficient form.

Invertors in foot & ankle complex

Anterior tibialis Posterior tibialis Soleus maintaining a stable and locked position from the rearfoot all the way up into the hip during force production

Lower Crossed Syndrome A and B both contain which of the following observable body positions?

Anterior tilted pelvis

shoulder transitional and loaded movement

Arms fall forward Scapular elevation Scapular winging

What joint is located between the first cervical vertebrae and the skull?

Atlanto-occipital joint

main substrates used by the body during endurance activity

Carbohydrates and fat as exercise duration continues (prolonged bouts of exercise), fuel substrates begin to shift, moving more from carbohydrates (glycogen) to fat stores.

endurance exercise relies primarily on

Carbohydrates are critical for an endurance athlete and a continuous supply (8 to 12 grams/kilogram of body weight/day) is optimal Athletes who continuously eat a carbohydrate-rich versus a protein- or fat-rich diet have greater muscle glycogen stores to draw from during training and racing

Local Injuries associated with Cervical Spine Impairment

Cervical disc lesions Cervical joint dysfunction Cervical strains Deep flexor dysfunction Elevated hyoid bone Levator scapulae dysfunction Pain/stiffness Text neck Trapezius dysfunction

flat back overactive/shortened muscles

Cervical extensors Pectoralis minor Shoulder adductors Upper trapezius and levator scapulae Anterior abdominals and intercostals Internal obliques (upper and lateral fibers) Hip extensors (hamstrings)

upper cross syndrome overactive/ shortened muscles

Cervical extensors Pectorals (major and minor) Upper trapezius Levator scapulae

layered cross syndrome overactive/shortened

Cervical extensors Pectorals (major and minor) Upper trapezius Levator scapulae Hip flexors Lumbar extensors Gastrocnemius/soleus

overactive/shortened muscles in sway back

Cervical extensors Upper trapezius and levator scapulae Pectoralis minor Intercostals Abdominals (upper fibers) Internal obliques (upper fibers) Hip extensors (hamstrings)

kyphosis-lordosis overactive/shortened muscles

Cervical extensors Upper trapezius and levator scapulae Shoulder adductors Intercostals Pectoralis minor Internal obliques (upper and lateral) Hip flexors (iliopsoas) Lumbar extensors

Key Muscles Associated with the Cervical Spine

Cervical extensors (erector spinae and suboccipitals) Deep cervical flexors Levator scapulae Pectoralis minor Rhomboids Scalenes Sternocleidomastoid Trapezius

What are common overactive/shortened muscles in the upper body?

Cervical extensors, pectorals, upper trapezius, and levator scapula

underactive/lengthened muscles in sway back

Cervical flexors Thoracic extensors Trapezius (middle and lower) Abdominals (external obliques) Hip flexors (iliopsoas)

kyphosis-lordosis underactive/lengthened muscles

Cervical flexors Thoracic extensors Trapezius (middle and lower) Anterior abdominals (external obliques) Hip extensors (hamstrings)

flat back underactive/ lengthened muscles

Cervical flexors Thoracic extensors Trapezius (middle and lower) Lumbar extensors Hip flexors (iliopsoas)

Injuries Above the Cervical Spine Associated with Cervical Spine Impairment

Cervicogenic headaches Dizziness/lightheadedness TMJ-related symptoms

Overactive muscle

Chronically elevated neural drive to a muscle - puts the muscle in a chronically contracted, shortened state

Underactive muscle

Chronically inhibited neural drive to a muscle - allows the overactive muscle on the opposing side of the joint to pull it into a lengthened state

LATERAL EPICONDYLITIS (TENNIS ELBOW)

Clients may demonstrate ROM restrictions in wrist flexion and/or extension and report lateral elbow pain with aggravating activities.

MEDIAL EPICONDYLITIS (GOLFER'S ELBOW)

Clients may demonstrate ROM restrictions in wrist flexion and/or extension and report medial elbow pain with aggravating activities. As mentioned previously, occupations involving repetitive UKC activity can predispose individuals to both lateral and medial epicondylitis

Extensor mechanism

Composed of the patellofemoral articulation, patellar tendon, quadriceps tendon, and tibial tubercle working together to produce concentric, eccentric, and isometric actions at the knee.

What can improve LPHC stability above the LPHC?

Core stabilization training has shown to increase thickness of the diaphragm and improve LPHC stability

Asymmetric weight shift

Look for the hip to shift toward one side or the other. The side of the body opposite the shift may also exhibit the hip dropping in the frontal plane.

knee varus

Look for the knees to bow outward.

Knee Valgus

Look for the knees to collapse inward.

What is considered normal mobility during the shoulder flexion test?

Elbows extended and arms in line with the lateral midline of the torso

Activation techniques

Corrective exercise techniques used to reeducate or increase activation of underactive tissues. ex. isolated strength training

Lengthening techniques

Corrective exercise techniques used to increase the extensibility, length, and range of motion (ROM) of neuromyofascial tissues in the body. ex. static stretching, neuromuscular stretching, dynamic stretching

Inhibitory techniques

Corrective exercise techniques used to reduce tension or decrease activity of overactive neuromyofascial tissues in the body. ex.foam rolling

Integration techniques

Corrective exercise techniques used to retrain the collective synergistic function of all muscles through functionally progressive movements. ex. dynamic movement

Through which movement does the subtalar joint load or absorb energy?

Eversion

Excessive anterior pelvic tilt

Look for the pelvis to roll forward and for the lumbar spine to extend beyond normal curvature, creating a prominent low-back arch.

Frequency of static stretching that is recommended

Daily (unless specified otherwise) 1 to 4* reps 20- to 30-second hold60-second hold for older clients (≥ 65 years)

Best dynamic testing for Cervical spine

Davis' law, OSHA& loaded ,movement assessment

Knee injuries often occur during landing and, therefore, it is important to assess if the client lacks musculoskeletal control of the lower extremity during landing if there are no compensations observed during earlier assessment. The depth jump is one such assessment. During a depth jump assessment most impairments will be observed during what phase?

Deceleration

ligament dominance

Decreased lower extremity frontal plane stability, usually evidenced by valgus and varus positioning, causing connective tissues to be the limiting factor of end range of motion control. cueing: "Keep your knees in line with your second and third toes of your feet." exercises: wall jumps tuck jumps

Quadricep Dominance

Decreased strength or recruitment of the posterior chain musculature relative to anterior chain musculature. cueing: "Bend your knees and hips as you land." "Keep your knees in line with your second and third toes." "Soft landing/feet." "Absorb your landing with your hips."

To help correct a client's forward head posture, the Corrective Exercise Specialist recommends that the client perform the chin tuck exercise. What primary muscle(s) are targeted when performing this exercise?

Deep cervical flexors

Polly demonstrates forward head posture during her assessment. Which of her muscles are most likely underactive?

Deep cervical flexors, lower trapezius, middle trapezius, and rhomboids

upper cross syndrome underactive/ lengthened muscles

Deep neck flexors Rhomboids, middle/lower trapezius Serratus anterior

layered cross syndrome underactive/ lengthened

Deep neck flexors Rhomboids, middle/lower trapezius Serratus anterior Anterior abdominals Hip extensors (hamstrings) Gluteus maximus and medius

Which type of exercises are the "gold-standard" for Achilles tendinopathy?

Eccentric

During which phase of the muscle action spectrum are most strength gains developed?

