ISSA CORRECTIVE EXERCISE SPECIALIST EXAM 2024, Exams of Nursing

Download ISSA CORRECTIVE EXERCISE SPECIALIST EXAM 2024 and more Exams Nursing in PDF only on Docsity! 1 | P a g e ISSA CORRECTIVE EXERCISE SPECIALIST EXAM 2024 WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |ALREADY GRADED A+|NEWEST|GUARANTEED PASS |LATEST UPDATE Which of the following professionals is not trained to work with people that have medical pain? Certified Personal Trainer What is the type of pain that's caused by a lack of strength, mobility or motor control? Movement pain What are the two benefits of referring a client that has a potential medical problem? You'll build trust with the client and build your professional reputation If a client experiences new pain during a workout, but you're pretty certain it's not a medical problem, what should you do if you're a personal trainer? Refer to a medical professional A female client with knee discomfort hires you so she can return to hiking. What type of goal is she seeking? Outcome goal It's important to know your client's outcome goal because it: Drives the client's behavior Which type of goal should be measurable, specific and realistic? 2 | P a g e Performance goal It's important to discuss a performance goal before the initial performance assessment in case you need to: Influence your client's expectations of what's realistic The Pain Intensity Measurement (PIM) scale is an example of what type of measure? Outcome measure Reducing a client's pain from 6/10 to 2/10 during an exercise is what type of goal? Performance goal Discomfort in a joint that lasts three months is what type of pain? Chronic pain What is the type of pain that lasts for a few days or a few weeks? Acute train Changes to soft tissue and motor programs typically takes how long to accomplish? Months What is the final step when preparing for the first corrective exercise training session with a client Gather quantifiable functional data The type of information that can be measured or counted is known as Quantifiable data What does it mean when an outcome measure has been shown to be reliable? It is useful in a variety of populations What does it mean when an outcome measure has been shown to be valid It meets the standards of the scientific method A score of 80 on the LEFS or UEFI indicates what The client has no movement restrictions What purpose(s) does the LEFS and UEFI serve? They inform you of the client's movement restrictions before your first session; They serve as a way to measure progress When the score of the LEFS or UEFI changes enough for the client to notice a difference it's known as the: Minimum detectable change 5 | P a g e Isolation exercise When a client has trouble performing a multi-joint exercise correctly, what should you do first? Try and correct the multi-joint exercise What is a primary benefit of an isolation exercise? It can improve the client's mind-muscle link When selecting an exercise for a client, it should be: At the edge of his/her functional capacity; A multi-joint exercise, whenever possible When a client learns to do an exercise correctly, the first progression should be to: Increase the load The number of sets you should have a client perform for a specific exercise should increase as long as his/her movement quality: Continues to increase To promote motor learning, what is the recommended way to approach sets and reps for the client More sets of fewer reps When should a client take more rest between sets? When the exercise is challenging; When he/she has poor cardiovascular endurance What are the two primary goals of a corrective exercise program? Restore a client's functional capacity and eliminate pain during any movement What is the primary purpose of performing a movement analysis? To determine if there's a problem with the way your client performs an exercise Why is it important for your clients to avoid poor lifting form? It impairs the fitness-building effect of the exercise, It increases the risk of injury What is the first step of a movement analysis? Divide the exercise into concentric and eccentric phases Which movement plane(s) should be the focus during a movement analysis? All of them The actions that are necessary to perform an exercise correctly are known as: Critical events How do you know if an exercise is being performed correctly? 