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Marc Bari

Mike Tona

Movement Analysis Project

Kinesiology

Dr. Biren

Tuesday-Thursday: 2-315 p.m.

Demographics:

Name: Marc Bari

Age: 21

Gender: Male

Height in inches: 66 inches Height in centimeters: 167

Weight in lbs: 170 lbs Weight in kgs: 77

Body Mass Index: 27

Medical and Physical History:

1) Have you suffered from a sports injury? If so, what was the injury? I have suffered two torn shoulder labrums from constant contact in football. I

have also pulled both hamstrings and my right quadriceps muscle. 2) If answering yes to the previous question, have you gone through any rehabilitation or

treatment? If so, what kind? For my pulled hamstrings and quadriceps, I underwent minimal rehabilitation.

This included electrical stimulation machine and icing, heating and stretching the muscle. For my shoulders, I decided not to undergo surgery to repair them since the surgery would not provide a permanent fix. I still try to incorporate shoulder strengthening exercises into my exercise regimen.

3) Have you suffered any traumatic brain or spinal injury? If so, how? Yes, I have 2 herniated disks from a car accident I was a passenger in a few years

ago. 4) Have you experienced any non-sport related lower body injury? If so, what kind?

Sprained ankle 5) Have you ever been in an automotive accident? If so, were there any significant injuries?

Yes, I have herniated disks. 6) Do you suffer from any muscle pain? If so, what muscle(s)? Please rate this pain from 1-

10 ( 1= minimal pain, 10= unbearable pain) None

7) If you answered yes to the previous question, does this pain increase or decrease with exercise?

None8) Do you suffer from any joint pain? If so, which joint(s)? Please rate this pain from 1-10

(1=minimal pain, 10= unbearable pain) Yes, The joints in both knees, the rating is a 4. For both shoulders the rating is a

6. 9) If you answered yes to the previous question, does this pain increase or decrease with

exercise? Both these pains increase with exercise.

10) Are there any exercises that cause you pain? If so, which one(s)? Squats cause me slight discomfort and certain variations of shoulder presses

cause pain in my shoulders. 11) Do you experience muscle spasms? If so, where?

none12) Are there any past injuries that still bother you to this day? If so, please describe them.

My shoulder injuries still bother me to this day. 13) Do you suffer from Scoliosis?

no14) Do you have any known medical condition that limits you from physical activity? If so,

please describe. no

Family History:

1. Has any member of your family been diagnosed with any of the following conditions: Osteoporosis? No Arthritis? Yes, My mother has Rheumatoid Arthritis Crohn’s Disease? No Osgood Schlatter’s Disease? No Parkinson’s disease? No Scoliosis? No Amyotrophic Lateral Sclerosis (ALS)? No

General Activity Information:

1) On average, how much time do you spend being physically active in a typical week? I am active for 2 or more hours a day, 5 days a week.

2) Are you involved with any organized sports teams? (Club basketball, football, soccer, etc.)

I am involved with an intramural flag football team and I occasionally partake in pickup basketball games.

3) On a scale from 1-10 (1= sedentary, 10= continuous physical labor), How active is your occupation?

54) Do you spend the majority of your leisure time being active or sedentary?

Active5) Do you partake in the ACSM’s weekly recommendation on 150 minutes of physical

activity a week? Yes

6) How would you describe your exercise experience level? ( beginner, intermediate, advanced)

Advanced7) Do you wish to increase, decrease, or remain the same with the amount of physical

activity you engage in? Remain the same

8) Do you engage in regular stretching or mobility exercises? Occasionally but I would like to increase this.

Movement Goals:

Increase range of motion and depth in the 3 different variations of squats: High bar squats, Low bar squats and Front squats.