Eccentric deceleration

Which phase of the muscle action spectrum leads to the most muscle damage, inflammation, impaired muscle function, and muscular soreness occurs, providing a good reason to limit the number of sets for the initial exerciser?

Eccentric deceleration

Forearm Supination

External rotation of the forearm and hand so that the palm faces upward.

screw home mechanism

External tibial rotation on the femur in open-chain exercises and femoral internal rotation in closed-chain exercises, resulting in the knee "locking-out."

Which bone, along with the pelvis, makes up the iliofemoral joint?

Femur

How deep should a client be instructed to squat to during the Overhead Squat Assessment?

Femur parallel to the ground

Evertors in foot & ankle complex

Fibularis (peroneus) brevis Fibularis (peroneus) longus Gastrocnemius play a role in unlocking the foot and hip to allow for deceleration and the absorption of impact forces

What is indicated as being overactive/shortened if restriction in 1st MTP extension is identified?

Flexor hallucis longus

strategies when training fundamental movement patterns in clients who compensate:

Focus inhibition and lengthening techniques on areas that exhibit impairments specific to the desired pattern (e.g., self-myofascial roll and stretch hip flexors to allow for better recruitment of hip extensors in a hinge pattern). Even if it is considered partial, have the client move through the exercise's range of motion they can perform successfully instead of omitting the exercise completely. During the activation and integration phases of the continuum perform complementary movements that support and reinforce the primary pattern being trained (e.g., if an overhead press is challenging, include scaption exercises to reinforce correct shoulder flexion and abduction).

Extrinsic muscles

Foot muscles that originate in the lower leg and insert in the foot as tendons. mobilizer

The knee is a part of the kinetic chain that is greatly affected by which segments proximal and distal?

Foot, ankle and lumbo-pelvic-hip complex

High compliance (↑ flexibility)

Forces absorbed by muscles and tendons over a longer duration (reduction in peak forces applied to musculotendinous unit)

Low Compliance (↓ flexibility)

Forces absorbed by muscles and tendons over a shorter duration (increase in peak forces applied to the musculotendinous unit)

dynamic movement assessment examples

Gait (walking) assessment Depth jump assessment The Davies test Dynamic assessments can be used in two ways. The first is as a method of refinement and confirmation for what was observed in the transitional assessments. This is the primary purpose of the gait assessment. For example, if excessive pronation is observed in a client who enjoys walking and running for exercise, the gait assessment can be used to see how that compensation translates to everyday life and affects their performance. Another use of the dynamic movement assessments is to add additional challenge to the movement assessment process for more advanced clients. Once movement impairments are relatively improved, clients will be able to perform tasks like the OHSA showing little-to-no compensation in their movement patterns.

overactive/shortened muscles in pes planus

Gastrocnemius and soleus Peroneals Adductors Iliotibial band Iliopsoas Hamstrings

What hip muscle is best to activate when valgus and overpronation are observed?

Gluteus maximus

Weaknesses in which muscle may allow over-pronation deviations in subtalar joint motion during gait?

Gluteus medius

Which of the following muscles should be activated if over-pronation is observed?

Gluteus medius

distal row of bones in the hand

Hamate, capitate, trapezoid, trapezium

Kyphosis-Lordosis static posture checkpoints

Head: Forward Cervical spine: Extended Thoracic spine: Excessive kyphosis Shoulders: Rounded, elevated Lumbar spine: Excessive lordosis, possible lateral shift Pelvis: Anterior tilt Hip joints: Flexed Knee joints: Flexed or hyperextended Ankle joints: Neutral or plantar flexed

Upper cross syndrome static position

Head: Forward Cervical spine: Extended Thoracic spine: Excessive kyphosis Shoulders: Rounded, elevated (scapular winging) Lumbar spine: Normal curve or extended Pelvis: Neutral Hip joints: Neutral or slightly flexed Knee joints: Neutral or slightly flexed Ankle joints: Neutral

layered crossed syndrome static position

Head: Forward Cervical spine: Extended Thoracic spine: Excessive kyphosis Shoulders: Rounded, elevated, possible scapular winging Lumbar spine: Excessive lordosis, possible lateral shift Pelvis: Anterior tilt Hip joints: Flexed Knee joints: Flexed or hyperextended Ankle joints: Neutral or plantar flexed

Flat back posture static posture

Head: Forward Cervical spine: Extended Thoracic spine: Excessive kyphosis (upper region), flat(lower region) Lumbar spine: Reduced lordosis or flat Pelvis: Posterior tilt Hip joints: Extended Knee joints: Hyperextended Ankle joints: Neural or plantar flexed

Sway back posture static posture

Head: Forward Cervical spine: Extended Thoracic spine: Excessive kyphosis with posterior displacement Lumbar spine: Reduced lordosis (flattening) Pelvis: Posterior tilt Hip joints: Extended Knee joints: Hyperextended Ankle joints: Neutral

LORDOTIC POSTURE CHECKPOINTS

Head: Neutral position Cervical spine: Normal curve Thoracic spine: Normal curve Lumbar spine: Excessive lordosis Pelvis: Anteriorly tilted Hip joints: Flexed Knee joints: Slightly flexed or hyperextended Ankle joints: Slightly plantar flexed

Myofascial Adhesions

Heightened activity of the central nervous system (CNS) and tissue mechanoreceptors and nociceptors (e.g., pain receptors) in the injured area create a type of microspasm or tension that causes spasms which can create knots in muscle tissue resulting in altered neuromuscular control this than can form a weak inelastic matrix that decreases normal mobility of the soft tissue

What position is recommended for the testing leg during the hip abduction and external rotation test?

Hip and knee bent to 45 degrees

overactive/shortened muscles in lordotic posture

Hip flexors Internal obliques (upper) Lumbar extensors

Lower cross syndrome overactive/ shortened muscles

Hip flexors Lumbar extensors Gastrocnemius/soleus

heels elevated modification

If elevated heels improve the alignment of the knee during the OHSA, then the root cause of the impairment is likely due to the lack of ankle dorsiflexion

what would cause alterations in normal tissue and cause relative flexibility

If the myofascial tissues are not stimulated by movement, lengthening, and broadening, these connective tissue fibers may act as a roadblock, preventing soft tissue mobility

All muscles of the superficial erector spinae share a common origin:

Iliac crest of the pelvis, sacrum, spinous, and transverse processes of T1-L5

Which is an abnormal movement associated with a seven-fold increase in ankle sprains?

Increased postural sway

Individuals with medial or lateral epicondylitis may present with certain activity limitations that the Corrective Exercise Specialist should be aware of when working with these individuals:

Individuals may have discomfort with gripping objects, such as a dumbbell. Individuals may have discomfort with repetitive UKC movements involving gripping tasks, such as a dumbbell row or kettlebell swing. Repetitive resisted movements for the elbow or forearm flexors or extensors could cause medial or lateral elbow discomfort.

external (augmented) feedback

Information provided by some external source, for example, a health and fitness professional, videotape, mirror, or heart rate monitor.

Forearm pronation

Internal rotation of the forearm and hand so that the palm faces downward.

renshawn cells

Interneurons that prevent excessive output of the central nervous system's contraction reflex response to sudden changes in muscle length.

What question is answered through mobility assessments?

Is a movement impairment primarily due to overactive/shortened muscles or underactive/lengthened mus-cles

How can forward head posture influence the position of the pelvis?

It can cause the pelvis to tilt anteriorly.

What type of myofascial intervention is Instrument-Assisted Soft Tissue Mobilization?

