a

MARIYA LEE

TEV KOKSALDI

MOVEMENT

ANALYSIS PROJECT

KINESIOLOGY

DR. UYGUR

T/R 11:00AM-12:15 PM

New Patient Demographic:

Personal Information:

Last Name: Lee First Name: Mariya Middle Name: Germanovna

Address: 123 Kinesiology Dr.

City: Glassboro State: New Jersey Country: United States

Home Phone: 856-797-8640 Cell Phone: 856-206-2538

Gender: Female

Date of Birth: Age: 21

Height (in): 64 in Height (cm): 162.6 cm

Weight (lb): 129 lb Weight (kg): 58.5 kg

Body Mass Index (if available): Has not been measured

Work/Lifestyle:

Current Work Status: Full time working student

Type of work (list all that apply): Retail, horse training, student

In your current position(s) are you required to walk or run excessively? If so, please explain: I

will be on my feet anywhere from 4-7 hours a shift in retail and another 4 hours or so when

training horses.

In your current position(s) are you required to perform any strenuous activity? If so, please

explain (Attaman, 2015): I handle heavy furniture in retail and training horses requires me to be

able to ride for hours if necessary. I also do additional barn chores like lifting hay bales, water

buckets and saddles.

Does your current position(s) require you to remain seated for extended periods of time? If so,

please explain (Attaman, 2015): As a student, I can remain seated for nearly 8 hours depending

on the day. Currently, I only attend college three times a week.

Pain Complaints:

Do you currently suffer from any pain that interrupts the actions of your daily life? If so, please

explain the type of pain and location (list all that apply): I have occasional pain radiating from

the posterior section of my pelvis, knee pain in both, and the feeling of my right shoulder sitting

loosely in its socket.

On a scale of 1 being the lowest and 10 being the highest, please indicate your current pain level

(Attaman, 2015):

1 2 3 4 5 6 7 8 9 10

Have you gone through any treatments to improve the current injury/pain? (list all that apply): I

have had physical therapy on both knees and ankles and occasionally get my back readjusted by

a chiropractor.

Medical-Physical History Questionnaire

Medical Conditions:

Do you currently have any medical conditions or physical anomalies that may inhibit your daily

physical performance, excluding past injuries? (list all that apply): My right leg is slightly longer

than my left forcing my pelvis to sit higher on that side. I am flatfooted and tend to fall medially

onto the insides of my feet when standing. I also have hyperextended knees due to being a retired

gymnast.

Do you currently suffer from a past injury that inhibits daily life? If so, please explain: I suffer

from tendinitis in both knees, ankles, and possibly in my right shoulder. I had a stress fracture

occur in my left tibia around 7 years ago.

Have you ever received treatment for the injuries or physical issues above? If so, please explain:

I received treatment through physical therapy for both knees and ankles only.

On average, how many days in the week does your injury or physical issue persist? Please circle

the number applicable:

1 2 3 4 5 6 7

On average, please indicate your pain level in regards to your injury or physical issue, 1 being

the least painful and 10 being the most painful. Please circle the number applicable:

1 2 3 4 5 6 7 8 9 10

Family History:

Do you or any of your family members suffer from scoliosis? (list all that apply): No one in my

family suffers scoliosis

Do you or any of your family members suffer from a skeletal or muscular degenerative disease?

If so, please explain: We do not currently have anyone with a degenerative disease

Do you or any of your family members suffer from arthritis in any form? If so, please explain:

My grandmother on my mother’s side has arthritis in her hands. My grandparents on my father’s

side both have it in various limbs.

Do you or any of your family members currently suffer from a disease or issue that affects

movement that has not been listed? If so, please explain: I have no known genetic diseases or

issues not listed above.

Lifestyle:

On average, how many days do you exercise per week? Please circle the number applicable to

days exercised:

1 2 3 4 5 6 7

Would you describe your exercise routine as aerobic (jogging, running long distance, biking) or

anaerobic (weight/strength training)?: Riding horses is more aerobic as we ride almost nonstop

anywhere from 30 minutes to an hour per horse. I also train at the gym and do both aerobic and

anaerobic exercise.

