Ace Personal Trainer Manual Chapter 7: Functional Assessments: Posture, Movement, Core, Balance & Flexibility

Front 1

bend and lift screen anterior view: lack of foot stability. Ankles collapse in (pronation), feet turn outward (eversion). What is underactive and what is overactive?

Back 1

overactive/tight: lateral gastrocnemius, soleus, peroneals

Underactive:medial gastrocnemius, sartorius, tibialis group

Front 2

Bend and lift screen- anterior view: knees move inward

Back 2

Tight: hip adductors, tensor fascia latae

Underactive: gluteus maximus and medius

Front 3

Bend and lift screen, anterior view: lateral shift to a side

Back 3

Side dominance and muscle imbalance due to a potential lack of stability in lower extremity during joint loading

Front 4

Bend and lift screen sagittal view: unable to keep heels in contact with floor. What is tight?

Back 4

overactive/ tight ankle plantar flexors (gastrocnemius medial head, gastrocnemius lateral head, soleus, plantaris, tibialis posterior, flexor hallucis longus, flexor digitorum longus, fibularis longus, and fibularis brevis.)

Underactive: n/a

Front 5

Bend and lift screen sagittal plane: movement initiated at knees

Back 5

overactive/tight quadriceps and hip flexors (psoas, iliacus, quad)

Weak glutes

Front 6

Bend and lift screen sagittal view: unable to achieve parallel between tibia and torso

Back 6

lack of dorsiflexion due to tight plantar flexors (gastrocnemius medial head, gastrocnemius lateral head, soleus, plantaris, tibialis posterior, flexor hallucis longus,flexor digitorum longus, fibularis longus, and fibularis brevis.)

Plantar flexors normally allow the tibia to move forward. Can also be due to poor mechanics.

Front 7

Bend and lift screen sagittal view: back excessively arches (increased lordosis)

Back 7

overactive/tight: hip flexors, back extensors (erector spinae, multifidi), latissimus dorsi

+ underactive core, abs, glutes, hamstrings

Front 8

Bend and lift screen sagittal view:

head downward

Back 8

increased hip and trunk flexion

Front 9

Hurdle step screen anterior view:

Lack of foot stability, ankles collapse inward (pronation), feet turn outward (eversion)

Back 9

overactive/ tight: soleus, lateral gastrocnemius, peroneals

underactive/ lengthened: medial gastrocnemius, gracilis, sartorius, tibialis group, gluteus medius and maximus- inability to control internal rotation

Front 10

Hurdle step screen, anterior view:

Knees move inward

Back 10

overactive/tight: hip adductors (pectineus, adductor longus, brevis, magnus, gracilis), tensor fascia latae

Underactive: lengthened: gluteus medius & maximus

Front 11

Hurdle step screen, anterior view:

Hip adduction > 2"

Back 11

Overactive/tight: hip adductors(pectineus, adductor longus, brevis, magnus, gracilis),

tensor fascia latae

Underactive/ lengthened:gluteus medius & maximus

Front 12

Hurdle step screen, anterior view:

Lateral tilt, forward lean, rotation

Back 12

Lack of core stability

Front 13

Hurdle step screen, anterior view:

Lack of ankle dorsiflexion

Back 13

Overactive/tight: ankle plantar flexors(gastrocnemius, soleus, plantaris)

Underactive/ lengthened: ankle dorsiflexors (tibialis anterior...)

Front 14

Hurdle step screen, anterior view: Limb deviates from sagittal plane

Back 14

Overactive/tight: raised leg hip extensors (Hams- biceps femoris, semimembranosus, semitendinosus, gluteus maximus)

Underactive/ lengthened: raised leg hip flexors (psoas, iliacus, rectus femoris QUAD)

Front 15

Hurdle step screen, anterior view: Hiking the raised hip

Back 15

Overactive/tight:stance-leg hip flexors(psoas, iliacus, rectus femoris QUAD)- limiting posterior hip rotation during raise

Underactive/ lengthened: n/a

Front 16

Hurdle step screen, Sagittal view:

anterior tilt with forward lean

Back 16

Overactive/tight: stance-leg hip flexors(psoas, iliacus, rectus femoris QUAD)

Underactive/ lengthened: rectus abdominis and hip extensors (Hams- biceps femoris, semimembranosus, semitendinosus, gluteus maximus)

Front 17

Hurdle step screen, Sagittal view:

Posterior tilt with hunched over torso

Back 17

Overactive/tight: rectus abdominus and hip extensors (Hams- biceps femoris, semimembranosus, semitendinosus, gluteus maximus)

Underactive/ lengthened: stance leg hip flexors(psoas, iliacus, rectus femoris QUAD)

Front 18

3 Bend and lift screen observations in frontal plane:

Back 18

1)foot stability

2) alignment of knees over 2nd toe

3) overall symmetry over base of support

Front 19

5 Bend and lift screen observations in sagittal plane:

Back 19

1) Heel in contact with floor?