It is a specialized technique that uses instruments to provide a mobilizing effect on the myofascia.

proprioception

It is the cumulative neural input from sensory afferents to the central nervous system that allow for the perception and awareness of the body's relative position in space. altered after injury

Integration Considerations for the Lower Extremities

Jumping tasks may be used as lower body integration phase progressions. It is important that clients are prepared to exhibit neuromuscular control at varying speeds in multiple planes. However, not all individuals will have the physical capabilities to perform many of the jump task progressions during this phase of their corrective program. The Corrective Exercise Specialist may need to modify the integrative movements to accommodate the client and ensure safety.

Patellar Tendinopathy (Jumper's Knee)

Knee valgus and varus An increased Q-angle Poor quadriceps and hamstrings complex flexibility Poor eccentric deceleration capabilities Overtraining and playing on hard surfaces

if the foot over-supinates, what compensation would one observe?

Knee varus

During a gait assessment, at which phase of gait are most compensation patterns observed?

Late midstance

Excessive posterior pelvic tilt

Look for the pelvis to roll forward and for the lumbar spine to extend beyond normal curvature, creating a prominent low-back arch.

ad libitum

Latin phrase that translates to "as desired"; refers to eating or drinking as you are normally driven to (i.e., not purposely overeating or undereating).

What are two muscles that may be overactive/shortened if a client demonstrates restricted shoulder flexion?

Latissimus dorsi and pectoralis major

trunk rotation check

Look for the trunk of the body to rotate internally or externally during single-leg movements.

Excessive forward trunk lean

Look for the trunk to lean forward and beyond ideal parallel alignment with the shins.

Osteoporosis

Literally "porous bone"; a disease in which the density and quality of bone is reduced.

loaded movement assessments examples

Loaded squat Standing push Standing pull Standing overhead dumbbell press

Knee dominance

Look for an upright trunk, the knees to move in front of the toes, and/or for more knee anterior displacement compared to hip posterior displacement; that is, the knees move forward more than the hips move back. May be seen with heel rise.

Test for excessive pronation

Look for the arch of the foot to collapse and flatten, eversion of the heel, or malalignment of the Achilles tendon.

separate recovery/deload/restorative workouts:

Many clients can benefit from occasional (or regularly scheduled) corrective exercise workouts as a form of active recovery placed within their mesocycle or microcycle planning to address subjective muscle soreness and maintain kinetic chain health and performance in the midst of high-intensity, high-demand training and/or competition.

Mobility assessment

Mobility assessments are used to identify deficits in joint range of motion and help refine observations discovered in the static and movement assessments used with the client. Human movement requires a combination of soft-tissue flexibility, joint range of motion, and neuromuscular control. Any lack of neuromuscular control or restriction in a body segment's mobility will alter movement patterns and lead to impairments throughout the kinetic chain.

A client demonstrates a knee dominance compensation. The observed compensation did not improve with OHS with heel lift. What mobility test will the fitness professional use to test the hip flexors?

Modified Thomas test

Deconditioned clients:

Movement patterns and work capacity must be established before any higher demands can be placed on the kinetic chain to minimize the risk of overuse or acute musculoskeletal injury.

Which muscle should be strengthened in a fitness program for a client with a lack of lumbar stabilization?

Multifidus

force transmission

Muscle forces applied to the skeleton via pathways other than muscular origin and insertion.

Text Neck

Neck and upper back pain caused by poor posture during excessive cell phone use.

What is the head position for the seated thoracic rotation test?

Neutral with nose in line with sternum

isometric muscle action

Occurs when a muscle generates force equal to an external load to hold it in place.

eccentric muscle action

Occurs when a muscle generates force while lengthening to decelerate an external load.

concentric muscle action

Occurs when a muscle generates force while shortening to accelerate an external load.

Disfacilitation

Occurs when a receptor decreases its firing frequency or neural discharge, resulting in a weaker signal. Example: Muscle spindles decrease their discharge frequency after prolonged static stretching.

Pattern Overload

Occurs when a segment of the body is repeatedly moved or chronically held in the same way, leading to a state of muscle overactivity.

Subtalar eversion

Occurs when the bottom of the heel (inferior calcaneus) swings laterally.

Subtalar inversion

Occurs when the bottom of the heel (inferior calcaneus) swings medially.

Forward head posture (FHP)

Occurs when the head is protruding anterior to the shoulders in the sagittal plane; can lead to development of head and neck pain, movement restrictions, and compensations above and below the cervical spine. can cause shoulders to round it may influence the location where the upper and lower teeth come together, which can also affect TMJ function there is over activity of the upper trapezius and levator scapulae muscles

Scapular dyskinesis

Occurs when the scapula does not move in a normal fashion during humeral elevation.

Patellar tendinopathy

Often associated with jumper's knee; commonly an overuse injury affecting the patellar tendon, resulting in anterior knee pain.

Iliotibial (IT) band syndrome

Often associated with runner's knee; usually an overuse injury where the iliotibial band rubs on the femur, resulting in lateral knee pain.

NMS vs. Static stretching

One advantage that NMS has over static stretching is that the contraction of the stretched muscle places more mechanical stress on the tendon than with passive static stretching. Because the muscle is already in an elongated position, the subsequent contraction will emphasize the elongation of the tendon (tissue creep), providing an additional mechanical factor (reduced tendon stiffness) not emphasized with static stretching and further helping to increase joint ROM (Behm, 2018). A traditional weakness of NMS compared to static stretching is that it usually requires the assistance of another person (help from a partner or supervision of a professional). However, it can also be performed as a self-applied technique where the target muscle is contracted against a stretch band (Behm et al., 2019)

Anterior cruciate ligament (ACL) injury

One of the main knee ligaments; stabilizes the knee by stabilizing the anterior translation of the tibia relative to the femur. Injuries often take the form of overstretching or tearing due to sudden lower extremity movements such as stops, changes of direction, rotation, etc.

"Weightlifter's shoulder" is a term associated with what clinical presentation?

Osteoarthritis of the AC joint

Orthotics are typically used to control which foot type?

Over-pronated

Referred pain

Pain perceived at a different location than the source.

Myofascial trigger points

Painful regions within a tight band of skeletal muscle that also give rise to referred pain.

pes planus observations

Pelvis: Anterior tilt Hip joints: Internally rotated Knee joints: Valgus, flexed Ankle joints: Pronated (flattened, pes planus)

someone who has been assessed as having overactive muscles and thus needs a flexibility or movement strategy for daily tension relief

Perform myofascial rolling before and after workouts, while watching TV or immediately after getting home from the evening commute. Invest in a percussion tool that can be taken on business trips and used in a hotel room or fitness center to improve circulation. Take breaks between calls or meetings with a preset stretching program that takes no more than 2 minutes to execute.

Which of the following muscles should be inhibited if over-pronation is observed?

Peroneals

Which muscle is the most appropriate to static stretch for the client who demonstrates over-pronation in the overhead squat?

Peroneus longus

what could be causing low back pain

Poor passive hip extension increased anterior pelvic tilt increased lumbar lordosis limited LPHC stability weak gluteus maximus weak gluteus medius too much sitting awkward trunk postures altered motor control of LPHC musculature pelvic floor dysfunction

plantar fasciitis

Plantar fasciitis presents as pain for the first step in the morning or after a period of rest (poststatic dyskinesia) or as pain in the plantar heel after periods of prolonged standing or ambulation if client has: work on mobility of ankle/foot

underactive/lengthened muscles in pes planus

Posterior and anterior tibialis Vastus medialis Gluteus maximus and medius Hip external rotators Hip flexors Thoracolumbar paraspinals

season based sport routine

Preseason: Corrective exercise, stabilization, strength, and power In-season: Maintain strength and power; stabilization via self-care routines Off-season: Corrective exercise, self-care routines, and active rest

The extensibility of which three muscles are assessed during the modified Thomas test?

