Feet Flatten = Eversion Note: This compensation pattern is often driven by a lack of dorsiflexion Short/Overactive Long/Underactive Evertors:

Fibularis (Peroneals)

Lateral Gastrocnemius

Lower Leg Flexibilty Invertors:

Tibialis Anterior

Tibialis Posterior

Tibialis Anterior Activation Tibialis Posterior Activation

Plantar Flexors:

Soleus

Gastrocnemius

Dorsiflexors:

Tibialis Anterior

Feet Turn Out = Tibial External Rotation Note: This compensation pattern is often driven by a lack of dorsiflexion Short/Overactive Long/Underactive Tibial External Rotators

TFL (via ITB)

Biceps Femoris

Lateral Gastroc

Tibial External Rotator Flexibility Lower Leg Flexibilty

Tibial Internal Rotators:

Gracilis

Semitendinosus & Semimembranosus

Sartorius

Medial Gastrocnemius

Vastus Medialis Obliquus

Tibial Internal Rotator Activation Tibialis Posterior Activation VMO Activation Tibialis Anterior Activation

Plantar Flexors:

Soleus

Gastrocnemius

Dorsiflexors:

Tibialis Anterior

Special notes:

The tibial internal rotators are activated as a group.

The VMO is actually involved in medial tracking of the patella, but is affected by this dysfunction.

The “Posterior Tibialis Activation” has been included in this graph to affect the medial gastrocnemius. Both muscles are activated using these techniques; however, do not get your functional anatomy confused. The posterior tibialis does not cross the knee, and therefore does not directly contribute to this compensation pattern.

Knees Bow In = Tibial External Rotation & Femoral Internal Rotation Note: This compensation pattern may be driven by ankle or hip dysfunction. If ankle dysfunction is to blame it will be necessary to release and lengthen the calf complex and activate the tibialis anterior. Short/Overactive Long/Underactive Tibial External Rotators

TFL (via ITB)

Biceps Femoris

Lateral Gastroc

Tibial External Rotator Flexibility Hip Flexor Flexibility Adductor Flexibility Lower Leg Flexibilty

Tibial Internal Rotators:

Gracilis

Semitendinosus & Semimembranosus

Sartorius

Medial Gastrocnemius

Vastus Medialis Obliquus

Glutues Medius Activation Gluteus Maximus Activation Tibial Internal Rotator Activation Tibialis Posterior Activation VMO Activation Tibialis Anterior Activation

Femoral Internal Rotators

TFL

Gluteus Minimus

Adductors

Femoral External Rotators

Gluteus Maximus

Gluteus Medius

Special notes:

The tibial internal rotators are activated as a group.

The VMO is actually involved in medial tracking of the patella, but is affected by this dysfunction.

The “Posterior Tibialis Activation” article has been included in this graph to affect the medial gastrocnemius. Both muscles are activated using these techniques; however, do not get your functional anatomy confused. The posterior tibialis does not cross the knee, and therefore does not directly contribute to this compensation pattern.

The “Hip Flexor Flexibility” and “Adductor” Flexibility articles address the muscles responsible for femoral internal rotation.

Knees Bow Out = Femoral External Rotation & Ankle Eversion

Note: This compensation pattern may be driven by ankle or hip dysfunction. If ankle dysfunction is to

blame it will be necessary to release and lengthen the calf complex and activate the tibialis anterior.

Short/Overactive Long/Underactive Femoral External

Rotators

Piriformis

Biceps Femoris

Adductor Magnus

Hip External Rotator

Flexibility

Lower Leg Flexibility

Femoral External Rotators

Gluteus Maximus

Gluteus Medius

Gluteus Maximus

Activation

Gluteus Medius

Activation

Tibialis Anterior

Activation

Tibialis Posterior

Activation

Evertors:

Fibularis (Peroneals)

Lateral Gastroc

Invertors:

Tibialis Anterior

Tibialis Posterior

Special notes:

This is a tricky dysfunction to analyze. Although you may be tempted to label this “Abduction of the

Hip”, this leads to the ineffective practice of inhibiting an underactive gluteus medius and activating

the commonly overactive adductors. Practice has shown that the overactive synergists of external

rotation are the primary culprit driving this dysfunction as they attempt to compensate for an

inhibited glute complex during extension (or eccentric flexion).

Believe it or not, if correcting this dysfunction results in “Knees Bow In”, this is an improvement. This

sign is one of our first “compensations within a compensation.” If the knees bow in on reassessment

treat the dysfunction as such and use the corrective strategy implied by the table “knees bow in.”

Excessive Forward Lean = Hip Flexion & Lack of dorsiflexion (a.k.a. excessive plantar flexion) Short/Overactive Long/Underactive Hip Flexion

Tensor Fasciae Latae (TFL)

Psoas

Iliacus

Rectus Femoris

Sartorius

Anterior Adductors

Hip Flexor Flexibility Adductor Flexibility Lower Leg Flexibilty

Hip Extensors

Gluteus Maximus

Semitendinosus & Semimembranosus

*Biceps Femoris

*Posterior Fibers of Adductor Magnus

Gluteus Maximus Activation Tibialis Anterior Activation *Tibial Internal Rotator Activation

Plantar Flexors:

Soleus

Gastrocnemius

Dorsiflexors:

Tibialis Anterior

Special notes:

In this dysfunction we are forced to confront our first set of “strange muscles” marked with an “*”. By “strange” I mean they pair a length and activity relationship that is not common. The muscles denoted by an “*” are long, but over-active. These are not muscles we want to stretch, or activate; however, release techniques may be effective for improving function.