What exactly does your exercise routine entail? (list all that apply): I do a lot of cardio between

strength training sessions. I run before and after each workout and do more strength training with

free weights or squats with the bars. I do not frequent gym machines. Additionally, I work with

young horses so I ride 1-3 every other day if not more often.

Do you currently play a sports recreationally or professionally? (List all that apply): I am a

member of the Rowan Equestrian Team, ride horses recreationally and for work. I also coach

gymnastics when I need to or have time to. This includes spotting or holding younger children.

During your work life do you do any strenuous activities that include lifting and excessive

walking or jogging? (if so, please explain): During retail hours I lift heavy furniture and place it

around the store or carry it out for customers. Riding also includes excessive strain on the back.

Does your job require you to sit in the same position for several hours?: Only during my classes

do I sit for more than 6 hours per day.

Do you currently have to work or care for younger children that require being lifted or carried? If

so please explain: Only if I am coaching do I need to spot or carry any children. Most are under

the age of 7.

Movement Goals

Goals:

I would like to work on not hyperextending both knees as it becomes an issue in normal

tasks. I developed it after being a gymnast for around 10+years.

No longer hyperflexing in dorsi flexion of both feet when walking. I tend to flick my toes

up high and over extend when I walk.

Increase latissiumus dorsi muscles and internal/external oblique muscle strength to

balance out my abdominal riding muscle strength,

I need to balance out my over bearing triceps from riding, as it looks like my triceps

overpower my biceps when lifting free weights.

I would like to improve my quadriceps muscle to balance out the hamstrings used in

horse back riding.

Lastly, I would like to regain some flexibility in my legs in order to once again be able to

do splits. I lost it after changing sports as a retired gymnast.

Initial Summary

Information From Demographics/Medical Questionnaire:

After reviewing the compiled information previously given it is evident that I currently

suffer from tendinitis and back pain due to strenuous activity from various old sports injuries as

well as my current lifestyle. In both the demographics and medical questionnaire I listed that I

lift heavy furniture, saddles, water buckets, hay bales, and do cardio workouts consistently every

week. This could irritate my already diagnosed tendinitis as well as create back and hip

problems. Since I have my right leg a bit longer than my left that could also explain why I have

back and pelvic pain due to the reactions from the kinetic chain. Flat feet would also tie into the

chain as being flat footed could lead into further damage to the ankles, knees and could create

issues as I analyze the superior sections of my body.

Information to Help with Movement Goals:

As discussed previously, one of my main goals is to balance my biceps to my triceps and

my quads to my hamstrings as this could heavily dictate whether I continue having knee and

shoulder problems. If the quads are strengthened to the level of my hamstrings this will provide

me with more stability at my knee joint and remove the tension felt during excessive workouts or

long work shifts. I have had some work on my quadriceps muscles for balance purposes, but will

continue learning how to properly balance them. The triceps to bicep issue is also something I

would like to work on in order to provide myself with less shoulder issues. Maybe I am doing an

exercise incorrectly regarding free weights or carry unbalanced objects like hay bales. I am

looking to find a more uniform way to build my bicep muscles to help with shoulder pain. I may

notice other issues but am not quite sure how to correct the extreme dorsiflexion when I walk

without tripping over my own feet, but it may be overcompensation for having flat feet or a

weakness in a particular muscle. Corrective insoles in shoes may be my next option and it may

correct some of the pelvic and knee pain. Also, additional muscle strengthening and stretching

well help improve total physical health. Hopefully, I will learn some corrective exercises for

each muscle group in order to help me sit in splits once again. Muscles must be balanced, strong,

and flexibility. It would be in my best interest to work on each section.