Psoas, TFL, and rectus femoris

primary movement patterns

Push Pull Overhead press Trunk rotation Squat Hinge Split stance Single leg and stepping

What is the most appropriate muscle to inhibit if a client demonstrates heel rise during assessment?

Quadriceps

Jon exhibits a knee dominance compensation during assessment. Jon's corrective exercise program should focus on inhibiting and lengthening what muscle groups?

Quadriceps and soleus

What is the recommended composition and timing for a post-exercise meal for the endurance athlete?

Quality carbohydrates and lean protein, 2 hours after exercise.

Naive range of motion

Range of motion improvements that are gained without being properly integrated into the existing proficiencies of the human movement system.

golgi tendon organs

Receptors sensitive to change in tension of the muscle and the rate of that change

Which muscle is thought to be overactive/shortened if the client demonstrates knee extension during the modified Thomas test?

Rectus femoris

intrinsic muscles

Refers to muscles located deep within a structure. stabilizer

grade 3 (severe strain)

Result: Complete tear of muscle fibers Symptoms: Pop or ripping sensation and severe pain, swelling, and discoloration Functional ability: Loss of muscle function

grade 1 (mild strain)

Result: Few muscle fibers damaged Symptoms: Mild or moderate pain Functional ability: Mild weakness or normal strength

grade 2 (moderate strain)

Result: Greater number of muscle fibers involved Symptoms: Moderate or severe pain, mild swelling, and possible discoloration Functional ability: Noticeable weakness

The serratus anterior muscle originates and inserts on what structures?

Rib cage and medial border of the scapula

shoulder static posture that would call for assistance

Rounded shoulders Excessive thoracic kyphosis (hyperkyphosis) Shoulders elevated

What is the recommended order of progressions when considering planes of motion?

Sagittal > Frontal > Transverse

The acromion is part of which bony structure?

Scapula

Which muscle would be considered underactive/lengthened, leading to scapular winging during the Davies test?

Serratus anterior

Which of the following would be the most likely movement compensations to observe in the head, neck, and shoulder regions during an overhead squat movement assessment?

Shoulder elevation, asymmetric CS shift, and forward head

if your client lifts heavy

Similar to repetitive movements, heavy lifting over a client's career can lead to musculoskeletal disorders and low-back injuries

kinematic adjustments

Small alterations in movement pattern execution made in response to repetitive or novel performance conditions.

precautions for Integrated Dynamic Movement

Special populations Neuromuscular disorders

The fitness professional uses activations to provide strength to muscles that lack the ability to appropriately eccentrically decelerate unwanted joint actions and do what else?

Stabilize unwanted movement

Davis's Law

States that soft tissue models along the lines of stress

improve flexibility without impairing performance

Static stretching followed by dynamic stretching

corrective strategy for the knee

Strengthening of the hip and core musculature, should be considered a valuable and necessary intervention.

A client presents with excessive wrist flexion during the assessment process. What activity would be a good next choice activity after inhibiting the wrist flexors?

Stretch the wrist flexors

Which is a reason for a high-arched or over-supinated foot to have restricted ankle dorsiflexion?

Structurally short Achilles tendon

What is the most appropriate term for an overuse injury to a tendon?

Tendinopathy

Intermuscular Coordination

The ability of different muscles in the body to work together to allow coordination of global and refined movements.

intramuscular coordination

The ability of the neuromuscular system to allow optimal levels of motor unit recruitment and synchronization within a muscle.

Dynamic stretching

The active extension of a muscle, using a muscle's force production and the body's momentum, to take a joint through the full available range of motion.

Which best describes the target motion of the knee flexion test?

The client actively flexes the knee as far as tolerable.

client intake screen

The client intake screen is the first step in the overall assessment process. This screen collects valuable subjective information and notes any "red flags" related to physical readiness, general lifestyle, and medical history. This subjective information will provide a first glimpse at potential movement impairments that may come to light later in the assessment process.

Cross Bridge - Mechanism

The collective physiological processes that cause actin and myosin filaments to slide across each other, functionally shortening the muscle as it develops tension.

viscoelastic

The collective properties related to fluid flow, heat dissipation, and elasticity of tissue.

Perception

The integration of sensory information with past experiences or memories.

Scapulohumeral rhythm

The interaction between the scapula and the humerus; important for shoulder function.

Osteoarthritis

The most common form of arthritis, affecting millions of people worldwide; occurs when the protective cartilage that cushions the ends of the bones wears down over time.

Thoracic kyphosis (TK)

The outward curvature of the thoracic spine that provides the rounded appearance of the upper back.

What is considered normal mobility during the elbow flexion test?

The palm of the hand almost touches the front of the shoulder without compensation.

CES Assesments

The process begins with the client intake screen followed by a static assessment. Next, a series of movement assessments are conducted. And then based on the findings from the static and movement assessments, mobility assessments are used to refine the observations and pinpoint strategies as you create programs using the corrective exercise continuum.

autogenic inhibition

The process by which neural impulses that sense tension are greater than the impulses that cause muscles to contract, providing an inhibitory effect to the muscle spindles.

static stretching

The process of passively taking a muscle to the point of tension and holding the stretch for a minimum of 30 seconds. -Elongation of muscle and myofascial tissue to an end-range and statically holding that position for a period of time -Maximal control of structural alignment -Minimal acceleration into and out of the elongated (stretch) position

Motor unit activation

The progressive activation of a muscle by successive recruitment of contractile units (motor units) to accomplish increasing gradations of contractile strength.

Muscle Action Spectrum

The range of muscle contractions use to accelerate, decelerate, and stabilize forces.

neural drive

The rate and volume of activation signals a muscle receives from the central nervous system.

Gama loop

The reflex arc consisting of small anterior horn nerve cells and their small fibers that project to the intrafusal bundle and produce its contraction, which initiates the afferent impulses that pass through the posterior root to the anterior horn cells, inducing, in turn, reflex contraction of the entire muscle.

length-tension relationship

The resting length of a muscle and the tension the muscle can produce at this resting length.

motor control

The study of posture and movements with the involved structures and mechanisms used by the central nervous system to assimilate and integrate sensory information with previous experiences.

motor learning

The utilization through practice and experience leading to a relatively permanent change in a person's capacity to produce skilled movements.

Rearfoot pronation or eversion is associated with what coupled motion?

Tibial internal rotation

What is the purpose of holding a ball (or other object) between the knees during the seated thoracic rotation test?

To lock hips in place

What ligament creates the carpal tunnel?

Transverse carpal ligament

biopyschosocial model of pain

Treatment paradigm for chronic musculoskeletal pain that accounts for the role of biological, psychological, and social factors in an individual's experience of pain.

Ankle joint & Subtalar Joint relationship when it comes to dorsi/plantar and everted/inverted

Triplanar Motion of the Rearfoot Dorsiflexion + Foot abduction + Eversion = Pronation = Unlocked rearfoot = Force absorption Plantar flexion + Foot adduction + Inversion = Supination = Locked rearfoot = Force production

If a client demonstrates feet turn out during the overhead squat assessment that was corrected with the heels elevated modification, what is the most appropriate next step?

