Axial

Skeleton
Kinesiolog
y
NEUMANN CHAPTERS
9-10
Goals of this Unit
• Know spine structures and their
associated functions.
• Know and understand
fundamental spine
biomechanics.
• Apply spine kinesiology (i.e.,
functional anatomy) to exercise
science especially assessment
and exercise prescription.
Outline /
Kinesiology Template
“The Core”
• Operationalizing terminology
Axial Skeleton
Operationalized
• Pelvis
• Sacrum/Coccyx
• Spine (L, T, C)
• Ribs
• Sternum/Manub.
• Cranium*
And There’s More
• LLAF
• KNEES
• HIPS
• SHOULDERS
• ELBOWS
• WRIST/HANDS
• HMS
Structure-Function (Macro)
• Why do we have an axial skeleton/a spine/core?
Axial Skeleton
Functions (Macro)
• Stability
• Mobility
• Protects the spinal cord,
nerves, vertebral artery,
and internal organs.
• Connects UE and LE
• Base of support
(attachment sites for
muscles and ligaments)
Axial Skeleton
Functions (Macro)
• Length-Tension
• Torque
• Work
• Power
• Coordination
• Proprioception
• Performance
Spine Osteology:
Vertebral Column Regions
• Curvature
• Primary Curves (kyphosis)
• Secondary Curves (lordosis)

• Prior to birth “C-shaped”

• Adult: 4 distinct curves
• Curve Function: Resist Compression
Osteology:
Curvature
+
What’s different
cervical vs. thoracic
vs. lumbar?

Test Q: “Compare and

contrast” the osteology of
the different vertebral
regions. Generate 5
answers.
Spine Osteology:
Typical Vertebra
What structure
lives here? a.k.a. Pillar

a.k.a. a.k.a. Pillar

Posterior
Arch

Spinal Canal
Osteology: IV foramen
a.k.a. a Facet joint

What happens to the size of the intervertebral foramen

during flexion, extension, lateral flexion?
Spine Osteology: Typical Vertebra
Parts and Their 1⁰ Functions (Neumann
Table 9.2)

• Body: Primary weight bearing structure

• Posterior arch: Everything except the body. Contains facet
joints, pedicles, processes, lamina, etc. for mobility, attachment
sites.
• IV foramen: Tunnel for spinal nerve roots
• Vertebral canal: Tunnel to house and protect the spinal cord
• Transverse processes L/R: Attachment site for muscles and
ligaments
• Spinous process: Attachment site for muscles and ligaments
Spine Osteology: Typical
Vertebra Parts and Their 1⁰
Functions
• Articular pillars: Bony columns that support the
facet joints
• Lamina: Vertical plate of bone that connects the
spinous process to the transverse processes.
Laminectomy is a common surgical procedure for
LBP.
Osteology: Typical
Vertebrae
Regional Features - Cervical
• Bifid spinous processes
• Uncinate processes
 Osteology: Typical Vertebrae

Regional Features - Cervical

• Transverse foramen:
Tunnel for passage and
protection of vertebral
artery.
• Common site for
impingement especially in
older clients.
• Dizzy, light-headed with
extension, LF, rotation
• Can cause “drop attack”
Osteology: Typical
Vertebrae
Regional Features - Thoracic
• Costal demi-facets:
Notch/divot for rib
articulation located
superiorly and
inferiorly
• Costal facets:
Notch/divot for rib
articulation located on
transverse process
• Spinous process
angulation
Osteology Regional
Features – Thoracic: Other
• Ribcage
• Sternum
• Manubrium
Osteology Regional
Features – Lumbar
• IV Foramen
• Spinous
process angle
Osteology Regional
Features – Sacrum and
Pelvis
• Anatomy: ASIS, AIIS, PSIS, Iliac crest, Ischial tuberosities
(“sits bones”), Pubic symphysis, SI joints
Osteology Regional
Features – Sacrum and
Pelvis
• 5 fused vertebra
• Innominate bones (2)
• Pelvic floor
• Biomechanics
• Force distribution
Osteology:
ATYPICAL Vertebrae – C1, C2, C7
• C1: No body • C7 Variation: Large
• C2: Dens transverse process
(“cervical rib”). TOS.
Osteology:
ATYPICAL Vertebrae – L5
• L5 wedge shaped to
match angulation of
sacral base.
• Taller vertebral body
on anterior surface
vs. posterior
Joint Stability:
Ligaments
• Sacroiliac (A & P) • Supraspinous
• Sacrotuberous • Interspinous
• Sacrospinous • Intertransverse
• Iliolumbar • Ligamentum flavum
• Interosseous • Alar
• Anterior longitudinal • Transverse ligament of atlas
• Posterior longitudinal • Joint capsules