Increase lower back flexibility and strength to assist with each squat motion Increase overall strength in each exercise Increase flexibility and range of motion in the hips Increase the efficiency of each movement pattern Increase shoulder mobility and flexibility for the various positioning of the

barbell in each lift

Initial Summary:

After reviewing the information from the demographic and medical history questionnaires, it seems that a major focus will need to be put on strengthening the core and lower back due to the disk herniations that were described. The squat is an exercise that utilizes the core and lower back to stabilize the weight in order to prevent the upper body from collapsing forward during the lift. If the core cannot withstand the weight that is being places upon it, this could cause the lifter to lean forward, placing the stress of the weight mainly upon the quadriceps muscles instead of the entire leg. This would not be something I would want to happen especially considering the fact that I have described that I experience pain in my knees during squats. This pain could also be caused by an over training of the quadriceps muscles as opposed

to the hamstrings. This unequal training of these muscles may have stemmed from previous hamstring injuries that were not treated and rehabilitated properly; causing more utilization of quadriceps muscles during certain lower body lifts. Another factor that will need to be improved upon is hip flexibility and mobility to accomplish a full range of motion throughout each lift. This can be done through adequately stretching and practicing the full range of motion before each lift to ensure that the hip joints are lubricated and can withstand a deeper range of motion. Shoulder mobility will be a secondary focus but will still be important for the proper performing of the front squat. This will be easier to improve upon since I have already started getting into the routine of performing shoulder stabilizing exercises before each of my workout sessions. I have already begun to practice proper movement and range of motion for the low bar squat position and it is becoming much easier as I progress week by week.

Strategies that can start to be performed now are implementing exercises that involve strengthening the lower back erectors and transverse abdominals so that my core begins to get stronger before I start practicing the new movements. The next step would be to improve upon my hip flexibility so that I can facilitate a full range of motion pattern for each of the lifts. I will start out with body weight to begin with and will only progress to free weights once I feel I can perform the motion effectively and correctly. During this time, I will also continue to strengthen and stretch my rotator cuff muscles so that they are flexible and strong enough to be able to hold the bar in each variation. Proper flexibility in my quadriceps and hamstrings will also need to be increased so that the muscles are pliable enough to complete the deeper range of motion. This will be done by performing an adequate dynamic warm up and stretching before and after each lift.

Range Of Motion Assessments:

Cervical Spine:

Neutral Position Lateral flexion (Left) Lateral Flexion (Right)

Frontal View Normal ROM: 45° Normal ROM: 45°

My ROM: 45° My ROM: 45°

Neutral Position Flexion Extension

Sagittal Normal ROM: 60° Normal ROM: 75°


Rotation (Left) Rotation (Right)

Normal ROM: 80° Normal ROM: 80°


Glenohumeral Joint:

Neutral Position Flexion (Right Arm) Flexion (Left Arm)

Sagittal View Normal ROM: 170° Normal ROM: 170 °


Neutral Position Abduction (Left Arm) Abduction (Right Arm)



Neutral Position (Right Arm) External Rotation (Right Arm) Internal Rotation (Right Arm)

Sagittal View Normal ROM: 90° Normal ROM: 70°


Neutral Position (Left Arm) External Rotation (Left Arm) Internal Rotation (Left Arm)



Neutral Position Hip Flexion (Right Leg) Hip Flexion (Left Leg)



Neutral Position (Right Leg) External Rotation (Right Leg) Internal Rotation (Right Leg)



Neutral Position External Rotation (Left Leg) Internal Rotation (Left Leg)

Frontal view Normal ROM: 45° Normal ROM: 35°


Sit and Reach Test Straight Leg Raise

Right Leg Left leg

Thomas Test

Left Leg Right Leg

Apley Scratch Test

Analysis

During this range of motion analysis, I was able to point out some limitations I have in executing proper ranges of motion certain joints. In my cervical spine tests, I was able to execute each movement to its’ fullest range except for cervical flexion. The normal degree of motion is 60° and I was only able to perform a 50° motion. This is not a substantial difference but it may cause for some discomfort and tightness when I perform high bar squats. One way I may be able to improve this range of motion is to adequately stretch before each squat session to ensure that my muscles are not tight. At the Glenohumeral joint, my right and left arm flexion and abduction were able to perform the thorough range of motion. For internal and external rotation for my right arm however, I was unable to perform the range of motion to its fullest. For external rotation I was only able to perform an 80° range of motion when the norm is 90°. For internal rotation I was only able to perform a 60° range of motion instead of 70°. In my left I was able to perform internal rotation to its fullest degree. However in my right arm, I was only able to perform an external rotation to about a 75° angle when the norm is 90°.My shoulder immobility was also evident during my Apley scratch test, I was unable to get my hands close together on either side when performing this test. This shows a poor range of motion and flexibility within the Glenohumeral joint. These limitations could be cause by my torn labrums that have not been repaired. It is essential that I try to strengthen and increase the mobility of

these joints and movements because I will need this mobility to properly position and grip the bar on my back when doing high and low bar squats. These limitations could also inhibit my ability to position the bar on my anterior deltoids when doing front squats as well. This could lead to improper form which will throw off the distribution of weight and hinder my range of motion for each exercise.