Weight-bearing lunge test

UCS or LCS

When observing a client's static posture, look for the most prominent static malalignments first. For example, if an anterior pelvic tilt is excessive, with less noticeable (but still present) associated malalignments above or below the hip, the client would be best matched with LCS (with the additional malalignments then pointing them toward either LCS-A or LCS-B). If malalignments at the shoulders, neck, and head are more prominent than malalignments below the thoracic region, the client would be best matched to UCS. Layered crossed syndrome then represents a situation where the client has equally prominent malalignments from both LCS and UCS at the same time.

When the knee is able to touch the wall during the weight-bearing lunge test?

When the knee is able to touch the wall during the weight-bearing lunge test

myofascial rolling

a compression technique where an external object (e.g., foam roller) compresses myofascial tissues External compression may stimulate afferent (sensory) receptors located throughout the muscle, fascia, and connective tissues of the HMS to override the dysfunctional yet protective mechanisms involved in the cumulative injury cycle.

past knee injuries effects on the kinetic chain

a decrease in the neural control to muscles that stabilize the patellofemoral and tibiofemoral joints. Noncontact knee injuries are often the result of ankle or hip dysfunctions. If the ankle or hip joint begins to function improperly, this can result in altered movement and force distribution of the knee, leading to further injury over time

titin

a protein that runs the entire length of the sarcomere and is thought to be responsible for a muscle's property of elasticity, preventing the actin and myosin filaments from being pulled apart and assisting the muscle to return to its resting length after being stretched

what causes static malaligments

a segment of the body is repeatedly moved or chronically held in the same way, leading to a state of muscle overactivity. frequently the result of pattern overload from either chronic sedentary positioning or repetitive stress injury.

What position should the shoulder be in when performing the shoulder internal and external rotation test?

abducted and bent to 90 degrees

Influences Above the LPHC

ability to recruit shoulder musculature, anterior translation of the humeral head and even the elbow are all related to LPHC dysfunction. Respiration has also been shown to be negatively affected by altered LPHC positioning .

What do you do to muscles identified as underactive/lengthened

activated in phase 3. The newly balanced length-tension relationships are then integrated into functional movement patterns in phase 4 to restore optimal force-couples throughout the body.

myofascial decompression

active approach to cupping Decompression occurs by using the suction to "lift" the superficial tissue.

lordosis

abnormal increase in the forward curvature of the lumbar spine

Primary external shoulder impingement

abnormalities of the superior bony structures, leading to encroachment of the subacromial space from above. An abnormally shaped acromion is often the cause, but an acromial bony spur may occur in older age groups

iliotibial band syndrome

an overuse injury caused by this band rubbing against bone, often in the area of the knee

Structural Efficiency

alignment of each segment of the HMS, which allows posture to be balanced in relation to one's center of gravity.

past shoulder injuries effects on the kinetic chain

altered neural control of the rotator cuff muscles, which can lead to instability of the shoulder joint during functional activities. Shoulder dysfunction associated with previous injuries has been linked to reduced thoracic mobility (Haik et al., 2014). For overhead throwing athletes, past injuries to the shoulder could also alter throwing mechanics, leading to further injury

posterior oblique

back-side stabilizing force across the SIJ

How often should you foam roll for positive results

between two and five times per week

the posterior oblique subsystem

both the gluteus maximus and latissimus dorsi have attachments to the thoracolumbar fascia, which connects to the sacrum, whose fibers run perpendicular to the SIJ prime importance for rotational activities such as swinging a golf club or a baseball bat or throwing a ball. Dysfunction of any structure in the POS can lead to SIJ instability and LBP. The weakening of the gluteus maximus, the latissimus dorsi, or both can lead to increased tension in the hamstring complex—a factor in recurrent hamstring strains prone flat or quadruped contralateral arm and leg lift exercises will activate the POS. Another example in standing is to perform simultaneous combination movements of shoulder internal rotation-adduction-extension with contralateral hip external rotation-extension with or without resistance bands

if your client wears dress shoes

can lead to tightness in the gastrocnemius and soleus causing movement impairments at the ankle, knee, and hip, such as overpronation of the feet during gait or an excessive forward lean when squatting

resistance-based exercise relies primarily on

carbohydrates

What is the name given for the wrist bones collectively?

carpals

Rotator Cuff Strain

caused by either overuse or an acute injury. The tendons that connect muscles to bones can overstretch (strain) or tear partially or completely (rupture)

Cumulative Injury Cycle

causes decreased performance, myofascial adhesions (which further alter length-tension relationships and joint arthrokinematics), and eventually injury. initiated by patterns of tissue overload and dysfunction, which leads to decreased neuromuscular control and microtrauma

sections of the spine (top to bottom)

cervial - 7 thoracic - 12 lumbar- 5 sacral- 5 coccygeal- 4

Patellofemoral Syndrome

clients will present with pes planus distortion syndrome, excessive pronation, or heel rise. The SLSA will result in knee valgus or varus. Pain will be associated on the front aspect of the knee behind the patella. If the client is unable to complete the movement assessment process due to pain or swelling, the Corrective Exercise Specialist should refer the client to a medical professional for further evaluation.

IT band syndrome

common knee injury results from overuse and is usually caused by muscle weakness in the kinetic chain and is commonly seen in runners

proximal radioulnar joint

composed of the head of the radius and the radial notch of the ulna

Shoulder Impingement Syndrome

compression of the rotator cuff and the subacromial bursa against the anteroinferior aspect of the acromion and the coracoacromial ligament, leading to pain and/or weakness around the shoulder joint, especially with overhead activity

Common static malalignments of the elbow may cause....

constant or chronic elbow flexion

Central Nervous system's role

coordinates deceleration, stabilization, and acceleration for all muscles of the body in all three planes of motion.

Primary objective of corrective exercise specialist

optimize quality movement, enhance performance, injury resistance, movement efficiency and recovery

In order to obtain neuromuscular efficiency and optimization of human movement, total-body integrated exercises are called on to provide and control which of the following?

degrees of freedom

multisegmental HMS impairment

described as a combination of contralateral pelvic drop, femoral adduction and internal rotation, tibial external rotation, and excessive foot and ankle pronation.

Steps in solving the problem

design phases of the corrective exercise continuum inhibit, lengthen, activate, integrate

Movement assessments

designed to evaluate a person's dynamic posture, which refers to the structural alignment of the musculoskeletal system when the body is in motion. Compensatory movement can be observed through a series of movement assessments such as the overhead squat assessment and other transitional, dynamic, and loaded movement assessments.

static malaligments

deviations from ideal posture that can be observed when standing still; essentially, they represent situations where an individual is said to have poor posture joint disfunction (excessive joint positioning) as well as myofascial adhesions that lead to or can be caused by chronic poor static posture.

dynamic malaligments

deviations from optimal posture during functional movements can only be observed when the body is in motion Common lower extremity movement impairments include excessive foot pronation, knee valgus (knock-knees), and increased movement at the LPHC (extension or flexion) during functional movements. Common upper extremity movement impairments include rounded shoulders, a forward head posture, and improper scapulothoracic or glenohumeral kinematics during functional movements

neurophysiological effects of foam rolling

direct roller pressure may influence tissue relaxation and reduce pain in the local and surrounding tissues

cause possible pain and neurological symptoms (e.g., numbness and tingling) down the leg into the foot

disc herniation at the L5-S1 level,

Which joint motion is considered to have normal mobility when the client is able to touch the wall by forward bending the knee during the weight bearing lunge test?

dorsiflexion

Which phase of the muscle action spectrum is the slowest during corrective exercise?

eccentric

What additional region of the body should undergo mobility testing if a client's arms fall forward during the overhead squat assessment?

elbow and wrist

Common static malalignments of knee

excessive anterior pelvic tilt; and decreased flexibility of the quadriceps, hamstrings complex, and iliotibial band

Which of the following are key compensations to observe at the cervical spine during a loaded push assessment?

excessive extension & elevated shoulders

kyphosis

excessive outward curvature of the spine, causing hunching of the back.

