Client body assessment
Male: 38 years old and active!
Sport: Weight training and Muay Thai
Injuries: Left shoulder / Right Quadricep
Client specifics: he is fairly flexible and this could be hereditary as one would expect inflexibility from weights and Muay Thai. He needs relaxation, lengthening and release in certain areas i.e. left upper trapezius. Any weight training and Muay Thai will exacerbate the elevation of the left scapula. Core activation is needed as most movements produced in the assessment reflected a more global stability.
He also has a flat back which is hereditary and due to this, over-mobilization of the spine might cause injury.
- Re-alignment of the neck will be imperative in order to gain scapula control with stability in functional movements.
- The scapulae are protracted with a greater protraction on the right hand side. This would also correspond with the right arm being his stronger arm in a punching action in Muay Thai if he is right handed.
- Thoracic spine is extended which is also hereditary and this will inhibit the abdominal strength during supine flexion of the spine.
- Pelvic tilt is posterior which will cause lengthened hip flexors, if these hip flexors are put under a lot of load as in kicking, then the quadriceps could possible dominate this strong hip flexion action with the actual kick on knee extension. This could cause an irritation at the rectus femoris due to it having to work double.
- Due to the hip extension, there could be a weakness in the gluteus medius and maximus as the hip will be in a constant relaxed stated due to the posterior tilt. This will create a lack of stability in the hip socket and therefore create problems in the areas around the hip and possibly the knees at a later stage.
- The slight hyperextension in the knees will cause a weakness at the posterior area of the knee, this will result in overactive quadriceps and will be exacerbated with any kicking action.
- The constant lateral rotation of the hip joints could cause a stiffness in the smaller lateral rotator muscles and with this, He will struggle to create a balanced muscular development and stability around the hip joint if it is not addressed. Due to this the pain that he experiences in his quadricep and leg will re-occur if the general hip balance and stability is not addressed.
- Pronation of his feet can lead to dropped arches in the future especially if he is doing foot impact sports.
- His weight is slightly back in the heels and this will contribute to inactive hamstrings and overactive and possibly tight quadriceps which he has.
Areas to lengthen:
Neck and shoulder; Neck extensors to avoid the chin poke. Upper trapezius and levator scapula, especially the left upper trapezius.
Shoulder and shoulder girdle; The pectoralis major needs flexibility, this will continue to be stiff with weight training and Muay Thai.
Pelvis and hips; the quadriceps need flexibility in order to allow the hamstrings to do their part in normal gait and general weight placement. There just through flexibility of the quadriceps, the functional movement of the hip will improve.
Feet: More mobility of the peroneals will create a balanced base for the feet, knees and hips to function from. With this a conscious thought of lifting the arch and rolling slightly onto the little toe will make a big difference to the overall alignment.
Areas to strengthen:
- Awareness of deep neck flexion and the deep neck flexors for cervical alignment will assist with the release of the levator scapulae and upper trapezius.
- Scapula retractors need to be strengthened as well as the general stability of the shoulder especially with the elevation in the left shoulder.
- The abdominals will need to be strengthened specifically for the exercise that he currently does however the spinal restrictions need to be taken into account as this will affect the neck health. Remember that these restrictions then affect range of motion of the thoracic spine.
- Due to the posterior pelvic tilt, the lumbar back extensors and hip flexors will need to be strengthened at a low load initially in order to avoid spasms. These two areas have to work in unison in order to create functional stability of the pelvis and spine.
- Due to the posterior pelvic tilt, the gluteus medius and maximus will need to be strengthened in an eccentric position initially in order to open the neural path of activation. Once the path is open, only then can the strength training take place. The lumbar flat back will have to be taken into consideration whilst doing the gluteus maximus work.
The Focus of his program should contain the following:
- Neck positioning
- Shoulder flexibility (pectoralis major) as well as abdominal strength in thoracic flexion.
- Shoulder stability through free movement, relaxation and functional gliding of the blade. This will alleviate the upper trapezius.
- Hip stability through glute and hip flexor strengthening as well as weight placement.
- Release of the TFL must be incorporated in order for the gluteus medius to activate efficiently.
- Eccentric muscular strength of most main joints in order to promote functional movement which will then prevent injury.
- Relaxation and He seems to tense up as soon as he exercises.
- Core stability
Specific areas assessed:
- Hip disassociation; This is fairly good, but needs to be more free and therefore we need to eliminate the idea that movement needs to cause tension or stress on the muscles.
- Abdominal hip flexor co-ordination; This is actually quite good as the lower abdominals seem to maintain the pelvis pretty well. The difficult for the abdominals will be as soon as the hip flexors are loaded.
- Abdominal Isolation upper and lower; He does struggle to maintain a neutral pelvis but is able to keep it neutral if he thinks about it.
- Spinal isolation; there is a restriction in his isolation due to the structurally stiff spine.
- Neck mobility; this is not bad but the left side of the neck appears to take more strain due to the left scapula being elevated.
- Shoulder stability; free movement is needed with a natural glide of the blade. The general postural position needs to be altered in order to get the scapula to a neutral position.
- Mind-body connection; this was very good except the fact that he needs to relax a lot more whilst training. This will encourage free movement in the shoulder and hip joints and will inevitably prevent injuries.
JUST MAKING A DIFFERENCE ONE ASSESSMENT AT A TIME!
THAT IS THE HEALTHY TRUTH!