During my hip mobility test, it was noted that my right leg was not able to perform the range of motion as fully as my left leg. This flexibility imbalance could potentially cause an injury when I am performing a squat. Also, it could cause muscle imbalances since one leg will be performing the exercise with a deeper range of motion thus, causing my left leg to do more work. This imbalance was also evident when I performed internal and external rotation for each leg. My left leg was able to perform each movement thoroughly however, my right leg had a slight limitation when performing an external rotation. It is important that I balance out and correct these limitations because hip mobility is a key factor in achieving my movement goal. Without being able to properly perform a full range of motion with both legs, I will not be able to perform each squat variation efficiently and effectively. Another area I would like to improve after observing the Thomas test and straight leg raise is my hamstring flexibility. I was able to perform an adequate range of motion for each test but would like to increase that range so that my muscles are able to perform a deeper range of motion for the squat variations in my movement goals. I can do this my consistently performing dynamic warm ups and stretches before each workout session.

Postural Analysis:

Frontal View Sagittal View (Left) Sagittal View (Right)

Posterior View

Posture Analysis Summary:

After reviewing the photos I have taken of my posture, there were a few dysfunctions and imbalances that I was able to point out that could potentially impact my movement goal. When viewing myself from the frontal view, it is possible to see that my left shoulder is slightly more elevated than my right shoulder. This imbalance could be due to my previous injury of a torn labrum in my right shoulder. Overcompensation may have occurred during the time that I was recovering from this injury, causing the elevation and overactive left side of the upper trapezius muscle. In order to correct this, it would be beneficial for me to stretch the left side of the upper trapezius and strengthen my right side. If this imbalance is not corrected, it could affect the way the weight is distributed upon my back when performing high bar squats. This imbalance could lead to back pains or causing one leg to work harder than the other. It was also noted that my patellas were slightly facing laterally. This could indicate external rotation at the hip which would again affect my squat depth and proper range of motion. Also, I observed that my knees were slightly angled inward, causing me to have a condition called genu valgum. This places excess stress on the medial collateral ligament and if it is not corrected could cause an

MCL injury during weight barring exercises, running, or jumping. I believe this to be a functional condition due to my poor squat and running form throughout my life. A good conditioning and postural program should aid me in correcting this problem so that I do not place any more stress on my knees when squatting. When examining the posterior view of my posture, it is clear that my feet evert which also explains the genu valgum at my knees and external rotation at the hip. This is relevant to my goal because if my feet evert during squats, it will force my hip to externally rotate and cause a valgus force on my knees. My elevated left shoulder is also much clearer to see in the posterior view. From the posterior view it is possible to see that my shoulders are slightly protracted which causes kyphosis in my thoracic spine. My head is also protruding forward which could be caused from poor posture when seated. With the combination of my head protruding forward, my elevated left shoulder and kyphosis, it is reasonable to assume that I have upper cross syndrome. This could be cause by overactive pectoralis minor and sternocleidomastoid and underactive serratus anterior and lower trapezius. If I do not correct this dysfunction it could lead to further neck and back pain in the future as well as excess pressure on my cervical and thoracic disks when performing squats.

Overhead Squat Assessment:

Frontal View Sagittal View Posterior View

Analysis:

From the anterior view of the overhead squat assessment I am able to see that my left knee points out laterally which causes a varus strain on the knee. This dysfunction can indicate an overactive piriformis which is the external rotator of the hip and an underactive adductor