Which view allows for the optimal assessment of frontal plane movements (adduction and abduction)?

excessive pronation

isolated strength training

exercises that require the joints to be placed in an optimal position to preferentially recruit a specific muscle or muscle group.

firing rate

frequency at which a motor unit is activated

anterior oblique

front-side transverse plane force production

Lateral subsystem

frontal plane functional movements gluteus medius, tensor fascia latae, adductor complex, and the quadratus lumborum, all of which participate in frontal plane and pelvofemoral stability Dysfunction in the LS starts on the ground during increased subtalar joint pronation and moves up the leg with increased tibial and femoral adduction and internal rotation during functional activities. example of activating the LS and correcting RI dysfunction is side stepping in a knee extended or flexed position progressed with a resistance band placed just above knee joint (easier) or ankle joint (more challenging)

What should the fitness professional do when they first observe movement compensations during integrated movement in order to allow the athlete to cognitively process proper form?

give verbal cues

Pain on the inside of the elbow may be a symptom of what condition?

golfers elbow

Cervicogenic headaches

headaches originating from neck pain common in individuals with FHP can arise from myofascial trigger points from muscles in the head and neck region

humeroulnar joint

hinge joint that is primarily responsible for elbow flexion and extension.

Which best describes the testing leg starting position during the active knee extension test?

hip flexed to 90 degrees with knee bent to 90 degrees

Foam rolling the posterior adductor magnus and hamstring complex helps to reduce tension in the tissues allowing for appropriate levels of which joint action to be achieved?

hip flexion

Duration if rolling out targeted muscle group

individuals who have increased sensitivity or who find the steps too complex may choose to simply roll the target muscle continuously for 90 to 120 seconds. If this rolling method is used, the user should roll the entire muscle slowly (approximately 1 inch per second) for the desired time.

De Quervain's tenosynovitis

inflammation of the sheath, or synovium, that surrounds the two tendons that run between the wrist and the thumb Symptoms may include pain in the back of the thumb and swelling at the base of thumb or wrist. Many clients will demonstrate ROM deficiency or increased pain during ulnar deviation. The pain from de Quervain's tenosynovitis can be very intense, and the client should be referred to a healthcare provider who can properly manage the condition.

Corrective exercise continuum

inhibit, lengthen, activate, integrate

Is static or dynamic stretching best for GTO

it has been shown that GTOs are not highly sensitive to the tension associated with static stretching. Contributions to muscle relaxation with GTOs are more likely to occur with dynamic stretches that use large ranges of motion (Guissard & Duchateau, 2006) such as leg swings. Furthermore, GTO inhibition stops around 60 to 100 milliseconds after stretching, so its effect would not persist after ending the stretch (Houk et al., 1980). Thus, because GTOs are more active during active muscle contractions, their inhibition effect would contribute more during dynamic stretching than with a passive holding of a stretch.

Greatest strength gains take place while the muscle is under resistance during what muscle action in isolation?

lengthening

movement impairments at the knee

knee valgus , knee varus , and knee dominance normally knee valgus will be the typical movement impairment seen at the knee.

alpine skiers are prone to

knee valgus forces and, as a result, may develop compensations in the ankle, knee, and LPHC

Most ankle sprains occur at which aspect of the ankle?

lateral

the anterior oblique subsystem

latissimus dorsi, gluteus maximus, internal and external obliques, adductors, and hip rotators functions in a transverse plane orientation, mostly in the anterior portion of the body. The prime contributors are the internal and external oblique muscles, the adductor complex, and hip external rotators. basic exercise example for the AOS is performing supine oblique core activation while reaching a hand to touch the flexed knee of a contralateral flexed and adducted hip. Another example would be while standing to perform a cross-body kicking motion using the contralateral arm to counter the motion with or without resistance bands

Which of the following tissues that surround the spine limit intersegmental motion, maintain the integrity of the lumbar spine, and may fail when proper motion cannot be created, proper posture cannot be maintained, or excessive motion cannot be resisted by the surrounding musculature?

ligaments

Observing a client's posture under an additional source of resistance, that should relate to the prime movement patterns

loaded movement assessment

What type of activations will provide mild stress to muscles, which may be used as part of a recovery day?

low-level activation

lumbosacral joint

lowest of the lumbar vertebrae connected to the sacrum stability

If someone does a lot of repetitive movements in their job

may lead to tissue trauma resulting in pain and eventually kinetic chain dysfunction Working with the arms over-head for long periods of time may lead to shoulder soreness that could be the result of tightness in the latissimus dorsi and pectorals and weakness in the rotator cuff musculature. This imbalance does not allow for proper shoulder motion or stabilization during activity, which can lead to shoulder and neck pain.

tissue creep

means that the muscles and tendons do not return to their original length after prolonged stretching because of physical changes in the proteins, such as collagen

Which of the following is defined as the inability to move a joint through what should be its full range of motion?

mobility restriction

If an excessive anterior pelvic tilt is improved with the hands on the hips, this indicates that

mobility restrictions above the hip at the shoulder (likely due to an overactive latissimus dorsi) are more responsible for the excessive tilt than below. For these individuals, protocols to correct arms fall forward should help improve their lumbar dynamic posture.

How many muscles are located in the cervical spine region and shoulder complex?

more than 30

What is practiced with limited resistance with slow tempos and high repetitions so that the client can modify and rehearse quality movement?

movement efficiency

Altered reciprocal inhibition

muscles become underactive/lengthened, leading to a muscle imbalance and, potentially, synergistic dominance a tight muscle (short, overactive, and myofascial adhesions) causes decreased neural drive and, therefore, less-than-optimal recruitment of its functional antagonist.

if elevating the heels does not improve the squat, then

musculature at the hips may be involved in the impairments, such as overactive adductors and underactive gluteals.

instrument-assisted soft tissue mobilization

myofascial technique that uses specifically designed instruments to provide a mobilizing effect to scar tissue and myofascial adhesions

Secondary external shoulder impingement

narrowing of the subacromial space by anterior tilt and excessive internal rotation of an unstable scapula. Weakness and inactivity of the scapular stabilizing muscles leads to an abnormal scapulohumeral rhythm

ecentric

negative contractions-lengthening

Which internal tissue or structure can get irritated and lead to pain when herniated discs press against it?

nerve

nuclear chain fibers

nuclear chain fibers preferentially respond to changes in muscle elongation

CARPAL TUNNEL SYNDROME

numbness, tingling, weakness, and other symptoms in the hand. may be associated with poor wrist alignment during activities such as typing. Excessive and repeated wrist flexion or extension may close off the carpal tunnel space irritating the nerves

neuromuscular stretching

optimal method for lengthening myofascial tissues, it is a technique that involves a process of isometrically contracting a desired muscle in a lengthened position to induce a relaxation response on the tissue, allowing it to further elongate

depth jump impairment

observed during deceleration. most common depth jump compensation is knee valgus however, knee varus or knee dominance will be seen in some may reflect underactivity in the muscles, such as the gluteus maximus, gluteus medius, and core stabilizers