Range of Motion

Cervical Flexion and Extension: 60 degrees and 75 degrees

After examining the cervical positions of the head and neck I discovered hyperextension

of the neck as I was able to touch the back of my head directly to my spin without pain or

compensation. In the same instance I was able to touch my chin almost directly to my chest if not

for some minor fat collection directly below it. This would indicate that I have hyperextension in

my neck. It may be in my best interest to build the scalenus muscle and sternocleidomastoid

muscle to reduce a possible neck injury in regards to flexion. In order to keep myself from

injuring the extensors of my neck with possible whiplash in a car accident to horseback riding

accident I will strengthen my spinals cervicis and spinals capitus muscles. My neck flexion is

almost directly at 80 degrees and fits into the normal range while my range of motion in

extension is nearly at 90 degrees; this is well past the 70 degree range. Cervical flexion can be

used in something as simple as sitting at a desk and taking notes or typing on a computer

keyboard. Neck extension can be used in looking up at the sky or for shorter people like myself,

looking up to speak to someone much taller than myself.

Cervical Extension

Cervical Rotation: 80 degrees

Compared to my extension and flexion, my left and right rotation of the cervical spine is

much smaller. When rotating my neck to the left the range of motion is right around 80 degrees

and fits into the normal range. When rotating my neck to the right I only reach around 75 degrees

making the rotating muscle on the right side of my neck less flexible than those on my left. This

is not within the normal range of motion. I would need to start preventative measures to avoid

injury by allowing the right rotating muscles to stretch further in that direction, even starting to

do some exercises to stretch them. I also know that I have problems with my right shoulder and

this may have caused my neck on that side to compensate for the dysfunction. In my frontal

anatomical position it is evident that my shoulders sit unbalanced. Most of the time my right

shoulder drops and it looks like the right side of my neck is compensating for the issue. The

range of motion in rotation is extremely necessary as we use our neck to turn and look at our

blind spots when driving.

Neutral (frontal) Cervical L. Lateral Flexion Cervical R. Lateral Flexion

Cervical Lateral flexion: 45 degrees

Both my lateral left and right flexion range of motion ends right at 45 degrees. This fits

right into the normal range of lateral flexion at 45 degrees. I may be a few degrees off as you can

see from my head tilt that I have more lateral flexion on the right side of neck when I go towards

that direction than my left. This could also prove my previous point of possibly having shoulders

muscles that are creating an issue that my lateral flexion muscles on that side struggle to

compensate for such as having a stronger trapezius muscle on my right than on my left. They

could be pulling to that side. I will need to analyze the issues with my right shoulder in order to

have a more decisive look at the issue regarding the right side of my neck. Lateral flexion is used

in more complicated motions than the previous ones. As a retired rhythmic gymnast I usually

laterally flexed my neck when I had to do cartwheels, but in a more everyday example sleeping

in a car could cause a person to laterally flex and rest on one side to sleep more comfortably.

Neutral (saggital) Left Left Shoulder Flexion

Shoulder flexion: 170 degree

I have evident hyperflexion in both shoulders. My left arm seems to go slightly past the

area of my right arm. The normal range of motion for shoulder flexion is 170 degrees while my

left arm goes to around 190 degrees while my left goes slightly past around 195 degrees. This is

around 20-25 degrees past the normal range of shoulder flexion. I almost definitely have some

type of dysfunction in my right shoulder that has been affecting my cervical muscles on the same

side as well. This may become a new goal to correct. Also, shoulder flexion is commonly used as

a way to a long and flat object, possibly carrying a tray of food if held from the bottom of it

rather than the sides. We use it in any situation that requires lifting an object with our arms even

if mixed with another motion, such as internal rotation if holding the sides of an object.

Neutral (saggital) Right Right Shoulder Flexion

Neutral (frontal) Left Shoulder Abduction Right Shoulder Abduction

Shoulder Abduction: 170 degrees

In both images my shoulder is abducted past the normal range of motion at 170 degrees.