*See Neumann Table 9.3, Fig. 9.43, Fig. 9.44, Fig. 9.70, Fig. 9.71
Joint Stability:
Ligaments
• MORAL: The spine is STRONG.
• Ligaments PREVENT motion by creating torque
when under tension (stretched).
• Ligaments get “SPRAINED”
 Related Pain
NeuroScience
• “I have a weak back.”
• “My back goes out.”
• “Lift with your legs,
not your back.”
• 85% of population
will experience
significant LBP at
some point in their
life.
Ligaments as Torque
Producers
EX: A.L.L.
PERFORM A
BIOMECHANICAL ANALYSIS.
Names & Functions of
Axial Skeleton Joints
• Names of axial skeleton joints
• ??????????
• Functions of axial skeleton joints
• ??????????
Arthrology: Facet & IV
Arthrology:
Spine Facet (Apophyseal) Joints
• Plane joints therefore arthrokinematic motion =
a glide (with one exception). See Neumann Fig. 9.32
• Cervical
• C0 on C1: Convex Occiput on Concave Atlas
• C1 on C2: Transverse plane
• C2 on C3, etc.: 45⁰ between horizontal and vertical
• Thoracic: Frontal Plane
• Lumbar
• L1/L2 through L4/L5: Sagittal Plane
• L5/S1: Frontal Plane
Arthrology:
Spine Facet (Apophyseal) Joints
• Structure – Function
• Test Q: Explain the relationship between facet joint
orientation and regional osteokinematics.
Arthrology:
Spine Facet (Apophyseal) Joints
• Structure – Function
• Test Q: Explain the function of facet joint capsules as
sensory organs.
Arthrology:
Spine Facet (Apophyseal) Joints
• Cervical
• C0 on C1: Convex
Occiput on Concave
Atlas
• Orientation/direction
therefore _____ plane?
• 50% of C-spine total
flexion and extension
• C1 on C2:
• Orientation/direction
therefore _____ plane?
• 50% of C-spine total
rotation
Arthrology:
Spine Facet (Apophyseal) Joints
• Cervical
• C2/C3 – C6/C7
• Orientation facilitates
_____ motion/s.
Arthrology:
Spine Facet (Apophyseal) Joints
• Thoracic
• Frontal plane
• Therefore
promotes _____
Arthrology:
Spine Facet (Apophyseal) Joints
• Lumbar • Lumbar
• L1/L2-L4/L5 • L5/S1
• Sagittal Orientation • Frontal Orientation
Facilitates _____ Facilitates _____
 Arthrology:
Spine
Motions/Osteokinematics
MOTION
SEGMENT

How many
DOF?
Arthrology (**Know LPP, CPP)
• Loose-Packed Position • Close-Packed Position
• Neutral • Extension
 Arthrology
• Capsular Pattern (fyi)
(proportionate ROM limitation)
• LF and Rotations equally
limited, Extension
Arthrology:
Spine Osteokinematics
• Nomenclature
Rule Review
 Osteology: Osteokinematic
Spine ROM Norms (per Neumann;
Know)