Janda's syndromes

observed in lateral view

Pelvic asymmetry

one or both ilia are irregularly rotated, showing altered movement in the Human Movement System during standing or sitting

Movement Impairment

one or more segments of the kinetic chain are out of alignment the state in which the structural integrity of the HMS is compromised because the components are out of alignment, causing the body to make compensations that put it at a higher risk of injury.

sleep aide recommendations

over-the-counter sleep supplements can be integrated on an as needed basis. Natural products such as magnesium, zinc, and cherry root are preferred, whereas "Z drugs" such as antihistamines and diphenhydramine should be used with caution. The addition of any supplemental sleep aids requires physician clearance. During sleep, light exposure should be at an absolute minimum and the room temperature should be no greater than 72 degrees Fahrenheit if reasonably possible. Overly thick, warm blankets can additionally disrupt the ability to achieve restorative sleep by means of interfering with the body's thermostat. Restorative sleep can also be achieved through the integration of meditation and mindfulness practices that have been shown to transition brain activity from higher to lower (sleep- and recovery-promoting) frequencies.

If a client has a history of ankle sprains, which assessment can be used to determine if this has negatively influenced gluteal strength?

overhead squat

tennis athletes are prone to

overuse injuries of the upper extremity, specifically the elbow and shoulder (e.g., tennis elbow). Changes to racquet grip or racquet properties as well as the repetitive swing motion could alter the biomechanics of the kinetic chain

Medial Tibial Stress Syndrome

pain and tenderness along the lower third of the medial tibia, especially during dynamic movement such as running and jumping if client has: avoid impact-related activities such as running and jumping. The focus is on ensuring proper foot mobilization, building increased intrinsic foot strength and foot-to-core integration, which can enhance gluteal strength. Orthotics may be recommended in the client with an overpronated foot type, as this can help optimize the timing of muscle stabilization.

Sacroiliac Joint Dysfunction

pain originate at the sacroiliac joint. Pain generated from the sacroiliac joint can refer pain to other parts of the hip and pelvis and, at times, down the leg

What muscle attaches to the coracoid process of the scapula?

pectorals minor

Steps in identifying the problem:

perform integrated assessments such as: -static -transitional -dynamic -mobility

After ACL surgery

perform movement assessments, especially the OHSA and SLSA, to identify any potential movement impairments. Adequate programming to address those impairments can be implemented, thus limiting the risk of future lower-extremity injuries.

Biceps Tendinopathy

presents as pain and dysfunction of the tendon around the long head of the biceps muscle

Achilles Tendinopathy

presents as pain either at the Achilles tendon insertion onto the calcaneus or as pain along the middle of the tendon (Figure 11-18). Achilles tendon pain that is more insertional (on the calcaneus) is associated with uncontrolled absorption of impact forces, whereas the mid-tendon pain is associated with insufficient elasticity during dynamic movement and a subsequent micro-tearing if client has: avoid impact-related activities and/or exercises that place excessive stress on the Achilles tendon and ankle mobility (Irving et al., 2006). The focus is on increasing foot and ankle mobility through myofascial release of the plantar foot and posterior muscle group (soleus and gastrocnemius). Eccentric training is also one of the most effective ways to reduce the symptoms and stress to the Achilles tendon.

infraspinatus and teres minor collab functions

prevent internal rotation of the shoulder, decelerate the humerus during internal rotation

ACL predisposing factors

programming should focus on improving movement impairment, such as excessive knee valgus, knee rotation, hip adduction, and hip rotation; improving single-leg neuromuscular balance; and improving muscle strength

Knowledge of performance

provides information about the quality of the movement. An example would be noticing that, during a squat, the individual's feet were externally rotated and the femurs were excessively adducting and then asking whether the individual felt or saw anything different about those repetitions. Or, to get individuals to absorb the shock of landing from a jump (and not landing with extended knees, which places the ACL in a precarious position), tell them to listen to the impact and land quietly, effectively teaching the individual to absorb the shock of landing.

uncovertebral joints (aka Luschka joints)

provides stability and guidance of cervical spine motion

De Quervain's Tenosynovitis affects which part of the hand?

radial

What are common underactive/lengthened muscles in the lower body?

rectus abdominis, gluteus maximus, tibialis anterior, and peroneals

past low back injuries effects on the kinetic chain

reduced lumbar mobility, slower movement, and reduced proprioception (Laird et al., 2014). If not addressed, limited lumbar mobility will be affected and this could have an impact on the kinetic chain as the entire spine works as a functional unit. Limited mobility in the lumbar spine could cause limited mobility in the thoracic spine, resulting in shoulder and cervical pathologies as well

Relative Flexibility

represents the body's ability to find the path of least resistance to accomplish a task, even if that path requires altered muscle recruitment and creates dynamic malalignments example: an excessive forward lean above the hip can be caused by a lack of dorsiflexion down at the ankle when squatting to pick up a box from the ground. The down position of the squat requires optimal triple flexion of the legs (ankle, knee, and hip) but, in this case, the ankle cannot dorsiflex as much as it needs to. However, the task (picking up the box) still needs to be completed, so, hip flexion naturally increases (bending over at the waist) to make up for the reduced range of motion at the ankle.

nuclear bag fibers

respond to both the extent and rate of elongation

Global muscular system

responsible for movement and consists of more superficial tissues that originate from the pelvis to the rib cage, the lower extremities, or both Type 2, fast twitch muscle fiber types strength, coordination, agility, and fast velocity training with a large variety of movement patterns and parameters of short duration across a spectrum of light to heavy resistance and loads abdominis, external obliques, erector spinae, hamstring complex, gluteus maximus, latissimus dorsi, adductors, quadriceps, and gastrocnemius.

Oversupination of ankle

rigid medial arch (i.e., the medial arch does not lower during the squat) or by a medial arch that rises during the squat (i.e., the individual shifts weight to the lateral portion of the foot). Oversupination is often due to rigidity in the foot and ankle. The Corrective Exercise Specialist is reminded to stay within their scope and not diagnose. A proposed solution is to begin with soft-tissue mobilization of the plantar surface via myofascial techniques once the client has been cleared by a healthcare provider.

duration of rolling that is recommended

roll for a total of 5 to 10 minutes (rolling each muscle group for between 30 seconds and 2 minutes) at a pace of 2 to 5 seconds per roll

3 motions available at the knee.

roll, slide, spin

What is the abnormal curvature of the thoracic spine in the frontal plane called?

scoliosis

example program for an athlete with an excessive forward trunk lean may include:

self-myofascial rolling (SMR): Gastrocnemius/soleus, hip flexors Static stretching: Gastrocnemius, kneeling hip flexor Isolated strengthening: Heel walking (tibialis anterior), floor bridge (gluteus maximus) Integration: Goblet squat, lunge to rotation (dynamic), leg swings (dynamic), A-skips (dynamic)

glenohumeral joint

shoulder joint where the humerus fits into the glenoid cavity of the scapula ball and socket.

past ankle sprain effects on the kinetic chain

shown to decrease the neural control to the gluteus medius and gluteus maximus muscles. Additionally, chronic ankle instability can lead to altered knee flexion on landing tasks. This, in turn, can lead to poor neuromuscular control and balance, potentially resulting in further injury

benefits of NSM stretching

substantial decrease in motor neuron excitability that is said to last up to 15 seconds, and thus acts in the same manner as static stretching. Similarly, increased stretch tolerance, decreased tissue viscosity, and increased muscle compliance (reduced stiffness) (contribute to an observable increase in joint ROM.

rotator cuff is made up of

supraspinatus and subscapularis anteriorly, with the infraspinatus and teres minor posteriorly

when to refer out

swelling, acute pain, when in doubt

scolosis

symptoms: One shoulder blade that is higher than the other One shoulder blade that sticks out more than the other Uneven hips A rotating spine Problems breathing because of reduced area in the chest for lungs to expand Back pain Sideways curvature of the spine that occurs most often during the growth spurt just before puberty core stability training and unilateral training to attempt balance between the muscle groups.