Without compensation from the rest of my body I have developed hyperabducted shoulders. My

right one is around 175 degrees and my left matches it around 180 degrees. Both shoulders are

overly flexible and beyond the normal range. My right is once again a weak point in comparison

to my left. It would signify that I am right handed and use that as my dominant arm and hand. It

could also point to dysfunction in the glenohumeral joint of my right arm. In order to understand

the dysfunction I would need to focus on pinpointing specific muscles, such as, focusing on the

possibility of having too strong of a trapezius muscle or even a slightly shorter one in

comparison to my left side. Waiters commonly use shoulder abduction to carry trays of food on

their dominant shoulder. This same movement is used in normal life if doing jumping jacks or

even clapping your hands above your head when clapping at a concert or event.

Neutral (saggital) Left Internal Rotation

Shoulder Internal Rotation: 70

degrees

The normal range of motion for internal shoulder rotation on either arm is 70 degrees. My

right arm rotates internally around 70 degrees and fits into the normal range as well as my

shoulder. There may be a slight variation, but it is very minor and difficult to notice without a

machine that measures the angle in a more decisive manor. Both are within normal range. Only

my right one looks as if in neutral position that my shoulder does not allow a completely flat,

neutral position as my left does. My right forearm seems to tip up very slightly. A right shoulder

dysfunction is still the probably cause to the imbalance. A weaker muscle like the subscapularis

muscle could also cause the issue as it is the internal rotator of the shoulder. I found myself using

internal rotation of my arm when I started swatting at a fly or if I am mad I may slam my hand

down on a table in frustration. They are obscure actions, but both involve internally rotating the

shoulder.

Neutral (saggital) Right Internal Rotation

Shoulder External Rotation:

90 degrees

The expected range of motion for both arms in external rotation is 90 degrees. My

shoulders are flexible and both reached past the normal range of motion by 10 degrees. My right

arm points back at 100 degrees as well as my left arm. Both are equal in external rotation, my

right arm’s dysfunction is not as evident in this motion compared to majority of the others. I did

notice that my right shoulder is more likely to slip from its socket in this motion. I will need to

strengthen my infraspinatus and teres minor in my right arm to avoid future injury. I tend to use

external rotation at the shoulder everyday just to raise my hand in class. Without this ability it

would be difficult to even lift the arm against gravity.

Neutral (saggital) Left External Rotation

Neutral (saggital) Right External Rotation

Neutral (saggital) Right Hip Flexion

Hip Flexion: 110 degrees

Due to being retired rhythmic gymnast both my hips are now hyperflexed when any hip

flexion occurs. The normal range of motion for the hip in flexion is 110 degrees. Since I am

standing beside the grid it is relatively easy to see that both legs are lifted around 135 degrees as

the number of blocks is the same on either side. Both the right and left hip flex 25 degrees

beyond the normal range without compensation. As my goals include wanting my quadriceps to

be as powerful as my hamstrings are from riding horses I will increase the duration of gym work

I do with my quadriceps in a flexed position. I will need to also increase my hamstring extension

and flexibility to balance out the hyperflexion of my quadriceps. Flexion is used in everyday

tasks like sitting down in a chair or squatting down to pick an item up.

Neutral (saggital) Left Hip Flexion

Neutral (frontal) Left Hip Internal Rotation

Hip Internal Rotation:

35 degrees (knee 90deg foot points out)

Internal rotation of the hip has a range of motion of 35 degrees for both left and right

hips. After examination my right leg is directly at 35 degrees as well as my left leg. Neither is

overly flexible or hyperflexed. They both fit into the normal range of motion. If needed, I will

begin exercises to stretch my internal rotators to provide more range of motion and avoid injury.

Common motions in everyday activities include crossing the leg when sitting down, this would

be when I place the outside of my ankle onto the superior portion of my knee when sitting at a

desk.