CERVICAL THORACIC LUMBAR TOTAL

Flexion 45-50° 30-40° 45-55° 120-145°
Extension 75-80° 15-20° 15-25° 105-125°
Lateral 35-40° 25-30° 20° 80-90°
Flexion (uni)
Rotation (uni) 65-75° 25-35° 5-7° 95-117°
Lateral Glide N/A N/A Symmetry N/A
(Not in Neumann)

Only 1 number required for

each motion in each plane.
 Critical Thinking and
Problem Solving Based on
ROM Limitations:
Hypothesis Generation
• Flexion
• Extension
• Left Lateral Flexion
• Right Lateral Flexion
• Left Rotation
• Right Rotation
• Left Lateral Shift
• Named for the direction of the shoulders relative to pelvis)

• Right Lateral Shift

 FGCU ES Hypothesis
Pool (20)
 Sensory-Motor Control / Motor  Kinesiophobia
“Program” / Technique  Anthropometrics (length, width,
 Weakness (due to atrophy) circumference. Ex: LLD)
 Decreased Flexibility  CardioRespiratory Fitness
 Bony: Deformity
 Overactive / Hypertonic  Joint laxity (excessive PROM)
Musculature  Pain (Assess. Refer as appropriate.)
 Underactive / Hypotonic  Environment
Musculature ( ↓ recruitment)  Joint Hypomobility (arthrokinematic)
 Joint Stiffness  Joint Hypermobility (arthrokinematic)
 Body Awareness Refer - out of scope.
 Decreased familiarity / knowledge Pathology – Neuro, Cardiac, Renal,
of TASK (cognitive) Musculoskeletal, Respiratory, etc. (Refer.
 Balance Period. Unless you’re an MD)
 Coordination
Arthrology:
Spine Functional Movements
Arthrology:
Facet Arthrokinematics
a.k.a. a Facet joint

What happens at the facet joints during flexion,

extension, lateral flexion, and rotation?
What happens at the facet joints
during flexion, extension, lateral
flexion, and rotation?
• Flexion: bilateral facet superior glide (a.k.a. upglide)

• Extension: bilateral facet inferior glide (a.k.a. downglide)

• L Lateral Flexion: L facet inferior glide and R facet superior glide
• R Lateral Flexion: R facet inferior glide and L facet superior glide
• L Rotation: L facet gaps and R facet is compressed
• R Rotation: R facet gaps and L facet is compressed
Arthrology:
Spine Facet Arthrokinematics
• Cervical
• C0-C1 (Occiput on C1)
• Flexion
• Extension
• CC Rule application is fyi
• C1-C2
• Left Rotation
• Right Rotation

See Neumann Fig. 9.46, Fig. 9.48

Arthrology:
Spine Facet Arthrokinematics
• Cervical
• C2/3-C6/C7
• Flexion
• Extension
• Left Rotation: L IMP / R SAL
• Right Rotation: R IMP / L SAL
• IMP = Inferior, Medial, Posterior
• SAL = Superior, Anterior, Lateral
• Left LF
• Right LF
See Neumann Fig. 9.48, Fig. 9.49
Arthrology:
Spine Facet Arthrokinematics
• Thoracic
• Flexion
• Extension
• Left Rotation
• Right Rotation
• Left LF
• Right LF

See Neumann Figs. 9.52-9.55

Arthrology:
Spine Facet Arthrokinematics
• Lumbar
• Flexion
• Extension
• Left Rotation
• Right Rotation
• Left LF
• Right LF

See Neumann Figs. 9.52-9.56

Arthrology:
Spine IV Joint Osteokinematics +
Arthrokinematics
• Flexion: Anterior TILT
• Extension: Posterior TILT
• L LF: L Side TILT
• R LF: R Side TILT
• Rotation (L and R):
Compression

KEY: Green = Osteokinematic TILT; Red = Arthrokinematic GLIDE

Arthrology:
Spine IV Joint Osteokinematics +
Arthrokinematics
• Flexion: Anterior TILT
• Extension: Posterior TILT
• L LF: L Side TILT
• R LF: R Side TILT
• Rotation (L and R):
Compression