6 | P a g e All of the critical events are met; There are no additional movements beyond the critical events What is the first question you should answer before watching your client perform an exercise for the first time? What do I expect to see? Elbow flexion during the concentric phase of a biceps curl is an example of a: Critical event How many reps of an exercise should your client perform during a movement analysis? As many reps as necessary to consider all planes of movement In order to answer the question "What did I actually see?" during a movement analysis, you should: Consider if the critical events were met An elbow flare during a biceps curl is known as a: Compensation The process of writing down all the important things you see during a movement analysis is known as: Documentation What is the most common reason why people can't perform a single-joint exercise correctly, assuming the load is light? Poor motor control Your client's right elbow flares during the concentric phase of a biceps curl. Which of the following provides an external focus for your client to correct the problem? Instruct the client to "smash his shirt" with his right elbow during the curl Which of the following is an objective of arm elevation? All of the above Cueing a client to push the dumbbell closer to the ceiling during an overhead press helps her achieve what type of focus? External focus The first 30° of arm elevation requires how many degrees of upward rotation from the scapula? None of the above Which of the following is not a critical event for the concentric phase of a one-arm shoulder press? 8° of lateral trunk flexion What is the primary side effect of the open scissors syndrome? 7 | P a g e It decreases intra-abdominal pressure Which of the following is not a quality of a functional exercise? Requires movement at only one joint When a guy is doing a heavy dumbbell shoulder press with his right arm, why is it common to see him lean his trunk to the left? To put the shoulder in a stronger, more stable position Why is the scapulothoracic region not considered a functional joint? Because it lacks ligamentous connections Poor posture can impair which of the following actions? All of the above How many degrees of freedom does the glenohumeral joint have? 3 For many non-athlete clients, what is the deepest squat required for work or home? A depth to the height of a standard chair, approximately 17" The reason(s) why a tall athlete commonly has more problems performing a full squat is/are due to: Proportionally long femurs; deep hip sockets Which of the following can impair a person's squat depth? Stiff hip joint capsule Hip dysplasia can lead to which of the following? All of the above When should you measure the knee flexion angle that's necessary to stand from a chair? At the moment when the client's hips are about to elevate from the chair At the bottom of a squat, posterior pelvic tilt pairs with what action of the lumbar spine? Flexion The quadruped rock back test is used to determine: The client's minimum stance width during a squat Why is it recommended to have your client perform a goblet squat without shoes during a movement analysis? To observe any possible compensations at the feet/ankles 10 | P a g e When your client performs a squat on an unstable surface that's new to him/her, how does it affect his/her squat depth? Decreases depth Stiffness in an undamaged muscle is often due to: Poor stability at an adjacent joint Which of the following muscles plays a key role for keeping the knees directly above the feet, and avoiding knee valgus, while running, jumping or squatting? Gluteus medius When the gluteus medius is weak, which muscle is typically gets strained or injured? Tensor fascia latae (TFL) An overly pronated foot is due to poor activation of which muscle? Posterior tibialis Why is it beneficial to perform corrective exercises that target many additional muscle groups? So the client will get a challenging workout while correcting imbalances Which of the following is typically not an underactive muscle within the trunk? Psoas Which of the following hip muscles are typically weak/underactive in people of all ages? Abductors What is a primary benefit of increasing stability within the trunk and pelvis? Increased mobility in the hips and shoulders If a client lacks mobility in the right shoulder, which muscles should you activate first, given that proximal stability creates distal mobility? Muscles within the trunk and pelvis Why is a mini-band placed above the knees during the modified side plank? To activate the hips' external rotators/abductors of the top leg What problem occurs when a client's weight shifts toward the toes during a lateral step with mini-band? Glute activation decreases How should you instruct your client to step during the monster walk? 11 | P a g e Take short steps, land with a flat foot Which of the following is a common compensation you'll see during the wall elbow walk? An elevated ribcage Which of the following is a cause of scapular winging? Poor eccentric control of the scapulothoracic region If your client has a wrist injury, how should you modify the downward dog exercise? Perform it with the elbows resting on the ground instead of the palms To what position should the arms be lifted during the Y raise on a Swiss ball? 10 and 2 o'clock What is the most common compensation seen during the sphinx with reach