Neutral (frontal) Right Hip Internal Rotation

Neutral (frontal) Left Hip External Rotation

Hip External Rotation: 45 degrees (knee 90 deg foot points in)

As previously seen in my hip internal rotators my external rotators also reach the normal

range of motion expected from them. The normal range of motion is 45 degrees for external

rotators and both my right and left leg stay almost directly at 45 degrees. There is also the

possibility of my right leg shifting a bit further by a miniscule amount of degrees, though it is so

small that it would only be noticed under closer examination. As the range is normal on both legs

the only preventable issues would be whether I find a way to correct the way my knees buckle

into one another during my neutral position. This may be a sign of weak internal rotators and

strong external rotators that compensate

for them. In daily life external rotation is used as a

pivot point in a sense as a ballerina may use

this as a way of turning out her feet in addition to

hip abductors if she needs to lift her leg.

Neutral (frontal) Right Hip External Rotation

Sit and Reach Test: Toe touch

The sit and reach test is meant to test hamstring flexibility and a person is generally

supposed to reach past the length of the toes. Women’s is slightly further than men’s, but the

length for the full legs and toes is the general range of motion accepted. I reached 12 inches in

my sit and reach test and reached around 3 inches past where my feet are within the box. After

that point I felt tightness and will need to stretch my hamstrings weekly in order to reach my goal

of being able to sit in splits once again. Hamstrings flexibility in necessary in any type of motion

that requires the leg to extend. This would include running, walking and biking.

Neutral (saggital) Right Neutral (saggital) Left

Straight Leg Raise: 90 degrees

Another assessment based on the flexibility of the hamstring is the straight leg raise. This

strictly focuses on the flexibility in the hamstrings rather than including the lower back as well. It

is generally accepted that the lifted leg must be at 90 degrees in order to have a full range of

motion. My right leg beyond that as it was my dominant leg in gymnastics and reaches 100

degrees while my left leg reaches 90 degrees. My right leg has more hamstring flexibility and I

will need to stretch my left hamstrings in order to avoid a future injury. Focusing on these

stretches will allow me to sit in splits once again. Once again, hamstring flexibility is vital in

almost anything having to do with moving the legs. This would mean kicking a ball or running

would be included.

Thomas Test: 90 degrees

The Thomas test isolates the flexibility of the hip flexors. For a normal range of motion

Right Straight Leg Test Left Straight Leg Test

the hip flexors would allow a person to create a 90 degree angle between the two flexors. I was a

rhythmic gymnast for 10 years and have very flexible hip flexors that go beyond the limit of 90

degrees without any pain or muscle constraints. Both legs hang low with little to no resistance.

My left and right leg have flexible iliopsoas muscles and rectus femoris muscles. Hip flexors are

used anytime the leg is lifted off the ground making the major flexors invaluable muscles for

everyday life. They interact in walking, kicking a ball, and running.

Aply Scratch Test: Flexibility of the shoulder

The Aply test is meant to assess the flexibility of the shoulder joint or the internal and

external rotators at the shoulder when being used in unison. There was not a specific degree

given though it is generally understood that both hands must be able to touch one another when

one is internally rotated behind the lower thoracic section of the back while the other externally

Neutral (frontal) Right Ext. Aply Test Left Ext. Aply Test

rotates at the upper thoracic section of the back. I noticed that in my tests I easily touched both

hands against one another, but I did have a minor issue with my left arm internally rotating

behind my back. My elbow visibly poked out much further than that of my right that sat snuggly

at my side. I will need to work on internally rotating my left shoulder though it was not a visible

issue until the Aply test was done. This is a great way to see whether both shoulders have gained

or lost flexibility depending on which arm is used more often.

Postural Analysis-Overhead Squat Assessment

Frontal Postural Analysis:

My eyes are not aligned in the frontal plane and the left eye dips 1-2 cm down below my

right eye. This is more than likely a kinetic chain issue stemming from my hip joint rather than it

Neutral (frontal) Initial Squat (frontal) Finished Squat (frontal)

only being my left scalenes being overactive on the left. This has provided a minor head tilt to

the left. The AC joint is not aligned with the right shoulder sitting lower. This same issue is

visible in the arm length as the arm is pulled slightly up on the left to accommodate the lifted

shoulder on the ipsilateral side. On the right shoulder the overactive muscle might be the lower

trapezius and underactive is the upper trapezius with the arm being pulled medially toward the

body. Some scoliosis is possible as the cause to this misalignment as the ASIS is uneven as well.

