Monday, October 10, 2011

Breaking Down The Functional Wall Squat (Part 6)

In the last 5 posts regarding the Functional Wall Squat (FWS), we’ve discussed the foundational knowledge of ideal posture, the FWS as a Physiotherapy (PT) functional assessment, and the FWS as a PT intervention. In this closing post of the FWS series, I will discuss the Functional Wall Squat as Preventive Therapy and as a modality of exercise.

The FWS as Preventive Therapy:

Kettlebell Therapy’s approach to Preventive Therapy is not just one of prevention, but, it is a life long approach to optimizing and maintaining health.

Below is a sequence of corrections to common functional deviations seen during the FWS assessment:

Thoracic Kyphosis with Rounded Shoulders & Head Forward Position: This deviation is particularly common in the computer and desk job populations. This risk includes (and are not limited to) poor lifting mechanics, musculoskeletal discomfort due to muscular imbalance, headaches, compression fractures, and nerve compression.
  • To correct this, begin with shoulder retraction. Tell the individual to pinch their shoulder blades together.
  • Ensure that the scapulae retract posteriorly and slightly inferiorly to avoid activating the upper traps.
  • Then incorporate thoracic spine extension with pushing the chest out.
  • Finally, encourage cervical spine retraction/elongation which should naturally occur as a process of the scapular and thoracic spine corrections.
  • From here, cue the individual to engage in a mini-squat and lower until the next deviation which is typically…

Flat Back & Posterior Leaning: Flat back tends to happen with weak lumbar spine extensors and a stiff lumbo-pelvic girdle. Flat back is also associated with posterior leaning. This occurs as a mismatched balance strategy – as one squats, ones center of gravity will shift. In order to balance, the proper strategy is to move into a spinal extension bias and shifting the lower trunk posteriorly and maintaining the upper trunk anteriorly over ones base of support.

However, if one has a flat back deviation, the only available strategy is to move the upper trunk. Since the flat back naturally shifts lower trunk weight anteriorly, the only option for the upper trunk is to shift weight and lean posteriorly to maintain balance.

In general, posterior lean can occur during a functional squat due to several factors including:
  • Tightness in the Lumbo-Pelvic girdle (primarily Hip Flexors)
  • Weakness in the Lumbar Spine Erectors
  • Weak Hip Extensors / Over-dominant Knee extensors
  • Tightness in the Muscles of the Calves (Plantarflexors)
  • Weakness in the Ankle Dorsiflexors
To correct this during the FWS:
  • Begin with cuing the individual to stick out his/her buttocks.
  • Next, instruct the individual to accentuate the lumbar lordosis “C” curve of the low back.
  • Continue with tactile cuing of the thoracic spinal erectors by drawing the scapulae together with your fingers in a pinching manner.
  • Combine this neuromuscular facilitation with downward & posterior pressure to the ASIS to encourage anterior pelvic tilt as such will accentuate the favored spinal extension bias and prevent the next functional deviation…

Lower Quarter Torsion and/or Collapse: Weakness in the hips is most commonly expressed with deviations in the knee and ankle/foot joints. Most commonly seen is the combination of genu valgum combined with internal rotation of the femur and resulting in pes planus (excessive pronation of the ankle/foot).

  • Genu Valgum: The knock kneed position is most commonly a result of a weak gluteus medius.  With poor hip abduction control, the femur easily veers medially.  To correct this functional deviation, instruct the individual to favor their knees outside their base of support.
  • Internal Rotation of the femur: Weak Hip External Rotators allow for the femurs to excessive internal rotation which also contributing to genu valgum.  To correct this functional deviation, instruct the individual to point their knees away from midline.
  • Pes Planus: Weakness in the muscles of the arch contributes to this functional deviation. To correct this functional deviation, instruct the individual to hollow out the foot into a cave along with the corrections above.
For the purpose of this video demonstration, the anterior view is given:

As you can see, this sequence of Neuromuscular Re-education can correct and re-sequencing lifting, squatting, and postural mechanics. The result is a habitual lifestyle of good movement in ideal body mechanics – this spells PREVENTION.

The Functional Wall Squat (FWS) as a modality of exercise:

Once the sequence of the FWS is perfected, one can move into the overloading principle of exercise physiology into strengthening and conditioning.  Here are a few variations to the FWS as an exercise shown in the following order:
  • Functional Wall Squat, Horn’s Grip Position
  • Functional Wall Squat, Suitcase Grip
  • Functional Wall Squat, One Handed Clean Position
  • Functional Wall Squat, Press Squat variation

The guiding principle behind good exercise is and will always be proper biomechanics. The Functional Wall Squat (FWS) is a versatile exercise which can be used to assess functional deviations, neuromuscularly re-sequence movement patterns, and strengthen proper biomechanics to prevent future impairments.  Used as a foundational exercise to lifting mechanics and postural correction, the FWS is a strong base for a successful building.

Coming up: Preventing Knee Injury with Kettlebell Therapy. In my next post, I will discuss an exercise I introduced at the 2010 National Speaking of Women’s Health Conference specifically addressing gluteus medius weakness, and, will discuss a screening exercise for the dynamic integrity of the knee joint.

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