KEY: Green = Osteokinematic TILT; Red = Arthrokinematic GLIDE

Arthrology:
Spine IV Joint Osteokinematics +
Arthrokinematics
• Flexion: Anterior TILT
• Extension: Posterior TILT
• L LF: L Side TILT
• R LF: R Side TILT
• Rotation (L and R):
Compression

KEY: Green = Osteokinematic TILT; Red = Arthrokinematic GLIDE

 Spine:
Osteo + Arthro Kinematics
Motion Osteokinematics Arthrokinematics
Flexion
Extension
L Lateral Flexion
R Lateral Flexion
L Rotation
R Rotation
Osteokinematics:
Spine Coupled Motion (Fryette’s
Laws)
• During spinal rotation see
component lateral flexion,
and vice versa.
• Relevance: If your client
lacks LF or rotation, can
work out of plane to
improve the target motion.
• “Fryette’s Laws” fyi with
one exception.
• III = Motion in one plane
limits motion in other
planes.
Spine Arthrology: IVJ Disc
• Pertinent Anatomy
• Annulus Fibrosus
• Collagen
• Only outer layers
innervated and
vascularized
• Nucleus Pulposus
• Water (70-90%)
• Vertebral Endplate
• Primary Functions = Shock absorption; Stabilize
against shear, distraction and torsion, sensory.
Spine Arthrology: IV Disc
Shock Absorption
Mechanics
• Fluid Filled Nucleus Pulposus
• Stability and Mobility

See Neumann Fig. 9.36

Spine Arthrology:
IV Disc Stabilization Mechanics
• Concentric Rings
• Fiber Orientation
• Shear/Glide
• Distraction
• Rotation
• Stability and Mobility
 Spine Arthrology: IV Joint Disc
Migration Mechanics (theories)
Panjabi & White

Kapandji
 Spine Arthrology: IV Joint Disc
Migration Mechanics (theories)

McKenzie
&
Neumann
Spine Arthrology:
IVJ Disc Pressures (know)
• See Neumann Fig. 9.37
Spine Arthrology:
IVJ Disc Pressures (know)

• Horizontal < Vertical

• Forward bending >
Upright standing
• Loaded > Unloaded
• What amount is safe?
 Disc Pressures ES
Relevance
• CAUTION
• Related
Myology
• Related
“ligamentology”
• EXERCISE
PURPOSE?
From Spine to
Pelvis/SI/Hips
Arthrology:
Sacroiliac (SI) Joints
• The articulation between
the ___ and the ___
• Mobile vs. Fused
• Classification: Plane
synovial joint
Arthrology:
SI Joint Osteokinematics

STA and ITA FYI

Arthrology:
SI Joint Osteokinematics
• Middle Transverse Axis/Sagittal Plane
• Flexion/Anterior Tilt
• Extension/Posterior Tilt
• Left Oblique Axis (named for superior location)
• Left Rotation (“left on left rotation”)
• Right Rotation (“right on left rotation”)
• Right Oblique Axis (named for superior location)
• Left Rotation (“left on right rotation”)
• Right Rotation (“right on right rotation”)
Arthrology:
SI Joint Osteokinematics
• Confusing Nomenclature FYI

• Use
Arthrology:
PELVIS Osteokinematics
• Confusing Nomenclature
• Pelvic Tilts
• Anterior
• Posterior
• Side
• Pelvic Rotation
• Anterior right or left
• “Protraction”
Arthrology:
PELVIS Osteokinematics
• Confusing Nomenclature
• MOTION IS NOT NAMED FOR MOVEMENT OF A
BONE IN SPACE (SCAPULA, PELVIS)
• ALWAYS CONSIDER AT MINIMUM 2 HIPS
AND THE LUMBAR SPINE WHEN
ANALYZING TRUNK AND PELVIS
MOVEMENTS DURING FUNCTIONAL
ACTIVITIES!!
Functional Kinesiology
• Lumbo-Pelvic Rhythm (see Neumann Figs. 9.61-9.62)
• Starting to put it all together to “see” the kinesiology
• Name the osteokinematic motions at the spine and hips
Lumbar/Hip
Osteokinematics
• Learning Objective: Be able to describe the osteokinematics of any
functional movement.
•Backbend
• Sagittal plane