The “Tibial Internal Rotator Activation” is only added as a means of increasing semitendinosus and semimembranosus activity.

Anterior Pelvic Tilt (Excessive Lordosis) = Hip Flexion & Lumbar Extension

Short/Overactive Long/Underactive Hip Flexion

Tensor Fasciae Latae (TFL)

Psoas

Iliacus

Rectus Femoris

Sartorius

Anterior Adductors

Hip Flexor Flexibility Adductor Flexibility Lumbar Extensor Flexibility

Hip Extensors

Gluteus Maximus

Semitendinosus & Semimembranosus

*Biceps Femoris

*Posterior Fibers of Adductor Magnus

Gluteus Maximus

Activation

TVA Activation

Intrinsic Stabilization

Subsystem Activation

Anterior Oblique

Subsystem Integration

Lumbar Extensors:

Erector Spinae

Latissimus Dorsi

Trunk Flexors:

Rectus Abdominis

Internal Obliques

External Obliques

Transverse Abdominis (TVA)

In this dysfunction we are forced to confront our first set of “strange muscles” marked with an “*”.

By “strange” I mean they pair a length and activity relationship that is not common. The muscles

denoted by an “*” are long, but over-active. These are not muscles we want to stretch, or activate;

however, release techniques may be effective for improving function.

The recruitment of trunk musculature is best explained by muscular synergies known as

“subsystems.” Although the TVA Activation is often the focus of lumbo pelvic hip programs it is likely

recruited with all of the muscles associated with the Intrinsic Stabilization Subsystem.

Similarly the anterior trunk musculature makes up the Anterior Oblique Subsystem

Asymmetrical Weight Shift Left = “Knee Bows Out” on Right + “Knee Bows in” on Left Note: A single direction was chosen for ease of visualization. Reverse rights and lefts if dysfunction occurs to the opposite side. Short/Overactive Long/Underactive Right Femoral External Rotators

Piriformis

Biceps Femoris

Adductor Magnus

Femoral External Rotator Flexibility

Left Tibial External Rotators

TFL (via ITB)

Biceps Femoris

Lateral Gastroc

Tibial External Rotator Flexibility Lower Leg Flexibilty

Right Invertors

Tibialis Anterior

Tibialis Posterior

Glutues Medius Activation Gluteus Maximus Activation Tibialis Posterior Activation Tibialis Anterior Activation

Right Ankle Evertors

Fibularis (Peroneals)

Lateral Gastroc

Lower Leg Flexibility

Left Femoral Internal Rotators

TFL

Gluteus Minimus

Adductors

Left Femoral External Rotators

Gluteus Maximus

Gluteus Medius

Special notes:

In future articles this dysfunction will be discussed in more detail. Often what cause an asymmetrical weight shift is simply having lower leg dysfunction on one side.

This is an abbreviated analysis and solution, for a more thorough look at this dysfunction see my article – “Sacroiliac Joint Motion and Predictive Model of Dysfunction

Most often this dysfunction is a “compensation within a compensation.” A corrective strategy that resulted in a symmetrical compensation such as, “Anterior Pelvic Tilt”, “Knees Bow In,” or an “Excessive Forward Lean” would be an improvement.

Arms Fall Forward = Shoulder Internal Rotation Note: The muscles that cause the shoulders to internally rotate in static standing posture are the same muscles that would cause extension/adduction of the arms from an overhead position. Short/Overactive Long/Underactive Shoulder Internal Rotators

Latissimus Dorsi

Pectoralis Major

Subscapularis

Pectoralis Major, Minor and Subscapularis Flexibility Lumbar Extensor Flexiblity (Lats)

Shoulder External Rotators

Infraspinatus

Teres Minor

*Posterior Deltoid

External Rotator Activation

Special notes:

In this dysfunction we are forced to confront our second “strange muscle” marked with an “*”. By “strange” I mean it pairs a length and activity relationship that is not common. The posterior deltoid is long, but over-active. This is not a muscle we want to stretch, or activate; however, release techniques may be effective for improving function.

It is very rare that shoulder dysfunction exists without scapula and thoracic spine dysfunction. Most often a corrective strategy would include many of the techniques recommended in the graph below “Shoulders Elevate”

Shoulders Elevate = Scapula Downward Rotation + Anterior Tipping Short/Overactive Long/Underactive Downward Rotators

Pectoralis Minor

Levator Scapula

Rhomboids

Scapular Muscle Flexibility

Upward Rotators

Upper and Lower Trapezius

Serratus Anterior

Serratus Anterior Activation Trapezius Activation

Anterior Tippers:

Pectoralis Minor

Levator Scapulae

Upper Trapezius

Posterior Tippers:

Serratus Anterior

Lower and Middle Trapezius.

Special notes:

This dysfunction is most often paired with shoulder dysfunction (graph above).

The upper traps fall on both sides of the graph (another strange occurrence). Although they are most often described as “tight,” the levator scapulae play a larger role in the perception of suprascapular and cervical spine “tightness.” The trapezius may be released and stretched if the assessor believes it is warranted, and the muscle is activated during certain progressions of Serratus Anterior and Trapezius activation.