drill? Shoulder shrug on the side of the supporting arm What is the primary purpose of the scapular activation drill? To increase motor control of the scapulothoracic region If the client has shoulder pain at 140° of shoulder flexion, at which angle should he hold his arm during the scapular activation drill? Just short of 140°, without pain If your client's feet roll excessively outward during a squat with mini-band, which of the following cues should you use to correct it? Maintain ground contact with the base of each big toe What is the purpose of having your client in the hip hinge posture during a lateral step or monster walk? To give the glutes a more effective line of pull The upper body compensations, identified by Janda, that occur from a forward-head, slumped posture is known as the: Upper-crossed syndrome What is the purpose of having your client perform a chin tuck or "double chin?" Activate/strengthen the deep neck flexors; Increase mobility of the suboccipital muscles What is the normal range of cervical rotation to each side? 80 When your client turns his/her head to the right, what is occurring in the left cervical facet joints? Upglide 12 | P a g e In order to stretch the left upper trapezius, where should your client's left hand be placed? Behind the low back During the pectoralis major length assessment, your client is able to completely rest his elbows, wrist, and posterior hands on the floor. However, he feels stretch tension in his right pectoralis major while in the assessment position. What does this indicate about the right pectorals? Stiffness/shortening that should be corrected During the t-spine foam roll corrective, why should the client's arms be crossed at his chest? To expose the upper back muscles to the foam roller During the quadruped t-spine rotation, what muscle is being engaged in the shoulder of the arm that's resting on the floor? Serratus anterior During the early stages of the ball wall push with hip hinge corrective, why is a large Swiss ball used as the contact point? Because it requires less shoulder stability than a smaller ball Which of the following muscles is not targeted during the posterior shoulder ball roll? Supraspinatus Anterior pelvic tilt is generally defined as which of the following? >5° of anterior tilt for males, and >10° for females The lower-crossed syndrome, described by Janda, is associated with weakness/inhibition of which two muscle groups? Glutes and abdominals For a client with excessive anterior pelvic tilt, which phase of the cat-camel movement should be emphasized? The "cat" position since it encourages posterior pelvic tilt Which of the following compensations is not identified during the modified Thomas Test? Shortening of the hamstrings What is a common problem people make while performing the quadriceps foam roll drill? They contract their quadriceps Which of the following is a reason why the rear foot is elevated during the hip flexors contract-relax stretch? Increased stretch of the rectus femoris 15 | P a g e Proprioception and pain Which of the following is not a function of skeletal muscle? Recruitment actions An eccentric muscle action occurs when? The pulling force of a muscle is less than the resistance force The primary roles of skeletal muscle are to? Contract and apply force to bones From the anatomical position, muscles origin is the position? Closest to the head What is the largest muscle in the human body? Gluteus maximus Which of the following is closest to the estimated number of muscles in the human body? 650 Skeletal muscle is a contractile tissue responsible for? Voluntary actions and reflex actions Skeletal muscle attaches to bone through a? Tendon What is the primary connective tissue that forms a tendon? Type 1 collagen Each bundle of skeletal muscle fibers, covered by a perimysium, is called a? Fascicle During a biceps curl, the biceps brachii and brachialis muscle act as? Synergists What is the primary function of a Golgi Tendon Organ Detect changes in muscle tension Which of the following is not a function required for the coordination of movement? Motivation What two types of cells make up the nervous system? Neurons and Glia 16 | P a g e What is the "transmitter" portion of a neuron that relays a signal? Axon What is the "integrator" part of a neuron that determines if there's enough information to create an action potential? Cell Body What is the name of the area, typically between two neurons or a neuron and gland, where electrical or chemical signals are transmitted? Synapse Which division of the peripheral nervous system is responsible for producing voluntary movements? Somatic Nervous System What structural component of white matter gives it a whitish appearance? Myelin Where does the spinal cord end? L1-L2 Which type of nerve only carries information away from the spinal cord to innervate muscle? Motor