• Gait (unilateral midstance R)

• Frontal plane

• Gait (advancing R LE)

• Transverse plane

• “Hip Hike”
• Circumduction https://www.youtube.com/shorts/Kw3IXQ5iNrc
• “Pelvic Clock”
 Functional
Kinesiology
• Hips + Trunk
• Hips + Trunk + Upper Extremities
• Feet + Legs + Pelvis + Spine + Head
• KEY = Movement analysis applications to assessment
and exercise that match functional demands
• Musculoskeletal + Neurological + Environment + Task +
Psychosocial…etc. (i.e., HMS)
• The pelvis and spine are links in the whole-body chain.
 Exercise Science
Application
Example
• What’s all happening during normal movement?
• i.e., Explain the kinesiology of spinal _____ ( flexion,
extension, LF L/R, Rotation L/R)
• Includes SI Joint

• Vertebral and sacral anterior tilt. • IV foramen size increases

decompressing nerve roots
• Facet superior glide, sense organs
• Posterior ligaments taut/stretched,
• IV joint anterior glide anterior ligaments slack
• Disc anterior compression, • Eccentric extensors, sense organs
posterior tension, nucleus migrates
anterior or posterior (theory • PNS, CNS (brain motor program)
dependent)
 Patho-Kinesiology
• Common patterns of
dysfunction.
• “Seeing” the kinesiology
• Link back.
◦ Assessment
◦ Posture, Movement, Exercise
◦ Exercise Prescription
◦ Referral
 Next Up: Neumann Ch.
10
• Myology
• Muscle and Joint
Interactions
• Recommendation:
Study as though
you have a quiz
next week.
Anatomy and Biomechanics
Review – with a twist
The “Twist”
•What makes a spinal flexor a spinal flexor?
•..... A spinal extensor a spinal extensor?
•..... A spinal left rotator a spinal left rotator?
•..... A spinal right rotator a spinal right rotator?
•..... A spinal left lateral flexor a spinal left lateral
flexor?
•..... A spinal right lateral flexor a spinal right
lateral flexor?
 FUNCTIONAL
ANATOMY/BIOMECHANICS -
MUSCLE
• Flexors create _____ with a concentric contraction by creating a _____ torque.
• Extensors create _____ with a concentric contraction by creating an _____ torque.
• L Rotators create _____ with a concentric contraction by creating a _____ torque.
• R Rotators create _____ with a concentric contraction by creating a _____ torque.
• L LF’s create _____ with a concentric contraction by creating a _____ torque.
• R LF’s create _____ with a concentric contraction by creating a _____ torque.
 FUNCTIONAL
ANATOMY/BIOMECHANICS -
MUSCLE
IN STANDING or SITTING:
• Flexors control/decelerate _____ with a/an _____ contraction by creating a _____ torque.
• Extensors control/decelerate ____ with a/an ____ contraction by creating an ____ torque.
• L Rotators control/decelerate ____ with a/an ____ contraction by creating a ____ torque.
• R Rotators control/decelerate ____ with a/an ____ contraction by creating a ____ torque.
• L LF’s control/decelerate _____ with a/an _____ contraction by creating a _____ torque.
• R LF’s control/decelerate _____ with a/an _____ contraction by creating a _____ torque.
FUNCTIONAL
ANATOMY/BIOMECHANICS -
MUSCLE
• In sitting and standing, what is the primary force that
creates flexion, extension, lateral flexion?
