Corrective ExerciseMuscular Impairments

Postural Assessment Client: Myself

I am well aware that it can be difficult to understand how a postural or movement assessment can be completed online, and what a Corrective Exercise Specialist is looking for in order to re-establish proper length-tension relationships to improve muscular force output.  My client information is always private, so I thought the best example would be to provide my findings on my own neuromuscular dysfunctions that create specific altered movement patterns in my kinetic chain.  Through my years, I have been troubled with the following:

  • Anterior Knee Pain (left side)
  • Lower Back Pain
  • Bicep Tendinitis (throwing arm)
  • Shoulder Impingement (throwing arm)
  • Shoulder Instability (right side)



I thought it might be beneficial to post pictures of my postural assessment, as I am a prime candidate for pelvic asymmetry.  When I was 2, I broke my femur, which caused an abnormal growth to my left(broken) leg.  By the time I was 12, the leg was 1 ½ inches longer than the other leg.  Surgery was performed to stop the growth in that leg to allow the other leg to “catch-up.”  Unfortunately, I stopped growing about an inch shorter than was anticipated which still left ¾ of an inch difference.  My current pelvic asymmetry greatly alters my static posture and has decreased my mobility of the lumbo-pelvic-hip-complex in such movements as hip internal rotation.  It is also noticeable that my right leg (injured) shows sign of atrophy in comparison to its contralateral leg.  This has resulted in numerous injuries to that knee from the length tension relationship that has occurred over the last few decades to help compensate for weakness in the quadriceps (vastus group) and hamstring (semi group).  Anterior knee pain and tightness and spasms in the biceps femoris are a recurring theme in my functional movements.  For the sake of Distortional Syndromes, my condition of my asymmetrical pelvis does not fit into one of the three categories, but does greatly effect my static posture and has altered my force-couple relationship throughout the LPHC.

I would determine from my posture that I would be Upper Crossed Syndrome candidate.  Having played baseball my entire childhood to early adult years, the mechanics of the throwing motion exemplified by a horizontal adduction shoulder motion and very little horizontal shoulder abduction, has shown signs of scapular protraction and cervical extension.   I have been susceptible to a few shoulder injuries such as shoulder impingement and instability of the shoulder joint. 

  1. The Deep Longitudinal Subsystem and the Anterior Oblique Subsystem would be greatly affected by my asymmetrical LPHC and my Upper Crosses Syndrome. In regards to the DLS, having a longer femur than its contralateral femur, this obviously creates an unbalance in the sacroiliac joint and affects the normal pattern of my gait.  Also affected would be the external and internal obliques and adductor complex that also aid in pelvic stability and rotation. 
  2. Possible over-active(shortened) muscles would include the pectoralis major and minor, latissimus dorsi, upper trapezius, sternocleidomastoid, and my subscapularis (Clark 2011). The under-active muscles would consist of the sternoclavicular adductor and abductors such as the serratus anterior, rhomboids, middle and lower trapezius.
  3. The shoulder joint which presents both over-active anterior and under active posterior, presents a faulty length-tension relationship which affects the tension produced by muscles that surround that joint (Clark 2011). Common result is a higher force output for horizontal shoulder adduction and weaker horizontal shoulder abduction.
  4. Possible dysfunction in the force couple relationship would be an undesired motion of the shoulder joint stemming from the shortened muscles of the pectoralis major and minor providing minimal eccentric action coupled with the middle and lower trapezius and serratus anterior being under-active(lengthened) (Clark, 2011). This dysfunctional alignment will create improper arthrokinematics with resulting shoulder impingement and/or rotator cuff injury.

As I have experienced shoulder impingement and rotator cuff injury, my upper crossed syndrome has displayed faulty arthrokinematics in the shoulder joint.  Heavy use of the horizontal shoulder adduction and shoulder joint abduction, in addition to the imbalance of muscle tissue around the shoulder joint, has presented problems throughout my adult hood in regards to weight training.  I have made a drastic change over the last decade increasing the strength of the posterior deltoid and the external rotators (infraspinatus and teres minor). 

Clark, M. A., & Lucett, S. C. (2011). NASM Essentials of Corrective Exercise Training. Philiadelphia, PA: Lippincott, Williams & Wilkins.

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