There is a visible overactive upper trapezius and levitator scapula on the left and an underactive

lower/middle trapezius on the same side. The pelvis is not aligned with my right hip sitting

substantially higher on the right side. The left leg is also shorter than the right in this image. On

the right leg it looks like the TFL physically is larger on the right leg and could indicate an

underactive piriformis on the right as well. On the left leg the overactive muscle is the quadratus

lumborum and the underactive is the gluteus medias. Patella height is uneven with a minor right

shift up. The left leg being shorter than the right and has created this issue more so than it being a

functional issue. Both patellas have no shifting laterally or medially though they are under stress

in the genu valgum position. This leaves the left and right adductors as the overactive muscle

group and the gleuteus medius and piriformis as the underactive muscles. I stated the same issue

in the ASIS alignment. The ankles are aligned, but both feet have subtle pronation from the genu

valgum and overactive peroneles with an underactive tibialis lateralis. They point outward, more

the right than the left. This is an indicator that I drive improperly with my right foot facing

outward. The piriformis and lateral gastrocnemius are the overactive muscles which contradicts

the previous statements and the medial gastrocnemius and medial hamstrings are underactive.

Frontal Squat Assessment:

As previously stated there is a left shoulder initial title down. This means there is an

overactive upper trapezius and underactive lower trapezius. Beyond that all other issues are

unchanged from the neutral view. When in the squat position there is an issue with the right knee

aligning with the right foot. The right foot is pronated and pointing outward away from the knee.

The overactive muscle is the piriformis and lateral gastrocnemius and the underactive muscle is

the medial gastrocnemius. This could also be an underactive tibilias anterior/posterior and an

overactive peroneal complex. Only the left foot faces forward; the right faces out slightly with

abduction. As a minor comment the picture looks like it may have been taken on an angle and

isn’t as clear on the left side of the body. Overall, I could work more on quadriceps strength as

the hamstrings seem slightly stronger in these positions than the quadriceps, so I could meet one

of my goals by improving the imbalance.

Saggital Postural Analysis:

The head does not protract and nor does the shoulder girdle protract. Had the pectoralis

major and minor been overactive and the medial trapezius and rhomboids been underactive this

Neutral (saggital) Initial Squat (saggital) Finished Squat (saggital)

would create the protracted shoulder look. Kyphosis and lordosis are normal. Had there been an

overactive anterior longitudinal ligament and underactive erector spinae there would have been

kyphosis of the spine. Excessive lordosis would have been created with overactive superficial

erector spinae and underactive rectus abdominus. The main issue on the saggital plane is the

slight genu recurvatium from both left and right knees. In the image the left is visible and the calf

bends slightly more posteriorly than necessary. This issue is more of a structural problem than

functional, though I was a rhythmic gymnast for ten years and they wanted excessive genu

recurvatium and we trained to have this performed with constant weighted stretches, meaning we

would place our posterior ankles on a stool and have someone sit on them. This is an issue I

would like to correct if possible.

Saggital Squat Assessment:

In the initial position there is no real difference from the neutral position. There is no

excessive lordosis when the arm is raised so no current latissimus dorsi issue in this position. In

the squat position there is normal flexion. When in the final squat position there is visible

excessive lordosis of the spine. This could mean that the overactive muscles in the position are

the superficial erector spinae and the hip flexors and the underactive muscles are rectus

abdominus and the hamstrings. It could also be caused by an overactive latissimus dorsi though

the arms do not change in their angle. In the image the head is slightly lifted so the ear on the left

is visible but it is more due to not keeping the head with the arms and looking straiht rather than

down. The angle is more perpendicular at the hip than necessary, it is caused by the excessive

lodosis. In all, I must strengthen the erectus abdominus and other core muscles to balance out

what seems like overactive spinal muscles.