2)glute or quad dominance? (movement initiated at knees indicated quad dominance.)

3)tibia and torso parallel? descent controlled?

4) Lordosis during lowering? thoracic extension?

5) changes in head position

Front 20

5 Hurdle step screen observations in frontal plane:

Back 20

1)observe foot stability

2) alignment of stance leg over foot

3) watch for hip adduction >2 "- downward hip tilting toward opposite side...

4)torso stability

5) alignment of moving leg- lack dorsiflexion at ankle, deviation from sagittal plane of knee/ankle, hiking of moving hip

Front 21

2 Hurdle step screen observations in sagittal plane:

Back 21

1) stability of torso and stance leg

2) mobility of hip- allowing 70 degrees of hip flexion without compensation (anterior tilting)

Front 22

2 Shoulder push stabilization screen observations:

Back 22

Observe any notable changes in position of scapulae relative to rib cage at both end ranges of motion

observe for lumbar hyperextension in press position

Front 23

Shoulder push stabilization screen: sagittal plane

Winging during the push up movement is caused by?

Back 23

Inability of parascapular muscles (serratus anterior, traps, levator scapulae, rhomboids) to stabilize scapulae against rib cage.

Can also be due to a flat thoracic spine.

Front 24

Shoulder push stabilization screen: sagittal plane

Hyperextension or collapsing of the lower back is caused by?

Back 24

Lack of core, ab and low back strength, resulting in instability.

Front 25

Thoracic spine mobility screen observations:

Back 25

Client is seated with block between legs and holds dowel across chest...

Observe any bilateral discrepancies between rotations in each direction

Front 26

Thoracic mobility screen, transverse plane-

normal results=

Back 26

trunk rotation achieves 45 degree rotation in each direction

Front 27

Thoracic mobility screen, transverse plane - reasons for bilateral discrepancies

Back 27

Side dominance

differences in paraspinal development

torso rotation, perhaps associated with hip rotation

*lack of thoracic mobility will negatively impact glenohumeral mobility

Front 28

4 movement screens are:

Back 28

Bent and lift

hurdle step

shoulder push stabilization

thoracic spine mobility

Front 29

3 areas of Flexibility and muscle length testing screens

Back 29

thomas test for hip flexion/quads length

passive straight leg raise- hamstring length

shoulder mobility- shoulder flexion, extension, apley's scratch test, internal & external rotation of humerus at shoulder

Front 30

3 main Balance and core tests:

Back 30

-sharpened romberg

-stork stand

-mcgill's torso muscular endurance test battery: trunk flexor endurance, trunk lateral endurance, trunk extensor endurance

Front 31

What does Thomas test test for?

Back 31

Hip flexion and quadricep length

Front 32

What does passive-straight leg raise test for?

Back 32

Length of hamstrings

Front 33

Apleys scratch test

Back 33

for shoulder mobility testing, but because it involves multiple and simultaneous movements of the scapulothoracic and glenohumeral joits in ALL THREE PLANES it is used in conjunction with: isolated shoulder flexion/extension and

internal/external rotation of humerus tests

Front 34

what is the sharpened Rhomberg test?

Back 34

Assesses static balance by standing with reduced base of support (1 foot directly in front of other), hands on shoulders, and removing visual sensory info. go for 60 sec or until they lose balance. Less than 30 sec =inadequate static balance and postural control.

Front 35

Stork stand balance test- what does it assess and how to perform

Back 35

Assesses static balance by standing on 1 foot in modified stork stand position, hands on hips. Eyes open. Raise heel and balance on ball of foot. allow 1 min practice. repeat on opposit foot.

Front 36

Stork stand balance test- what results are excellent/good/ang/fair/poor

Back 36

MALES: >50 sec is excellent. 41-50 good, 31-40 avg, 20-30 fair, <20 poor. (GO IN INCREMENTS OF 10 with 50 being BEST)

FEMALES: >30 excellent, 25-50 good, 16-24 avg, 10-15 fair, <10 poor. GO IN ~INCREMENTS OF 5 with 30 being best)

Front 37

McGill's Torso muscular endurance test battery- what are 3 parts?

Back 37

Assesses all sides of torso.