Nerve How many pairs of spinal nerves connect to the spinal cord? 31 What is the name of the cluster of cell bodies, from lower motor neurons, that are contained within the spinal cord? Motor Neuron Pool Sensory information is carried within: Ascending tracts What is a primary function of interneurons during movement? Integrate lower motor neuron activity Descending tracts originate from what two areas of the brain? Motor cortex and brainstem When a muscle is quickly stretched, which of the following receptors is activated? Golgi tendon Organ The brain's ability to change its structure and function is known as: 17 | P a g e Neuroplasticity Which of the following is not a function of the basal ganglia? Inhibit lower motor neurons An important component of sleep is to: Allow CSF to flush out waste Which of the following is not a function of the cerebellum? Directly control lower motor neurons The reference point for all locations within the human body is known as the Anatomical Position Which term describes a position that's toward the top of the head? Cranial Which term describes a position that's close to the trunk? Proximal Which plane divides the body into left and right segments and is associated with flexion and extension movements? Sagittal Hip abduction and adduction occur in which plane? Frontal Throwing a baseball is which type of motion? Multiplanar Movement of a limb in a specific direction is referred to as its: Direction of rotation When lifting free weights, the direction of resistance is always: Straight down to the earth When using a cable or exercise band, the direction of resistance is always: In the direction the cable or band is pulling Which of the following movements is not associated with the cervical spine? Horizontal adduction How many different movements can the shoulder girdle perform? 20 | P a g e Which of the following best describes the neuromuscular junction? The space between a lower motor neuron and muscle The feeling of being stable is known as: Sense of balance The sense of body orientation and self-motion is controlled by which system? Visual system How many systems work together to maintain a person's sense of balance? 3 The movement pattern developed through practice is known as a: Motor program Which of the following best describes how motor learning is possible? The brain and synapses can adapt to the input they receive What is the primary function of Golgi tendon organs? Sense changes in muscle tension During closed-loop motor control, which structure does not send information to the cerebellum? Brainstem What is the primary function of muscle spindles? Sense changes in muscle length When a person frequently practices a movement, the area of the motor cortex devoted to that movement will: Enlarge A meaningful movement is known as: A movement that's essential to a person's life or sport What is the maximum number of weeks that a client should be cleared for exercise by a physician before working with you? 8 Your client recently had a fever, night sweats, and feels more fatigued than normal. What should you do? Tell the client to see his/her physician before your next training session 21 | P a g e Which client should fill out the 2015 PAR-Q+ before training with you? All of the Above Myofascial rolling time Frequency Most days of the week (unless otherwise specified) Sets 1 Repetitions Hold areas of discomfort for 30 to 60 seconds Perform four to six repetitions of active movement Intensity Should be some discomfort, but able to relax and breathe Duration 5 to 10 minutes total time; 90 to 120 seconds per muscle group Movement patterns Common combinations of joint motions the human body sues to move in all three planes of motion Agonist The prime mover muscle for a given movement pattern or joint action Antagonist A muscle that acts in direct opposition to the prime mover Reciprocal inhibition When an agonist contracts, its functional antagonist relaxes to allow movement to occur at a joint Synergists Muscles that. assist prime movers during functional movement patterns Stabilizers Muscles that support or stabilize the. body while the prime movers and the synergists perform the movement pattern Muscle action spectrum 22 | P a g e The range of muscle contractions used to accelerate, decelerate, and stabilize forces (eccentric, concentric, and isometric) Eccentric muscle action Occurs when a muscle generates force while lengthening. to decelerate an external load Concentric muscle action Occurs when a muscle generates force while shortening to accelerate an external load Isometric muscle action Occurs when a muscle generates force equal to an external load to hold it in place Muscle origin The beginning attachment point of a muscle Muscle insertion Where the end point of a muscle connects back to the skeleton Isolate muscle function The joint motion. created when a muscle contracts