• Therefore, what are the two types of contractions we
usually use in typical daily functions?
• Applications to exercise science practice?
• Assessment: Posture, ROM, Strength, Flexibility, Agility, Power,
Coordination, Proprioception, Motor Control & Palpation, CR Fitness,
Nutrition, Performance
• Exercise Prescription: Posture, ROM, Strength Training, Flexibility
Training, Agility, Power, Motor Control, Coordination,
Proprioception, CR Fitness, Nutrition, Performance
FUNCTIONAL
ANATOMY/BIOMECHANICS
– RESISTANCE
TRAINING
FUNCTIONAL
ANATOMY/BIOMECHANICS
– RESISTANCE
TRAINING
ANATOMY/BIOMECHANICS
– RESISTANCE
TRAINING
ANATOMY/BIOMECHANICS
– RESISTANCE
TRAINING
• Howwill you strengthen the muscle/muscle group
throughout the muscle’s full length? (i.e., full ROM)
FUNCTIONAL
ANATOMY/BIOMECHANICS
–
• Repeat for power
• Repeat in a different positions
• Plank, prone, supine, sidelying, pike, etc.
• Repeat with superior fixed and inferior moving
• Concentric and eccentric
• Repeat with different equipment
• Cable/resistance bands, dumbbells/kettlebells, body weight, medicine
balls, etc.
• Repeat and vary the surface
• Physioball, foam, foam rollers, etc.
• Be able to perform manual resistance for any combination
• Ex: prone eccentric left lateral flexors superior fixed
• Ex: sidelying concentric right rotators superior fixed
FUNCTIONAL
ANATOMY/BIOMECHANICS
- STRETCHING
• When stretching the _____ muscle group what
motion(s)/torque(s) do you need to instruct the client to perform?
• Flexor, Extensor, L Rotator, R Rotator, L Lateral Flexor, R Lateral Flexor
• When stretching the _____ specific muscle what
motion(s)/torque(s) do you need to instruct the client to perform
to maximally stretch the target muscle?
• Upper trapezius, Iliopsoas, SCM, Lats, Teres Major, Pectoralis Major and
Minor, Gastrocs, etc.
• How long is the optimal hold time?
• What is the optimal # of reps?
• What is recommended frequency (x’s/day, x’s/week)?
• How are flexibility gains best maintained?
FUNCTIONAL
ANATOMY/BIOMECHANICS
- STRETCHING
• How long is the recommended hold time each repetition?
• ACSM: 10-30 seconds (total 60 seconds)
• EBP: 15-30 seconds
• What is the recommended intensity?
• To the point of tightness or slight discomfort
• What is the recommended # of reps?
• ACSM: 2-4x
• EBP: 4x
• What is recommended frequency (x’s/week)?
• ACSM: 2-3x/week
• EBP: 2-3x/week
FUNCTIONAL
ANATOMY/BIOMECHANICS
- STRETCHING
• Repeat in different positions
• Use different equipment
• Be able to maximally stretch any muscle by knowing the
muscle actions and doing the opposite.
• Be able to perform PNF Hold-Relax to any individual muscle
or muscle group.
• Ex: Left rotators
• Ex: Right upper trapezius
• Be able to perform reciprocal inhibition to any individual
muscle or muscle group
• Ex: Trunk extensors
• Ex: R Quadratus Lumborum
Axial Skeleton Muscles
(reminder slides)s
• Perform RT as
described above.
• Perform stretching as
described above.
• Perform PNF H-R
• Repeat for all muscles
below and any others
not included here.
Neck Extensors and
Flexors
 Scalenes

What structure runs

through the scalenes?