Trunk flexor endurance (remove back of decline "chair")

Trunk lateral endurance (side bridge)

Trunk extensor endurance (hold body 180 degrees with only feet-pelvis on table, belly button to head is off table

Front 38

What should flexion:extension ratio be for trunk flexor endurance test?

Back 38

Ratio should be less than 1.0

For example, a flexion score of 120 seconds and an extension score of 150 seconds = 120/150= .80 ratio.

Front 39

what should right-side bridge:left-side bridge score be?

Back 39

No greater than .05 from a balanced score of 1

ex: rt side bridge of 88 sec and left side bridge of 92 sec= 88/92= ratio score of .96 which is within the .05 range from 1

Front 40

What should side-bridge extension ratio be?

Back 40

Ratio less than .75

ex: right side bridge 88 sec and extension score of 150 seconds = 88/150= .59

Front 41

How do you perform the thomas test

Back 41

assesses length of hip flexors and quads (rectus femoris)

Mid thigh aligned with table edge

Gently flex both thighs toward chest, back and shoulders to table top (laying on table)

pull thigh toward chest and relax opposite leg

Front 42

Thomas test: Back of lowered thigh does not touch table and knee does not flex to 80 degrees

Back 42

Tightness in primary hip flexor muscles (illiopsoas, sartorius, rectus femoris- quads)

Front 43

Rectus femoris

Back 43

Quads

Front 44

Biceps femoris

Back 44

Hams

Front 45

Thomas test: back of lowered thigh does not touch table but knee does flex to 80 degrees.

Back 45

tight illiopsoas is preventing the hip from rotating posteriorly and inhibiting thigh from touching table

Front 46

Thomas test: back of lowered thigh touches table but knee does not flex to 80 degrees

Back 46

Tight rectus femoris (quads) which does not allow the knee to bend

Front 47

Passive straight leg raise: raised leg achieves > or equal to 80 degrees of movement before the pelvis rotates posteriorly

Back 47

Normal hamstrings length

Front 48

Passive straight leg raise: raised leg achieves <80 degrees of movement before the pelvis rotates posteriorly or opposing leg lifts off table

Back 48

Tight hamstrings

Front 49

How to perform passive straight leg PSL raise

Back 49

trainer's hand between lumbar spine/low back and mat

slowly raise 1 leg until you feel spine compress hand under low back (this indicated end range of motion with movement of hamstrings now occurring as the pelvis rotates posteriorly)

Front 50

How to perform shoulder flexion test

Back 50

Client lays on back (supine) and raises arms above head to touch mat/floor (keeping arms close to sides of head) or as close to floor as poss.

Front 51

How to perform shoulder extension test

Back 51

client lays face down (prone)raises both arms off mat/floor keeping them close to sides

Front 52

How to evaluate shoulder flexion test

Back 52

hands should be able to touch floor or come very close (indicates 170-180 degrees flexion)

Front 53

reason for inability to flex shoulders to 170 degrees during shoulder flexion test, or discrepancies between limbs

Back 53

Potential tightness in pectoralis major and minor, lats, teres major, rhomboids and subscapularis. Tight lats will force back to arch.

tight pecs might tilt scapulae forward and prevent arms from touching floor.

Tight abs will depress rib cage tilting scapulae forward

Thoracic kyphosis

Front 54

How to evaluate shoulder extension test

Back 54

should be able to extend the shoulders to 50-60 degrees off floor

Front 55

Shoulder extension test: inability to extend to 50 degrees or discrepancies between limbs

Back 55

potential tightness in Pec major, abs, subscapularis, shoulder flexor such as anterior deltoid, coracobrachialis, biceps brachii....tight abs may prevent normal extension of thoracic spine and rib cage

Tight biceps may prevent adequate shoulder extension with an extended elbow (but ok w/ bent)

Front 56

How to perform internal/ external rotation of humerus at shoulder evaluation

Back 56

Client lays on back (supine) in bent-knee positionstart with arms abducted to 90 degrees

Rotate arms forward (in) (keep elbows at 90 degree angle) hands toward feet to check internal/medial rotation.

