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

Leg Flexibilty Invertors: Fibularis Tibialis (Peroneals) Anterior Lateral Tibialis Gastrocnemius Posterior Plantar Flexors: Dorsiflexors: Soleus Tibialis Anterior Gastrocnemius

Tibialis Anterior Activation Tibialis Posterior Activation

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 Tibial External Tibial Internal Rotators: Tibial Internal Rotator Rotator Flexibility Activation TFL (via ITB) Gracilis Biceps Femoris Lower Leg Flexibilty Semitendinosus & Tibialis Posterior Semimembranosus Activation Lateral Gastroc VMO Activation Sartorius Tibialis Anterior Medial Activation Gastrocnemius Vastus Medialis Obliquus Plantar Flexors: Dorsiflexors: Soleus Tibialis Anterior Gastrocnemius 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 Tibial External Tibial Internal Rotators: Glutues Medius Rotators Rotator Flexibility Activation Gracilis Hip Flexor Flexibility TFL (via ITB) Semitendinosus & Gluteus Maximus Adductor Flexibility Biceps Semimembranosus Activation Lower Leg Flexibilty Tibial Internal Rotator Femoris Sartorius Activation Lateral Medial Tibialis Posterior Gastroc Gastrocnemius Activation Vastus Medialis VMO Activation Obliquus Femoral Internal Femoral External Rotators Tibialis Anterior Activation Rotators Gluteus Maximus TFL Gluteus Medius Gluteus Minimus Adductors 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 Femoral External Rotators Piriformis Biceps Femoris Adductor Magnus Long/Underactive Femoral External Rotators Hip External Rotator Flexibility Lower Leg Flexibility Invertors: Tibialis Anterior Tibialis Posterior Gluteus Maximus Gluteus Medius Gluteus Maximus Activation Gluteus Medius Activation Tibialis Anterior Activation Tibialis Posterior Activation

Evertors: Fibularis (Peroneals) Lateral Gastroc

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 Hip Flexor Flexibility Hip Extensors Gluteus Maximus Activation Tensor Fasciae Adductor Flexibility Gluteus Maximus Lower Leg Flexibilty Latae (TFL) Semitendinosus & Tibialis Anterior Psoas Semimembranosus Activation Iliacus *Biceps Femoris *Tibial Internal Rectus Femoris *Posterior Fibers Rotator Activation of Adductor Sartorius Magnus Anterior Adductors Plantar Flexors: Dorsiflexors: Soleus Tibialis Anterior Gastrocnemius 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 Hip Flexion Tensor Fasciae Latae (TFL) Psoas Iliacus Rectus Femoris Sartorius Anterior Adductors Lumbar Extensors: Erector Spinae Latissimus Dorsi Long/Underactive Hip Extensors Gluteus Maximus Semitendinosus & Semimembranosus *Biceps Femoris *Posterior Fibers of Adductor Magnus

Hip Flexor Flexibility Adductor Flexibility Lumbar Extensor Flexibility

Gluteus Maximus Activation TVA Activation Intrinsic Stabilization Subsystem Activation Anterior Oblique Subsystem Integration

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 Femoral Left Tibial Tibial Right Invertors Glutues External Rotators External External Rotators External Medius Tibialis Rotator Rotator Activation Piriformis TFL (via Anterior Flexibility Flexibility Gluteus ITB) Biceps Tibialis Lower Maximus Femoris Biceps Posterior Leg Activation Femoris Adductor Flexibilty Tibialis Magnus Lateral Posterior Gastroc Activation Right Ankle Lower Left Femoral Left Femoral External Tibialis Evertors Leg Internal Rotators Rotators Anterior Flexibility Fibularis TFL Gluteus Activation (Peroneals) Maximus Gluteus Minimus Lateral Gluteus Gastroc Medius Adductors 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 Pectoralis Major, Shoulder External Rotators External Rotator Rotators Minor and Activation Infraspinatus Subscapularis Latissimus Teres Minor Flexibility Dorsi *Posterior Deltoid Lumbar Extensor Pectoralis Flexiblity (Lats) Major Subscapularis 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 Downward Rotators Pectoralis Minor Levator Scapula Rhomboids Long/Underactive Upward Rotators Upper and Lower Trapezius Serratus Anterior

Scapular Muscle Flexibility

Serratus Anterior Activation Trapezius Activation

Anterior Tippers: Posterior Tippers: Pectoralis Serratus Minor Anterior Levator Lower and Scapulae Middle Trapezius. Upper 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.