concentrically Integrated muscle function The joint motion(s). created when. a muscle contracts eccentrically or isometrically Muscle innervation A muscle's point of connection to the nervous system Motor behavior The human movement system's response to internal and external environmental stimuli Sensory information The data that the central nervous system receives from sensory receptors. to determine such. things as the body's position in. space and limb orientation as well as information. about the environment, temperature, texture, etc. Motor control The study of posture and movements with the involved structures and mechanisms used by the central nervous system to assimilate and integrate sensory information with previous experiences Motor learning The utilization of these processes through practice and experience leading to. a relatively permanent change in person's capacity to produce skilled movements 25 | P a g e Structural. efficiency The alignment of each segment of the human movement system, which allows posture to be balanced in relation. to a person's center of gravity Functional efficiency The ability of the neuromuscular system. to recruit correct muscle synergies, at the right time, with the appropriate amount of force to perform functional tasks with. the least amount of energy. and stress. on. the human movement system Local musculature system Muscles that connect directly to the spine and are predominantly involved in LPHC stabilization Global muscular system Muscles responsible predominantly for movement and consisting of more superficial musculature that originates from the pelvis to the rib cage, the lower extremities, or both Cumulative injury cycle A cycle whereby an injury will induce inflammation, muscle spasm, adhesion, altered neuromuscular control, and muscle imbalances Movement impairment State in which the structural integrity of the human movement system is compromised because one or more segments of the kinetic chain are out of alignment Static malaigments Deviations from ideal posture that. can be seen when standing still Pattern overload Occurs when a segment of the body is repeatedly moved or chronically held in the same way, leading a state of muscle overactivity Altered reciprocal inhibition 26 | P a g e Process whereby an overactive/shortened muscle causes decreased neural drive, and therefore less- than-optimal recruitment of its functional antagonist Synergistic dominance The process by which a synergist compensates for an inhibited prime mover to maintain force production Dynamic malalignments Deviations from optimal posture during functional. movements Relative flexibility The body's ability to find the path of least resistance to accomplish a task, even if that path creates dynamic malalignments Kinetic chain checkpoints Key points on the body to observe and assess an individual's static and dynamic posture; feet/ankles, knees, LPHC, shoulders, & head/neck Self-myofascial techniques The category of flexibility techniques used to reduce tension in muscle fibers. Primarily used for overactive tissue Myofascial adhesions Knots in muscle tissue that can result in. altered neuromuscular control Inelastic Possessing the inability to stretch Davis's law Soft tissue will model along the lines of stress Myofascial rolling 27 | P a g e A compression intervention where an external object (foam roller) compresses the myofascia Gamma loop The reflex arc consisting of small anterior horn nerve cells and. their small fibers that project to the intrafusal bundle and produce its contraction, which initiates the afferent impulses that pass through the. posterior root to the anterior horn. cells, inducing, in turn, reflex contraction of the entire muscle Myofascial balls Spherical tools used for myofascial rolling that come in different sizes and densities; often called massage balls Cupping A form of myofascial therapy commonly. practiced in Asian and Middle Eastern cultures that has recently become more popular in the US Myofascial flossing Method intended. to increase flexibility by wrapping an elastic band around a region. of the. body and performing movements Instrumental assisted soft tissue mobilization (IASTM) Specifically designed isntruments to provide a mobilizing effect to scar tissue and myofascial. adhensions Static stretching The process of passively taking a muscle to the point of tension and holding the stretch for a minimum of 30 seconds Dynamic stretching The active extension of a muscle, using a muscle's force production and the body's momentum, to take a joint through t he. full available. range of motion Neuromuscular stretching (NMS) A flexibility. technique that incorporates varied combinations of isometric contraction and static stretching of the target muscle to create increases in range of motion. Also called proprioceptive neuromuscular facilitation (PNF) Flexibility The present state or ability. of a joint to move through a range of motion Stretching An active process to elongate muscles and connective tissues in order to increase the present state of flexibility Viscoelatic 30 | P a g e Malalignments of bodily. segments that place undue stress on the joints; for example, poor posture at one or more of the kinetic chain checkpoints Kyphosis Natural curvature of the thoracic spine toward the back of the body Lordosis Natural curvature of the lumbar or cervical spine towards the front of the body Pes planus distortion syndrome A postural distortion pattern characterized by flat feet, knee valgus, & an anterior pelvic tilt Transitional movement assessments Assessments that involve movement without a change in the base of support Loaded movement assessments Observing a client's posture under an additional source of resistance Primary movement patterns Common patterns of functional movement used by all humans Dynamic movement assessments Assessments that involve movement with a change in the base of support Range of motion (ROM) The amount of motion available at a specific joint Flexibility The present state or ability. of a joint to move through a range of motion Mobility The entire available range of motion at a joint and the body's neuromuscular control of that motion. Active motion The amount of motion obtained solely through voluntary contraction Passive motion The amount of motion observed without any assistance from an external force Mobility restriction The inability to move a joint through what should be its full range of motion Abduction 31 | P a g e A body segment is moving away from the midline of the body Adduction A body. segment is moving toward the midline of the body Pronation A triplanar movement that is associated with force reduction Supination A triplanar motion that is associated with force production Pes planus A flattened medial arch during weight bearing Pes cavus A high medial arch during weight bearing Extrinsic muscles Foot muscles that originate in the lower leg and insert in the foot as tendons Intrinsic muscles Refers to muscles located deep within a structure Subtalar inversion Occurs when the bottom of the heel (inferior calcaneus) swings medially Supination of the foot A multiplanar, synchronized joint motion that occurs with concentric muscle function; the combination of subtalar inversion, plantar flexion, and adduction Subtalar eversion Occurs when the bottom of the heel (inferior calcaneus) swings laterally Pronation of the foot A multiplanar, synchronized joint motion that. occurs with eccentric muscle function; the combination of subtalar eversion, dorsiflexion, and abduction Postural sway A measure of postural stability and control, often while standing. Refers to the amount of reflexive movement made by an individual around their center of gravity. to remain balanced. Tendinopathy 32 | P a g e A broad term encompassing pain, swelling, and impaired performance occuring in and around tendons in response to overuse; commonly associated with the Achilles tendon. Medial tibial stress syndrome (MTSS) Pain in the front of the tibia caused by an overload to the tibia and the associated musculature. Ankle sprain An injury to the ankle ligaments in which. small. tears occur in the ligaments. Chronic ankle instability Repetitive episodes of giving way at the ankle, coupled with. feelings of instability. Patellar tendinopathy Often associated with jumper's knee; commonly. an overuse injury affecting. the. patellar tendon, resulting in anterior knee pain. Patellofemoral pain syndrome A musculoskeletal condition in. which. a. client experiences pain behind and around. the patella with. running, squatting, jumping, or other physical activity Iliotibial (IT) band syndrome Often associated with runner's knee; usually an overuse injury where the iliotibial band rubs on the femur, resulting in lateral knee pain. Screw-home mechanism 35 | P a g e Neck and upper back pain caused by poor posture during excessive cell phone use Hypermobility Increased movement and functionally of a joint beyond normal range of motion Myofascial trigger points Painful regions within a tight band of skeletal muscle that also give rise to referred pain. Referred pain Pain perceived at a different location than the source. Cervicogenic headaches Headaches originating from the neck Cocontractions The simultaneous contraction of muscles around a joint Scapulohumeral rhythm The interaction between the scapula and the humerus; important for shoulder function Scapular dyskinesis Occurs when the scapula does not move in a normal fashion during humeral elevation Thoracic kyphosis (TK) The outward curvature of the thoracic spine that. provides the rounded appearance of the upper back Hyperextension Extension of a limb or joint greater than the normal range of motion. Recovery A