Rotate hands up toward head (away aka external) to check external/lateral rotation

Front 57

=good mobility in internal (medial) rotators allowing shoulder joint to achieve full ROM

Back 57

ability to externally rotate forarms to 90 degrees to touch the mat

Front 58

=good mobility in external (lateral) rotators allowing shoulder joint to achieve full ROM

Back 58

ability to internally rotate forarms to 70 degrees to touch the mat (forearms are 20 degrees off the mat)

Front 59

Inability to reach floor during external shoulder rotation screen or discrepancies between limbs

Back 59

potential tightness in internal rotators of arm (subscapularis)

or tight joint capsule/ligaments

Front 60

Inability to internally rotate forearm 70 degrees, or discrepancies between limbs

Back 60

potential tightness in external rotators of arm (infraspinatus and teres minor)

or joint capsule and ligaments might be tight

Front 61

Apley's scratch test PALM TO BACK movements include:

Back 61

Shoulder flexion, external rotation, scapular abduction

Front 62

How to perform apley's scratch test

Back 62

Client reached behind head with palms toward back toward mid spine..then with palms up

seated or standing

no arching or rotating

Front 63

Apley's scratch test PALM FACING UP movements include:

Back 63

shoulder extension, internal rotation, scapular adduction

Front 64

Inability to reach specific landmarks during apley's scratch test or limb discrepancies=

Back 64

further evaluation needed to determine source of limitation-

shoulder flexion and extension

internal and external rotation of humerus

scapular abduction and adduction

Front 65

Static postural assessment- frontal plane

Shoulders not level. What muscles are tight?

Back 65

Upper traps

Levator scapulae- above shoulder, back neck

Rhomboids

Front 66

Scapular winging- what is it and what muscles are weak?

Back 66

Posterior view: Protrusion of inferior angle PLUS vertebral (medial) border outward (aka shoulders are popping out/protruding)

Cause: lengthened and weakened Serratus anterior

Front 67

serratus anterior- where is it

what happens if it's tight?

weak?

Back 67

between pecs and lats from side view

tight= scapular protrusion

weak=scapular winging

Front 68

scapular protrusion- what is it, what causes it

Back 68

posterior view: protrusion of vertebral (medial) border of scapula outward (WIDE shoulder blades) (combined with protrusion of inferior angle=winging)

Anterior view: Palms face backwards. Internal/medial rotation of humerus and/or scapular protraction

TIGHT SERRATUS ANTERIOR

Front 69

name 2 scapular stabilizers

Back 69

rhomboids

serratus anterior

Front 70

glenohumeral joint- mobile or stable?

Back 70

HIGHLY MOBILE, less stable

120 degrees of overhead movement

Front 71

scapulothoracic joint- mobility or stability?

Back 71

STABILITY+++

less mobility, although still 60 degrees of arm overhead movement

Front 72

Decribe anterior pelvic tilt and causes

Back 72

in sagittal plane ASIS (anterior superior illiac spine tilts downward and forward- "water spills out of bucket")

Cause: Tight hip flexors (sitting all day...)

Generally coupled with tight erector spinae aka lower cross syndrome (hip flexors + low back)

Increased lordosis in lumbar spine.

Weak hams & abs

Foot pronation (eversion)can increase lumbar lordosis due to anterior pelvic tilt)

Front 73

describe Posterior pelvic tilt and causes

Back 73

in sagittal plane ASIS anterior suprailiac spine tilts up and backward- "water falling out back of bucket"

reduces lordosis in lumbar spine (flat back)

Tight abs & hamstrings

weak hip flexors & erector spinae

Front 74

Left or Right hip adduction postural deviation

Back 74

Posterior view: hip shifted right for right hip adduction and vice versa

Lateral tilt of pelvis that elevates 1 hip higher than the other-

Can tell by looking at anterior suprailliac spine- are they level?

if right hip is moving into adduction (tightening) it will lengthen and weaken abductors.

Front 75

ankle pronation- describe

Back 75

ankle caving inward, foot everting (arch flattening)

(remember, foot INversion faces INward toward body. Eversion foot faces out)

Goes along with internal rotation of the knee and femur (picture your foot turning outward, your knee will rotate inward)

Front 76

Ankle supination- decribe

Back 76

ankle caving outward, foot inversion (facing INward)

Creates high arches.

Goes along with external rotation of tibia & femur

(picture your foot turning in, your knee will turn out)

Front 77

Plantarflexion- what is movement and what muscles responsible

Back 77

foot flat to toes pointing down- like dipping foot in to test pool water.

Gastrocnemeus & soleus are posterior compartment muscles responsible for movement.

Front 78

Subtalar joint supination

Back 78

Causes foot inversion and high arches

(INversion= facing INward)

Goes along with external rotation of knee/femur

Front 79

Subtalar joint pronation

Back 79

Causes foot eversion (facing out) and internal rotation knee/femur

Front 80

Flat back- what is it and what causes it

Back 80

Decrease in anterior lumbar curve

Mainly tight abs and weak hip flexors (iliacus, psoas major, quads)

often w/ tight hamstrings. weak erector spinae

Front 81

Lordosis- define and name weak/tight muscles

Back 81

Increased anterior lumbar curve (big curve in lower back above butt)

Tight hip flexors- quads, iliacus, psoas major & minor

weak hip extensors- glutes & hams

Front 82

Name 2 major hip extensors

Back 82

Glutes

Hams (biceps femoris)

Front 83

Proper name for hams?