Posterior Postural Analysis:

There is no winged scapula as there would be a visible shadow on the back even with an

all black outfit choice. If there had been the underactive muscles would be the rhomboids and

serratus anterior. The feet evert slightly on both sides with an overactive peroneal complex and

underactive tibialis anterior and posterior. In general, the lowered right shoulder is much more

visible here and almost looks as if the lower trapezius is overactive and the upper trapezius is

underactive, which is rare. There is a more distinct scoliosis issue here with how sharp the angle

is on my left ASIS area vs that on the left. The TFL is still overactive here and and the piriformis

is more than likely underactive. Overall, there is severe compensation throughout the body just to

try and keep it straight.

Posterior Squat Assessment:

The same issues in the posterior postural analysis have carried over into the initial and

final squat position. The right arm is held more laterally from the midline of the body and is

more adducted than the left arm. This is still the right shoulder sitting in a dropped position. The

ASIS is off with the right liliac crest sitting slightly higher as previously stated. Genu valgum is

still present. The feet evert meaning there are overactive peroneals and underactive tibialis

anterior and posterior. Had there been inverted feet the tibialis anterior and posterior would have

been the overactive muscle and the underactive muscle would have been the pernoeals. In each

position the heels never left the ground. I initially thought that there was an asymmetirical shift

to the right in the final squat position, but when looking closely it is just my upper body curving

to the right slightly, but my pelvic region, knees and feet stay in the balanced position. The most

evident issue would be a possible scoliosis or the leg length discrepancy that is corrected by

chirpractors every few months to make sure I do not develop scoliosis. Since the hip on the right

sits higher my upper body tends to tilt to that direction.

Gait Analysis

Walking-Right leg on saggital plane:

Running-Right leg on saggital plane:

R: Mid-stance (saggital)R: Toe-off (saggital)

R: Heel Strike (saggital) R: Mid-stance (saggital) R: Toe-off (saggital)

Right leg (saggital):

The initial issue I noticed was an upper body tilt from the pelvis on the saggital plane. It

may be due to having a heavier upper body/torso compared to my lower body so my rhomboids

and middle trapezius must act as my base points to keep my posture upright during running more

so than walking. This could mean that the rhomboids/middle trapezius are overactive muscles

and try to balance my underactive pectoralis major and minor muscles. In both my walking heel

strike and throughout every stage of my running I dip forward, this is an issue more with my left

leg than my right even when looking at the right side. I also, swing my arms and take away the

effectiveness of both my walk and run since I am using the calories to swing my arms rather than

put everything into my legwork. There is a noticeable swing across my body indicating

overactive upper trapezius and underactive lower trapezius, as well as, underactive rectus

abdominus. Not entirely sure of the proper step length for my height, but it does look like I may

be taking too large a step when running. Also, there is the issue of hyper flexing in dorsi flexion

as I stated as a goal I wanted to work on. I will need to strengthen the plantar flexors of my feet

in order to fix the issue. Overall, my hip flexion looks normal, dorsi flexion is in hyper flexion,

and there is a large issue in my upper body tilting anteriorly at the waist, not at the ankle. I will

need to strengthen my core and stretch my shoulders.

Walking-Left leg on saggital plane:

Running-Left leg on saggital plane:

Left leg (saggital):

L: Heel strike (saggital) L: Mid-stance (saggital) L: Toe-off (saggital)

As a brief comparison from the left to the right leg I have a higher level of tilt on my right

leg or side than on the left leg or side. It may indicate compensation from my left leg being

slightly shorter than my right. My arms still cross my body at a run, so there are overactive upper

trapezius and underactive middle trapezius and underactive rectus abdominus. There is still

hyperflexion in dorsi flexion occurring in the left foot, which will be corrected by stretching the

dorsi flexors and strengthening the underactive plantar flexors. From the images above in both

walking and running it seems like I tend to hold my left shoulder up higher than the right when

compared to the right saggital images. It indicates an overactive upper trapezius on the left side