systematic. physiological. and. psychological process in which. the. body and brain require replenishment and rejuvenation in. order to prepare for the next training or competition. Reset Aspect of recovery that focuses on improving daily sleep amount and quality, limiting stress, and increasing physical and psychological relaxation Refuel 36 | P a g e Aspect of recovery that. focuses on nutrition and hydration habits prior to , during, and after activity Regenerate Aspect of recovery that focuses on movement-based-self-care strategies to optimize movement quality and minimize compensation. Six dimensions of wellness Interdependent categories used by. the National Wellness Institute to illustrate the primary properties of an individual's holistic health and overall functioning. Self-efficacy An individual's belief and confidence in their capacity to execute necessary behaviors to attain specific performance results. Naive range of motion Range of motion improvements that are gained without being properly integrated into the existing proficiencies of the human movement system. Principle of overload Implies that there must be a training stimulus provided that exceeds the current capabilities of the kinetic chain to elicit the optimal physical, physiological, and performance adaptations Local Muscular System (Stabilization system) Muscles *Connect directly to spine *primary type I (Slow twitch) *Transverse abdominis *Multifidus *Internal obliques *Psoas *Diaphragm *Pelvic floor muscles Global Muscular System Muscles *Originate from the pelvis to the ribcage *Type II fast twitch *Rectus abdominis *External obliques *Erector spinae 37 | P a g e *Hamstring complex *Gluteus maximus *Latissimus dorsi *Adductors *Quadriceps *Gastronemius Peripheral joint support system Local systems that support joints (shoulder girdle) Deep Longitudinal Subsystem (DLS) Subsystem of the global movement system that includes the peroneus longus, anterior tibialis, long head of the biceps femoris, sacrotuberous ligament, thoracolumbar fascia, and erector spinae. These muscles work together to create a contracting tension to absorb and control ground reaction forces during gait. Posterior oblique subsystem (POS) GMS subsystem composed of latissimus doors and contralateral gluteus maximus, with the thoracolumbar fascia creating a fascial bridge for the cross body connection. Theses muscles create nearly straight line across the sacroiliac joint and when they both contract they produce a pulling force across the thoracolumbar fascia and stabilization force at the sacroiliac joint (force closure). System works concurrently with DLS during gait Anterior oblique subsystem (AOs) GMS subsystem composed of the internal and external obliques, adductor complex, and external hip rotators. The synergistic coupling of AOS creates stability from the trunk, through the pelvic floor, and to the hips. It contributes to rotational movements, leg swing and stabilization. AOS & POS work together in enabling rotational force production in the transverse plane 40 | P a g e Dynamic stretching uses a controlled movement through the full or nearly full joint ROM Active stretching techniqe Active stretching uses multiple repetitions of a 2-second static stretch but emphasizes a contraction of the antagonist to induce reciprocal inhibition. This intervention is used to movemuscles that tend to be overactive through available ranges of motion and to prepare them for work Ballistic Stretching technique Ballistic stretching is also dynamic, but it differs from dynamic stretching in that ballistic stretching incorporates higher-speed movements with bouncing actions at the end of the ROM. Due to the higher movement velocities and less control of the movement with ballistic stretching, it is riskier and carries a greater chance for injury, especially when a proper active warm-up is not incorporated beforehand. It is not considered a part of the corrective exercise strategy. It is used by competitive athletes in a warm-up in an attempt to activate the central nervous system and muscle. Suggested Warm-up components Myofascial Rolling 90 seconds to 2 minutes of myofascial rolling per muscle group to increase muscle temperatures, decrease tissue viscoelasticity, increase inhibition, and other factors. Static Stretching < 60 seconds per muscle group if participating in high-intensity exercise or athletic activity. No need to go to the point of discomfort or pain. Stretch major muscle groups and specific muscle groups to the activity. Focus on muscles identified as overactive/shortened during assessment stages. Dynamic Stretching ≤ 90 seconds per muscle group. Use full range of motion with a controlled movement at moderate speeds Task-Specific Activities 5 to 15 minutes. Practice movements that are associated with the sport or task at velocities close to the actual movement. This