Back 83

Biceps femoris

Front 84

Proper name for quads?

Back 84

Rectus femoris

Front 85

Name some Hip Flexors

Back 85

Quads (rectus femoris)

Psoas major & minor

Iliacus

Front 86

Kyphosis- define and name tight/weak muscoles associated.

Back 86

Increased posterior thoracic curve from neutral (rounded upper back)

Tight hip flexors (quads, iliacus, psoas)

weak hip extensors (glutes, hams)

Front 87

Sway back- define

Back 87

decreased anterior lumbar curve (flat back) paired with increased posterior thoracic curve (kyphosis)

Front 88

Scoliosis

Back 88

lateral spinal curvature, often accompanied by vertebral rotation

Front 89

muscle dominance/tightness associated with kyphosis/lordosis

Back 89

TIGHT: Hip flexors (iliacus, psoas, quads- rectus femoris)

Lumbar extensors- erector spinae, multifidi

anterior chest/shoulder: pecs, delts

Lats

Neck extensors

Front 90

Muscle WEAKNESS associated with kyphosis/lordosis

Back 90

WEAK: Hip extensors- glutes, hams (biceps femoris)

external oblique

upper back extensor: lats, teres major

scapular stabilizers- shoulder, rotator cuff

neck flexors

Front 91

Sway backdecreased anterior lumbar curve (flat back) paired with increased posterior thoracic curve (kyphosis)

Muscle TIGHTNESS/DOMINANCE aka shortened or hypertonic

Back 91

Hamstrings (hip extensor)

upper fibers of posterior oblique

Lumbar extensors (erector spinae, multifidi)

neck extensors

Front 92

Sway back decreased anterior lumbar curve (flat back) paired with increased posterior thoracic curve (kyphosis)Muscle LENGTHENING/WEAKNESS

Back 92

Hip flexors- iliacus, psoas major

Quads (rectus femoris) (another hip flexor)

external oblique

upper back extensors- lats, teres major

neck flexors

Front 93

Hypertonic- define

Back 93

shortened or tight/ dominant muscle

Front 94

Flat back (Decrease in anterior lumbar curve) muscle hypertonicity- dominance, tightness

Back 94

Rectus abdominus (abs) often with tight hams (biceps femoris)

upper back extensors- lats, teres major

neck extensors

ankle plantarflexors (dipping foot in pool motion)

Front 95

Flat back ( Decrease in anterior lumbar curve) muscle inhibition/lengthening/weakness

Back 95

Hip flexors (iliacus, psoas)

internal obliques

lumbar extensors (erector spinae, multifidi)

neck flexors

Front 96

name 2 upper back extensors

Back 96

Lats

teres major

Front 97

Name 2 lumbar extensors

Back 97

erector spinae

multifidi

Front 98

define lower cross syndrome

Back 98

Tight hip flexors (iliacus, psoas, quads- aka quad dominance) and tight erector spinae

Produce:

Anterior pelvic tilt + lordosis/kyphosis

Front 99

Describe transverse view

Back 99

splits body in half top/bottom

Front 100

Describe the sagittal plane

Back 100

Splits body back/front from side view

Front 101

describe the frontal view

Back 101

splits body in left/right halves from anterior or posterior view

Front 102

Bend and lift screen sagittal view:

Hamstrings contact back of calves

Back 102

Muscle weakness and poor mechanics resulting in an inability to stabilize and control lowering phase

Front 103

Bend and lift screen sagittal view:

Back rounds forward

Back 103

overactive latissimus dorsi, teres major, pectoralis major & minor

underactive upper back extensors

Front 104

Hurdle step screen, anterior view:

Stance leg inward hip rotation

Back 104

Overactive/tight: stance leg or raised leg INTERNAL ROTATORS (anterior gluteus medius, gluteus minimus, semitendinosis, semimembranosus, tensor fascia latae, gracilis)

Underactive/ lengthened: stance leg or raised leg EXTERNAL ROTATORS (sartorius, adductor muscles, iliopsoas, biceps femoris HAMS, Gluteus MAXimus)

Front 105

Bend and lift screen sagittal view:

head upward

Back 105

compression and tightness in cervical extensor region