group. This dysfunction can affect my movement goal because it could cause me to shift to my right leg when performing the squat which will cause a muscle imbalance between both legs. Also, this varus strain increases the risk of a knee injury. I also noted that my feet abduct when moving into the squat position. This can indicate an overactive soleus and lateral gastrocnemius and an underactive medial head of the gastrocnemius. From the sagittal view it is possible to see a slight forward lean in my posture when performing the squat. Also, an excessive lordosis can be seen as well. This posture indicates that my hip flexor and erector spinae muscles are over active or tight and need to be stretched. On the opposing side, this posture suggests that my rectus abdominis and hamstrings are underactive and cannot hold my torso into the proper position. This excessive lordosis can also be caused by tight or overactive latissimus dorsi and pectoralis muscles and underactive middle, lower trapezius and posterior deltoids. Strengthening these weaknesses will assist me in my squat goals so that I can maintain a proper form with added weight on my back. Without strengthening these underactive muscles and stretching the over active muscles, it could put me in an excess lean when squatting which will put more stress on my lumbar spine and disks. When looking at myself from the posterior view, I have noted that my feet evert when entering the squat position which indicates overactive peroneal muscles and an underactive tibialis posterior and anterior. This puts me at risk for having shin splints or plantar fasciitis. It is also clear to see that I have a slight asymmetrical shift to the right. This shift means that I have overactive adductor muscles on my right side and an overactive piriformis on my left side. This also indicates that I have an underactive gluteus medius on my right side and underactive adductor groups on my left side. This imbalance could be due to my past hamstring injuries that I never rehabilitated correctly. By not correcting this imbalance, I could potentially be causing more injury to myself and furthering the shift to my right side.

Gait Analysis

Walking

Posterior View(Right Foot)

Heel Strike Mid-Stance Toe Off

Posterior View (Left Foot)

Heel Strike Mid-Stance Toe-Off

Sagittal View (Right Foot)


Sagittal View (Left Foot)

Heel Strike Mid- Stance Toe-off

Jogging

Posterior View (Right Foot)

Heel strike Mid-Stance Toe-off

Posterior View (Left foot)


Sagittal View (Right Foot)

Heel Strike Mid-Stance

Toe-Off

Sagittal View (Left Foot)


Analysis Summary

During this Gait Analysis, I was able to see that my right foot stays pronated and abducted throughout the normal gait process. This can be a problem because this causes my foot to lose its’ efficiency to act as a proper lever. Also, this can cause problems in my right knee and hip

because since my foot is not properly inverting, it is not dispersing the force given back by the ground when I am walking or running. This pronation can also cause medial tibial stress syndrome or “shin splints” if not corrected. My left foot however, seems to go through the proper mechanics when I am walking and running. Another thing I noticed during this analysis was that my vertical displacement when running was a little high. This can be seen by the distance that both my feet have from the ground when I am in the “flight phase” of running. I have also noted that my natural running style causes me to land on my mid foot rather than performing a heel strike. This is beneficial because it minimizes the breaking force when I am running which causes less stress on my knees and hip. When I run, I also tend to extend my leg father back during the swing phase. This is an inefficient way to run because it causes me to have more distance to cycle my leg back through thus increasing energy expenditure and decreasing my speed. During the time that I run, I tend to keep my weight leaning forward, so that my momentum aids me in moving forward. This makes my running mechanics much more efficient and helps me use less energy when trying to move farther or faster.

Corrective Stretches and Exercises for Trunk, Neck, and Shoulder Complex

Upper Trapezius Stretch

Muscles Involved: Upper Trapezius

Corrects: Tight Upper Trapezius muscle

“Y” Raise

Muscles Involved: Posterior Deltoids, Lower Trapezius,

Middle Trapezius

Corrects: elevated shoulder girdle

Reverse Flies

Muscles Involved: Posterior deltoid, Middle Trapezius,

Rhomboids, Teres Minor, Infraspinatus

Corrects: Protraction of shoulder girdle

Doorway Stretch

Muscles involved: Pectoralis Minor


Cable Row

Muscles Involved: Rhomboids, Middle Trapezius


Cable Internal Rotation:

Muscles Involved: Subscapularis

Corrects: Weakness in rotator cuff

Cable External Rotation

Muscles Involved: Teres Minor and Infraspinatus

Corrects: Protraction of shoulder girdle and weakness

in rotator cuff

Towel Apley Scratch Stretch

Muscles Involved: Internal rotators of the arm over shoulder

and external rotators of arm behind the back.

