The Over-Head Lunge Maneuver. Stand in front of a full length mirror, or enlist a friend to watch your mechanics for this test. You will use the over-head lunge maneuver as the first mechanical test for your analysis. This maneuver puts your entire body in an unstable position and highlights where your alignment and stability problems exist. It is an analysis of your global (full body) posture and stability. You will be looking for any unbalanced movement or alignment tendencies. Begin by reaching over-head and step forward with one leg. Allow your rear heel to raise off the floor. Allow both of your knees to bend as far as possible, taking note of any unbalanced movement or alignment. If you begin to feel unbalanced, note the first movement that your body makes. Do not record any secondary movements as you try to re-balance yourself. You are only interested in your body's first unbalanced movement tendencies. As you bend your knees and descend into the over-head lunge position, check all of the following points to begin a list of your mechanical faults:
1-Did your lead hip move upwards (pelvis swing up towards the ribs on the lead side)? Normally, the hips should remain level. If your lead hip moved upwards, you have identified the hip hiking mechanical fault on that side.
2-Did your pubic bone turn away from your lead leg? Normally, it should still be facing straight forward. If it turned away, you have the mechanical fault of pelvic rotation to the side it is turning towards.
3-Did your lower back arch increase? Normally, the curve in your lower back should remain motionless during this maneuver. You may use one of your hands to monitor this as you perform the lunge. If the arch increases, you have the mechanical fault of lower back hyperlordosis. This is usually associated with your tailbone moving higher than your pubic bone (anterior pelvis). Use your fingers on your tail bone and pubic bone to monitor this.
4-Did your torso or shoulders lean or twist to one side? Normally, they should not lean (tilt) or twist. If they lean/tilt to the right, your mechanical fault is right torso side tilting. If they lean to the left, your tendency is left torso side tilting. If your chest twists to the right, you have right torso rotation, and if it turns to the left, you have left torso rotation.
5-Did your head move forward so that your ears are in front of your shoulders (forward head posture tendency)? Normally, your ear should remain vertically in line with your shoulder during the lunge.
6- Did your head or neck tilt sideways (head-neck side tilt posture), or did your face turn to one side (head-neck rotation)? Normally, your head and neck should remain straight.
7- Did your shoulders round (rounded shoulder posture) or move up (elevated shoulder posture) towards your ears?
8-Did your front heel/ foot tilt inwards (pronation) or outwards (supination)? Normally, the heel should stay balanced with equal weight on the inner and outer edges.
9-Did your front knee move inwards (knee valgus mechanical fault), or outwards (knee varus mechanical fault)? Normally, the front knee should remain centered over the ankle as it bends and should not move in or out.
10- Do your knee caps face the same direction as your toes do? Check this on both the front and rear legs. Normally they should. If they do not, you have a knee rotation mechanical flaw.
11- Did your front knee move forward past your front toes? Normally, it should not move forward past the tips of your toes. If it does, you have a forward knee mechanical fault on your lead leg side.
12- Are your wrists more forward than your shoulders? Normally, you should be able to hold them directly over your shoulders with your elbows bent to 90 degrees. If you cannot rotate them into this position in the lunge, you have identified internal rotation posture of your shoulder(s).
Make note of any of the above mechanical faults as you descend into the lunge, and also as you hold the bottom position of the lunge for 10-15 seconds. Sometimes a mechanical fault will appear during descent, and sometimes it will show itself while holding the bottom position. Note any of the above findings and then repeat the test with your other leg stepping forward. Many of your findings may match your standing posture analysis findings, while others may be new discoveries. If you cannot find any of the above alignment tendencies, try the same test again with your eyes closed (enlist a friend to help with this analysis). Closing your eyes will help you discover slight mechanical faults that may not be apparent during a typical standing posture or lunge analysis.
While the over-head lunge tests full body global alignment and stability function, the following local analysis tests will help you to identify region-specific mechanical stability and coordination faults. To maximize the effects of any Pain Free and Fit TM Healing Exercise Program, you will want to correct both global and local mechanical problems. This is essential before beginning any conditioning (strength, endurance, flexibility or balance) training program. Without identifying and correcting your mechanical faults first, you will only strengthen dysfunction. By correcting mechanics and knowing what to watch out for in terms of mechanical problems, you can get the full pain-relieving and healing-stimulus effects of the routine.
1. Drawing-In Abdomen and Glute Bridge Test. This first local mechanical test is done lying face up with your knees and hips bent. Your feet are flat on the floor. Begin the first part of the test by placing your fingertips two inches to the sides and one inch below your belly button. Do not press in deeply as you want the touch to remain soft to sense what you will do next. Gently pull (suck-in) your lower abdomen toward your spine. Feel your lower abdomen move down and away from your fingers. Do both sides move away equally? Does one side move less? Does one or both sides bulge out toward your fingers?
The deepest of your abdominal muscles (known as your transverse abdominus) will draw your lower abdomen away from your fingers equally on both sides if you have proper mechanics. If you feel one side drawing in less, or bulging outward, it indicates a compensatory internal oblique muscle contraction. Make note of which side this mechanical fault occurs on, if it exists. The abdominal oblique muscles are more superficial to the transverse abdominus and should not contract with this draw in maneuver under normal circumstances. Internal oblique contraction causes a bulge outwards instead of a hollowing inwards with this test. This is a sign of improper mechanics, and demonstrates incorrect abdominal muscle stabilization of your lower back and "core". Record your findings and proceed to the second part of this test.
From the same position, lift your hips off the floor as high as is comfortable (Glute Bridge Maneuver). Hold this top position and compare the "tightness" or "hardness" of your lower back erector spinae muscles to your buttock muscles. Your lower back erector spinae muscles are located 1-2 inches away from the midline of your spine on both sides. Use your fingers to judge the comparative "hardness" or "softness" of each muscle.
The buttock muscles should normally feel slightly harder than the lower back muscles. If you feel more hardness or tension in your lower back, it indicates compensatory "over working" lower back erector spinae muscles for weak buttock muscles. This is a very common mechanical fault, and is often responsible for lower back and hip pain. The buttocks are used for every step you take, every stair you climb, and every time you get up from a stooped or seated position. When the buttocks (gluteus max muscles) are weak, the lower back will compensate and over-work (strain) in an attempt to help the weak buttocks do their mechanical job. The erector spinae are smaller muscles which were never designed to work that hard, and as a result, place excessive stress on spinal joints and discs. Weak buttocks cannot support proper hip function, and cause a compensatory over-stress to other hip muscles and soft tissue structures.
As you hold the top position, look at your hip alignment. Check to see that your hips are not rotated (one hip higher than the other), or tilted (one hip closer to the bottom of your ribs "hip hiking" than the other) in this position. Previous posture findings often are evident during this test. Record your findings.