Movement Analysis ProjectRyan KennedyKinesiology, 8-915Spring 2014

Demographics

Name: Ryan Kennedy

Gender: Male

Age: 22

Height: 5’7

Weight: 162lbs

BMI: 25.4

Medical History

List Previous Medical Conditions:

-_Heart Murmur__________________________________________________

-_Kidney surgery_________________________________________________

-_L-knee Meniscal surgery_________________________________________

-_Severe R-Knee trauma__________________________________________

-_____________________________________________________________

Noteworthy Family Medical Conditions:

-_None_________________________________________________________

-______________________________________________________________

-______________________________________________________________

-______________________________________________________________

-______________________________________________________________

Briefly describe all physical activities in which you are involved regularly

-Ice hockey; skates at least twice a week______________________________

-Weight lifting; 2-3 times per week___________________________________

-______________________________________________________________Movement Goals

Please list all personal movement goals in as much detail as possible

Improving overall flexibility, with a particular focus on the lumbar extensors

Improving and maintaining overall posture, standing and sitting, due to leg length discrepancy

Correcting muscular imbalance in right shoulder and scapula

Injury preventative exercise on hips, knees, and feet

Improving on ice skating stride

Summary

Ryan is a healthy, twenty two year old male who could use some lower extremity work in terms of flexibility, strength, and conditioning (including preventing future injuries). He may also benefit from some corrective upper-body exercise, more specifically exercises involving the right shoulder girdle and scapula. Ryan is a physically fit individual, with strength distributed well between his upper body, core, and lower body. His overall flexibility is already above average, but could still use work because of the type of activities in which he partakes. He has previous injuries that he has seemingly recovered well from. However, these areas should still be of primary focus in regards to injury preventative exercise.

Range of Motion Assesment

Degree Range of Motion Chart

Cervical Spine: Neutral Position, Frontal View

Cervical Spine: Neutral Position, Sagittal View

Cervical Spine: Flexion

Cervical Spine: Extension

Cervical Spine: Rotation

Glenohumeral Joint: Neutral Position for Abduction/Adduction

Glenohumeral Joint: Neutral Position for Flexion and Extension

Glenohumeral Joint: Abduction

Glenohumeral Joint: Extension

Glenohumeral Joint: Neutral Position for Internal and External Rotation

Glenohumeral Joint: Internal Rotation

Glenohumeral Joint: External Rotation

Humeroulnar Joint: Flexion

Humeroulnar Joint: Extension

Radioulnar Joint: Mid-Supination Neutral Position

Radioulnar Joint: Supination

Radioulnar Joint: Pronation

Radiocaroal Joint: Neutral Position for Flexion and Extension

Radiocaroal Joint: Neutral Position for Ulnar and Radial Deviation

Radiocaroal Joint: Flexion

Radiocaroal Joint: Extension

Radiocaroal Joint: Radial Deviation

Radiocaroal Joint: Ulnar Deviation

Acetabulofemoral Joint: Abduction

Acetabulofemoral Joint: Flexion

Acetabulofemoral Joint: Internal Rotation

Acetabulofemoral Joint: External Rotation

Tibiofemoral Joint: Extension

Tibiofemoral Joint: Flexion

Summary of Findings The above photographs represent client Ryan Kennedy performing a full body ROM assessment. When comparing these findings to the client’s movement goals, it is evident that he does indeed have an imbalance in his right shoulder girdle. This may be slightly hindering his posture and can be seen on most of the images; on internal rotation of the glenohumeral joint in particular. Working through all the movements of the Glenohumeral joint will accomplish two of the clients goals: improving flexibility and posture, which will also subsequently prevent further injury. Additionally, working through the entire ROM of the Acetabulofemoral joint will likely address the client’s goal of improving his on ice skating stride.

Postural Analysis

Anterior

Lateral

Posterior

Summary of Findings An assessment of the client’s leg length was not done because of an already diagnosed discrepancy. Both of his left sided appendages are roughly 1-3 cm longer than those on his right. Seen more on the Anterior view but also in the Posterior view, the client’s feet are slightly turned out and, very minimally, everted. Despite having a documented, right sided appendage length discrepancy, any postural misalignment is difficult to notice without a quantitative analysis. With the very slight exception of the shoulders in the Anterior view, the client appears to have respectable posture despite his documented appendage discrepancy. This can also be seen on the Posterior view by focusing specifically on the hands, and how they fall in the anatomical position. The client also has documented, right sided Winged Scapula, as well as right shoulder impingement. This is difficult to see with the naked eye even when shirtless on this particular subject. These findings are consistent with the client’s goals for corrective exercise for maintaining posture despite a leg-length discrepancy, in addition to improving all around flexibility and strength.