with an underactive lower and middle trapezius. I also tend not to lift my legs high during the

initial swing very high, meaning my running/walking is not very effective. I would have to

relearn how to run effectively and stop my upper body from tilting at the waist. It should be tilted

at the ankle. This issue could simply be due to the overbearing weight at my chest in comparison

to my posterior superior section. I hold my shoulders back with my rhomboids and middle

trapezius and they may end up being a bit overactive in comparison to my underactive pectoralis

major and minor. I also step a bit too far forward rather than underneath of my body, this is more

evident in the images above than on the video when on the treadmill where I step almost directly

underneath of my body. Overall, I need corrective training in balancing my upper body to avoid

the tilt, work on strengthening the plantar flexing in my feet and need to work on my initial

swing being higher to become more effective.

Walking-Right leg in posterior view:

Running-Right leg in posterior view:

Right leg (posterior):

The first issue I saw once again was the extremely overactive upper trapezius on my left

side. It is almost 3-4 inches above my right shoulder. It is extremely evident in my walking

R: Heel-strike (posterior) R: Mid-stance (posterior) R: Toe-off (posterior)

R: Mid-stance (posterior) R: Toe-off (posterior)

sequence as scoliosis is a probable issue as my lower and middle trapezius on that side are most

likely much more underactive in comparison to my right. I may also have an underactive upper

trapezius on my right side and a possible over active middle trapezius. I actually notice this when

riding horses because I am so much stronger when using my entire right side. During the heel

strike on both the walking and running sequence my right leg almost crosses in front of me so it

could mean I have stronger adductors on my right leg. It has a genu valgum issue as well. The

adductors in my right leg are overactive and my gluteus medius is underactive. I do take a

straight step, so internal rotation is unlikely. During the mid-stance/heel-strike my foot pronates

and everts to take and load the initial step. This is an overactive peroneal complex and

underactive tibialis anterior and posterior. Supinating exercises would be beneficial for my

ankle/knee joints. I would need to strengthen the tibialus anterior and posterior to correct the

issue. My right leg’s tendency to cross my left makes it appear that I initially have the proper gap

between my feet then shorten the gap in an ineffective manner. This would also need to be

corrected through specific training.

Walking-Left leg posterior view:

Running-Left leg posterior view:

Left leg (posterior):

L: Heel-strike (posterior) L: Mid-stance (posterior) L: Toe-off (posterior)

L: Heel-strike (posterior) L: Mid-stance (posterior) L: Toe-off (posterior)

As previously stated, the upper trapezius on my left side is substantially higher than that

on my right and is very overactive in comparison to my underactive middle and lower trapezius.

I will need to do extensive stretching of my upper trapezius and will have to do major work on

my lower and middle trapezius. When in the walking toe-off position there is evident hip

dropping on my left hip. This could be a sign of scoliosis and the underactivity of the gluteus

medius (Trendelenburg). I noticed this issue when looking at the postural analysis as well as my

gluteus medius on my right leg appeared substantially larger than the left. Beyond that, the rest o

the issues were relatively the same as the right leg. In toe-off position walking and running, there

is evident eversion of the foot. This means the personal complex is overactive and the tibialis

anterior and posterior are underactive. I would need to strengthen the latter in order to balance

out the muscle strengths and avoid injury of the lower extremities. I hadn’t noticed it on the right

leg, but my left foot is actually supinated in the heel-strike and pronated in the mid-stance more

so in the running images. That almost contradicts itself as a pronated foot signifies overactive

peroneals, but an inverted foot signifies overactive tibialis anterior and posterior. I would have to

go through additional tests to see which is actually the problem in this situation. Additionally,

genu valgum is still present in this leg as well, so it is an overactive adductor complex and an

underactive gluteus medius. This is more than likely the weaker leg from the knee up.

References

Attaman, J., Dr. (2015, January 15). Dr. Attaman New Patient Form [Digital image]. Retrieved

September 17, 2016, from http://www.slideshare.net/drattaman/dr-attaman-new-patient-intake-

form