The glenohumeral joint is what type of joint?

synovial ball and socket joint

what type of a joint is the knee

synovial joint

Internal (sensory) feedback

the process by which sensory information is used by the body to monitor movement and the environment. Internal feedback acts as a guide, steering the human movement system to create the proper force, speed, and amplitude of movement required for any given situation. Proper form during movement ensures that the incoming internal (sensory) feedback is the correct information, allowing for optimal sensorimotor integration.

synergistic dominance

the process in which a synergist compensates for a prime mover to maintain force production

Duration & frequency of stretching to improve ROM

the recommended duration for each muscle is 30 to 60 seconds. Stretch to the onset of or near the point of discomfort, but there is no need to elicit great discomfort or pain. Just place moderate stretch tension on the muscle. ROM can be improved within 2 to 6 weeks if performed 3 to 5 days per week.

contract, relax, agonist ,contract (CRAC method)

the target muscle being lengthened is considered the antagonist. This technique involves an additional contraction of the agonist muscle (i.e., the muscle opposing the target muscle) immediately following the isometric contraction and prior to the additional stretching of the target muscle.

tibiofemoral joint

tibia and femur

golfers are prone to

to LPHC and shoulder compensations due to poor swing mechanics

Why do muscle spasms occur?

to protect the inflamed area, which is the body's way of immobilizing a joint through sustained muscle contraction. To avoid the pain involved with muscle spasms, injured body segments are often immobilized externally, allowing the injured segment to better relax and heal.

the deep longitudinal subsystem

transmits forces between the trunk and the ground erector spinae, thoracolumbar fascia, sacrotuberous ligament, biceps femoris, tibialis anterior, and fibularis (peroneus) longus example of a basic level exercise to activate the DLS unilaterally: starting from the quadruped position. First extending the head to neutral while also extending the hip and knee of one leg, then lifting the straight leg against gravity toward the ceiling, and then lowering would provide concentric and eccentric exercise of the DLS. superficial erector spinae, the psoas, and the intrinsic core stabilizers (transverses abdominis and multifidus). the erector spinae and psoas create lumbar extension and an anterior shear force at L4 through S1, during functional movements, the local muscular system provides intersegmental stabilization and a posterior shear force. Dysfunction in any of these structures can lead to SIJ instability and low-back pain

local muscular system

transversus abdominis, multifidus, internal obliques, psoas, diaphragm, and the muscles of the pelvic floor muscles that attach directly to the spine and are predominantly involved in stabilization Type 1, slow twitch muscle fiber types suitable for endurance, balance, and slow movement training with parameters of long duration, light resistance, low load, and slow velocity

sacroilic joint

triangular bone set between the left and right ilia, where the axial skeleton attaches to the pelvic girdle and the appendicular skeleton of the lower extremity. Little movement occurs at this joint, which is classified as a diarthrodial joint

Deficits in neuromuscular control of the LPHC may lead to

uncontrolled trunk displacement during functional movements, which, in turn, may place the lower extremity in a valgus position, increase knee abduction motion and torque (femoral adduction or internal rotation and tibial external rotation occurring during knee flexion), and result in increased patellofemoral contact pressure, knee ligament strain, and ACL injury (Levine et al., 2012; Page et al., 2010).

overactive/shortened: Latissimus dorsi

undderactive/lengthened: Middle and lower trapezius

Overactive - Levator scapulae

underactive- rhomboids

overactive/shortened: Hamstrings

underactive/lengthened: Fibularis (peroneal) muscles

overactive/shortened: Hip adductors

underactive/lengthened: Rectus abdominis

overactive/shortened: Levator scapulae

underactive/lengthened: Rhomboids

overactive/ shortened: Pectorals (major and minor)

underactive/lengthened: Serratus anterior

overactive/shortened: Piriformis

underactive/lengthened: Tibialis anterior and posterior

overactive/shortened: Psoas

underactive/lengthened: Transverse abdominis

overactive/shortened: Quadratus lumborum

underactive/lengthened: Vastus medialis and lateralis

overactive/shortened: gastrocnemius

underactive/lengthened:Gluteus maximus and medius

Overactive: Cervical extensors

underactive: Deep cervical flexors (longus coli and capitis)

overactive/ shortened: Cervical extensors

underactive: Deep cervical flexors (longus coli and capitis)

overactive: hamstrings

underactive: Fibularis (peroneal) muscles

overactive: Gastrocnemius

underactive: Gluteus maximus and medius

overactive: latissimus dorsi

underactive: Middle and lower trapezius

overactive: hip adductors

underactive: Rectus abdominis

overactive: Pectorals (major and minor)

underactive: Serratus anterior

overactive: Piriformis

underactive: Tibialis anterior and posterior

overactive: Psoas

underactive: Transverse abdominis

over active: Quadratus lumborum

underactive: Vastus medialis and lateralis

What muscle is best inhibited for the scapular winging compensation?

upper trap

knowledge of results

used after the completion of a movement to inform individuals about the outcome of their performance The fitness professional might inform individuals that their squats were "good" and ask clients whether they could "feel" or "see" their form. By getting clients involved with knowledge of results, they increase their own awareness and augment their impressions with multiple forms of feedback.

ballistic stretching

uses higher-velocity movements with bouncing actions at the end of the joint ROM

best integration exercise for a knee varus compensation?

wall jump

when to foam roll?

warm up, cool down, if there is any intermissions during sporting events

sternoclavicular joint

where the clavicle and sternum meet connects the shoulder girdle to the rest of the body

muscle insertion

where the end of the muscle attaches to movable bone

iliofemoral joint

where the femur attaches to the ilium ball-and-socket joint with the ability to move in all three planes of motion (Cheatham & Kolber, 2016).

What do you do to muscles identified as overactive/shortened in a static assessment

will be inhibited and lengthened in the first two phases of the Corrective Exercise Continuum

Posture and dynamic movement assessments reveal excessive wrist flexion. What muscle group should be lengthened?

wrist flexors

Lower cross syndrome static positions

​​​​​Head: Neutral to forward Cervical spine: Normal to extended Thoracic spine: Normal to rounded Shoulders: Neutral to rounded Lumbar spine: Neutral to excessive lordosis, possible lateral shift Pelvis: Anterior tilt Hip joints: Flexed or neutral Knee joints: Flexed or hyperextended Ankle joints: Neutral or plantar flexed

What muscle is primarily responsible for elbow flexion?

​​​​​​​Brachialis

When forward head is observed during assessment, which of the following is most appropriate to static stretch?

​​​​​​​Sternocleidomastoid

↑ Muscle and tendon peak force absorption over shorter durations

↑ Force and trauma to muscle and tendon fibers

dynamic stretching warm up recommendations

≤ 90 seconds per muscle group. Use full range of motion with a controlled movement at moderate speeds.


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