T/F: Muscles can refer

pain.
Erector Spinae Group: primary
extensors
Transversospinalis group
Iliopsoas
POSTU
RE
•A
complex sensory-
motor task
Posture Cueing
• Functional
• Sitting
• Standing

• Weight Bearing
• Sitting
• Standing

• Analogies
• Sitting
• Standing

• Ineffective strategies
• Sitting
• Standing REALLY?
Structural Models: Stack of Blocks
and Tensegrity
Ramifications: Posture, Mobility, and
Stability
The Spine
as a Stack
of Blocks
Tensegrity
Mast Model
BUCKMINSTER FULLER
(NOT NEUMANN)
Bio-
Tensegrity
• Continuous Tension
• Muscle/Tendon
• Fascia
• Skin
• Ligaments
• Discontinuous
Compression
• Bone
 Bio-
Tensegrity
• Continuous Tension
• Discontinuous
Compression
 Bio-Tensegrity: Relevance to
Exercise Science
• Commonly
dysfunctional
• ES Assessment
• S:
• Observation
• Palpation

• ES ExRx
• Inhibit
• RI
• Positional Inhibition
• Stretch
• Activation
• Retraining
 What’s
Missing
from These
Models?
• Brain
• Sensory receptors
• Soul/Personality
• Emotions
• Environment
• Etc. (see human
movement system)
 Optimal Posture
Considerations -
Standing
• Balanced torques (compression test)
• Mastoid process
• Acromion
• Anterior to 2nd sacral vertebra
• Posterior to hip joints
• Anterior to knees and ankles

• Optimal Load Dispersion

• Allows for maximal neuro-muscular efficiency
• Normal length-tension relationships

• Promotes normal arthrokinematics

• Related Psychology
• Functional definition of optimal = able to move in
any direction with minimal prior reorganization .
Optimal Posture
Considerations -
Sitting
• Balance of torques (compression test)
• Weight on ischial tuberosity inferior
tips
• Knees at/slightly lower than hips
• Functional definition same as standing
• Stand to sit
• Settle
Patho-Kinesiology:
Forward Head Posture and Related
Biomechanics

QUIZ:
• Assuming the head weighs 10 lbs, how many inches forward is it at
each degree of tilt?
•And what are the units for torque produced?
Patho-
Kinesiolog
y:
Common
Dysfuncti
ons
FORWARD HEAD
POSTURE (FHP)
Patho-
Kinesiology:
Common
Dysfunction
s
FHP
COMPENSATIONS
 Patho-
Kinesiology:
Common
Short or Dysfunctions
Hypertonic

Upper Crossed Syndrome

◦ Exercise Prescription
◦ What does “tight” mean?
◦ Apply the FGCU ES problem
solving template to generate
additional underlying cause
Short or hypotheses.
Hypertonic
 Patho-
Kinesiology:
Common
Dysfunctions
LOWER CROSSED
Or short SYNDROME

Or short
Patho-
Kinesiology:
Common
Dysfunctions

Overpronation
(a.k.a. “Miserable Malalignment
Syndrome”)
(a.k.a. “Whole Limb Pronation”)
What to do?
1. Assess
2. Exercise Prescription
a. Activate/Strengthen
b. Stretch
c. Motor control/motor learning

3. Orthotics
a. Custom
b. Off the Shelf

4. Refer as needed
FGCU EXERCISE
SCIENCE
PROBLEM
SOLVING
TEMPLATE
FGCU ES Hypothesis
Pool (21)
• Weakness due to atrophy • Balance
• Decreased Flexibility • Anthropometrics (length, width,
• Sensory-Motor Control / circumference. Ex: LLD)
Motor “Program” / • CardioRespiratory Fitness
Technique • Bony Deformity (Assess and refer as
• Decreased task familiarity / indicated)
knowledge • Joint Hypo/Hyper Arthrokinematic
• Overactive / Hypertonic mobility (Refer if out of scope – state
Musculature dependent.)
• Underactive Musculature • Pain (Refer.)
• Coordination • Neural Tension
• Kinesiophobia • Pathology – Neuro, Cardiac, Renal,
• Joint Stiffness Musculoskeletal, Respiratory, etc. (Refer.
• Joint Laxity Period. Unless you’re an MD, PA, NP, etc.)
• Body Awareness • Environment
Example/Application:
Faulty Forward Bending