Corrects: Range of motion in rotator cuff muscles

Plank

Muscles Involved: Transverse Abdominis

Corrects: Excessive lordosis

Leg Raises and Hold

Muscles Involved: Transverse abdominis, hip flexors

Corrects: Excessive lordosis

Summary

The exercises and stretches above are all ones that I can include into my workout routine to aid me in strengthening my weaknesses and correcting my dysfunctions. During my postural analysis, I recognized that my left shoulder was slightly more elevated than my right shoulder. This could be due to a number of things including past injuries and poor form on certain exercises. To stretch out my left side so that it is not as overactive, I will be performing an upper trapezius stretch by putting my left arm behind my back while laterally flexing my head to the right and also using a slight flexion. The exercise I chose to correct this dysfunction was a “Y” raise which targets the lower trapezius muscle. The lower trapezius aids in keeping the shoulder girdle in place. This dysfunction is important to correct for my movement goal because it could lead to uneven distribution of weight on my back when performing the high bar squat. Another dysfunction I identified in myself is that my shoulders were protracted. This indicates tight pectoralis muscles and weak retractor muscles. In order to stretch out my pectoralis minor I have included a doorway stretch. To increase the strength of my retractors I am going to be doing reverse flies which target the posterior deltoids and cable rows which target the rhomboids and middle trapezius muscles. Due to my previous shoulder injuries, my rotator cuff muscles are weak and need to be strengthened to avoid any future injuries. In order to strengthen these muscles I am going to be performing internal cable rotations which target the subscapularis and external rotations which target the infraspinatus and teres minor. These muscles should be regularly worked to maintain proper shoulder complex health. To increase my range of motion in my shoulders I am also going to be performing the towel apley scratch stretch. It can be seen in my range of motion analysis that my apley scratch test needs a lot of improvement. I will be performing this stretch every other day in order to correct this

limitation. Lastly, during my overhead squat analysis I noticed that I have an excessive lordosis. This is due to a weak transverse abdominis. In order to strengthen this, I will be performing the plank and leg raise hold exercises daily. This will allow my spine to have a proper brace once my transverse abdominis is strengthened. This is important for my movement goals because during a squat, if the transverse abdominis is not doing its’ job properly, it could lead to excessive forward lean or an excessive lordosis which will put stress on the facet joints.

Lower Extremities

Hamstring Curls

Muscles Involved: Hamstrings

Corrects: Weakness in the hamstrings

Adductor Machine

Muscles involved: Adductors ( TFL)

Corrects: Varus motion in knees during squats

Standing Calf Raises ( Toes pointed inward)

Muscles Involved: Gastrocnemius (medial head)

Corrects: Abduction of the foot

Gastrocnemius Stretch (Toes pointed in and knee extended):

Muscles involved: Gastrocnemius (Lateral Head)

Corrects: Tightness of lateral head of Gastrocnemius

Soleus Stretch (Knee flexed)

Muscles involved: Soleus

Corrects: Abduction of the foot, tight soleus

Toe Touches Stretch

Muscles Involved: Hamstrings, Erector Spinae

Corrects: Tightness in erector spinae

Internal Rotation Stretch

Muscles involved: External Rotators (piriformis)

Corrects: Externally rotated hip

Summary

Each of these stretches and exercises will aid me in correcting my imbalances and dysfunctions to allow me to better enhance my movement goals of proper form, depth, and efficiency of the 3 variations of the squat. Due to my past hamstring injuries, my hamstrings have been a weak point and are an area for reoccurring injuries over the years. The hamstring curl is an exercise that isolates the muscles of the hamstrings to allow them to do the majority of the work and become stronger. Along with this exercise, I have included a hamstring and erector spinae stretch to enhance my flexibility and to ensure that my hamstrings do not become tight over time. The erector spinae stretch is important for my movement goal as well because during my overhead squat I noted that my erector spinae was a little tight and caused a slight excessive lordosis. The adductor exercise I have implemented will allow me to strengthen my adductors to prevent any varus motion during my squat. I have also included an internal rotation stretch to stretch an overactive piriformis that causes an externally rotated hip. During my overhead squat assessment I had also noticed that my right gastrocnemius was tight. I was able to identify this through the viewing of my right foot being abducted. This is caused by an overactive/tight lateral head of the gastrocnemius and soleus. In order to correct this, I have included standing calf raises but with my feet pointed inward to emphasize the medial head of the gastrocnemius. I have also included a gastrocnemius stretch with my foot turned slightly inward to enhance the stretch of the lateral head. Also, I have included a soleus stretch. This stretch differs from a gastrocnemius stretch because the knee is slightly flexed in the soleus

stretch which allows the soleus to be emphasized and better targeted during the stretch. Since my movement goal deals mostly with the lower body, these stretches and exercises will be crucial for me to achieve success in my movement goal.

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