Over-head Squat Assessment

Anterior

Lateral

Posterior

Summary of Findings Due to a documented leg-length discrepancy, there is minimal asymmetrical shift in the client’s hips. Although difficult to see in any of three views provided, it is very easily noticeable via quantitative analysis. The discrepancy causing the shift, however, is noticeable in all three views. It is best seen by focusing on the arm length in both the Anterior and Posterior views. The actual shift itself, although more difficult to pin-point, can be seen in the lower extremities by focusing on how the client’s shorts ride up the thighs as he depresses. As the client depresses his thorax into the deepest part of the squat, his feet begin to slightly evert or point outward. The client’s documented, right sided Winged Scapula is difficult to identify during this analysis, but is somewhat identifiable when performing a squat shirtless. These findings are consistent with the client’s goals for corrective exercise for maintaining posture despite a leg-length discrepancy, in addition to improving all around flexibility and strength.

Gait Analysis

Saggital View

Heel Strike

Foot Flat

Mid Stance

Heel Off

Toe Off

Initial Swing

Mid Swing

Terminal Swing

Posterior View

Heel Strike

Foot Flat

Mid Stance

Heel Off

Toe Off

Summary of Findings

The above images show that the client has an average gait. Despite a documented leg length discrepancy, there appear to no identifiable irregularities in his gait through a qualitative, still image analysis alone. This seems consistent with the client’s current health; despite a documented leg length discrepancy, he reports no significant abnormalities throughout his lower extremities. The client’s primary issue requiring correction is the dysfunction in his right-shoulder girdle. Saggital images show normal flexion and extension of the hip and knee and dorsi and plantar flexion of the ankle through one full step or half stride. Posterior images reveal slight pronation from heel strike to mid stance. This is consistent with normal functioning of the lower extremities via the knee’s screw home mechanism. A real time recording of the client’s gait may reveal differing angles of movement on each extremity, as well as further asymmetrical shift clarification at the hip due to leg length discrepancy.

Corrective Exercise Program

Below is a corrective exercise program for Ryan Kennedy, a Rowan University ice hockey player. This program is tailored towards correcting muscular imbalances of the right shoulder complex as well as improving strength, flexibility, and injury prevention of the core and lower extremities.

Warm Up

Posterior Deltoid Stretch

Apley Scratch Test

Pectoralis Minor Stretch

Single Knee to Chest

Straight Leg Raise

The posterior deltoid stretch stretches the rhomboids, posterior capsule, and posterior deltoid. The Apley scratch test helps to stretch the internal rotators, capsule of involved arm, external rotators, and the posterior capsule of the arm behind the back. The primary function of the posterior deltoid stretch is the stretch the posterior capsule, while the Apley stretch helps increase both internal and external rotation of the shoulder. The Pectoralis Minor stretch assists the muscle from which it is named, and is beneficial for individuals with a protracted shoulder girdle. The single knee to chest stretches the gluteus maximus, hip adductors, and superficial erector spinae. The straight leg raise serves to stretch the hamstrings at both the hip and knee joints, and is excellent as identifying any passive insufficiency.

Exercises

Ball Rolls Against Wall

Wall Slides

Internal Rotation

Single Leg Dead Lifts

Partner Assisted Reverse Leg Curls

Ball Rolls help to stabilize the scapula, in particular the serratus anterior. It is an ideal exercise for stabilizing the muscles of the shoulder girdle. Wall slides help train the rhomboids, middle trapezius, posterior deltoid, and the external rotator cuff. It helps to strengthen the shoulder girdle retractors and the shoulder joint external rotators in one synchronized motion. This is especially beneficial for those with a protracted shoulder girdle. The Internal Rotation exercise targets the subscapularis. Strengthening the subscapularis this area helps depress the head of the humerus in abduction. This may prove beneficial for shoulder impingement. The partner assisted leg curl is an essential exercise for strengthening the hamstrings. It helps to protect the various ligaments of the knee, making it ideal for injury prevention. It also eccentrically trains the hamstrings, reducing the risk of injury to this area. The single leg dead-lifts train the hamstrings, gluteus maximus, gluteus medius, knee proprioceptors, quadriceps, and core. This helps to train the proprioceptors to maintain proper positioning of the knee, protects the ACL by strengthening the hamstrings, and also strengthens the core. It also stabilizes the pelvis, and trains the gluteus medius to resist valgus motions at the knee.