may include exercises performed during the Activate and Integrate phases of the Corrective Exercise Continuum. Stretching precautions *Special populations (e.g., pregnant women, osteoarthritis, and rheumatoid arthritis) *Seniors *Hypertensive patients *Neuromuscular disorders 41 | P a g e *Joint replacements *Fibromyalgia *Marfan syndrome Stretching Contraindications *Acute injury or muscle strain or tear of the muscle being stretched *Recent musculoskeletal surgery or treatment (i.e., shoulder dislocations, ligament repairs, or fractures) *Acute rheumatoid arthritis of the affected joint *Osteoporosis Actue training variables for static stretching Frequency Daily (unless specified otherwise) Sets n/a Repetitions 1 to 4* Duration 20- to 30-second hold60-second hold for older clients (≥ 65 years) Neuromuscular stretching acute training variables Frequency Daily (unless specified otherwise) Sets n/a Repetitions 1 to 3 (or cycles of contract-relax w/ isometric contraction time from 7 to 15 seconds) Mennell's four basic truisms 1. When a joint. is not free to move, the muscles that move it cannot be free to move it. 2. Muscles that cannot be restored to normal if the joints that they move are not free to move. 3. Normal muscle function is dependent on. normal joint movement. 4. Impaired muscle function perpetuates and. may cause deterioration in. abnormal joints. Precautions and contraindications for isolated strengthening Precautions *Special populations 42 | P a g e Neuromuscular disorders *Clients with poor core stabilization strength Contraindications *Special populations Neuromuscular disorders *Clients with poor core stabilization strength *Acute injury or muscle strain or tear of the muscle being strengthened *Acute rheumatoid arthritis of the affected joint *Impaired joint motion Pain produced during the movement Acute training variables for isolated strengthening Frequency 3 to 5 days a week Sets 1 to 2 Repetitions 10 to 15 Duration of Repetition 4/2/1 *4 seconds eccentric *2 seconds isometric hold at end-range *1 second concentric Precautions and contraindications for integrated dynamic movement Precautions *Special populations *Neuromuscular disorders Contraindications *Acute injury or muscle strain or tear of the muscle being worked *Acute rheumatoid arthritis of the affected joint 45 | P a g e Upper body muscles prone to imbalances Overactive/shortened 1. Cervical extensors 2. Latissimus dorsi 3. Levator scapulae 4. Pectorals (major & minor) 5. Scalenes 6. Sternocleidomastoid 7. Upper trapezius Underactive/lengthened 1. Deep cervical flexors (longus coli and capitis) 2. Middle and lower trapezius 3. Rhomboids 4. Serratus anterior LPHC & lower body muscles prone to imbalances Overactive/shortened 1. Gastronemius 2. Hamstrings 3. Hip adductors 4. Piriformis 5. Psoas 6. Quadratus lumborum 7. Rectus femoris 8. Soleus 9. Tensor fascia latae Underactive/lengthened 1. Gluteus maximus and medius 2. Fibularis (peroneal) muscles 3. Rectus abdominis 46 | P a g e 4. Tibialis anterior and posterior 5. Transverse abdominis 6. Vastus medialis and lateralis Factors related to postural imbalances * Chronic suboptimal postures *Habitual repetitive movements *Acute injuries *Recovery from surgery *Incompletely rehabilitated past injuries Lower crossed syndrome Static Positions Head: Neutral to forward Cervical spine: Normal to extended Thoracic spine: Normal to rounded Shoulders: Neutral to rounded Lumbar spine: Neutral to excessive lordosis, possible lateral shift Pelvis; Anterior tilt Hip joints: Flexed or neutral Knee joints: Flexed or hyperextended Ankle joints: Neutral or plantar flexed MUSCLE ACTIVITY Overactive/shortened *hip flexors *lumbar extensors *gastronemeus/soleus Underactive/lengthened *Abdominals *Gluteus maximus and medius *Hamstrings Upper crossed syndrome 47 | P a g e STATIC POSITIONS Head: Forward Cervical spine: Extended Thoracic spine: Excessive kyphosis Shoulders: Rounded, elevated (scapular winging) Lumbar spine: Normal curve or extended Pelvis: Neutral Hip joints: Neutral or slightly flexed Knee joints: Neutral or slightly flexed Ankle joints: Neutral MUSCLE ACTIVITY Overactive/shortened *Cervical extensors *Pectorals (major and minor) *Upper trapezius *Levator scapulae Underactive/lengthened *Deep neck flexors *Rhomboids, middle/lower trapezius *Serratus anterior Layered crossed syndrome STATIC POSITIONS Head: Forward Cervical spine: Extended Thoracic spine: Excessive kyphosis Shoulders: Rounded, elevated, possible scapular winging Lumbar spine: Excessive lordosis, possible lateral shift Pelvis: Anterior tilt Hip joints: Flexed 50 | P a g e Hip extensors (hamstrings) Underactive/lengthened Cervical flexors Thoracic extensors Trapezius (middle and lower) Lumbar extensors Hip flexors (iliopsoas) Sway-back posture Static Positions Head: Forward Cervical spine: Extended Thoracic spine: Excessive kyphosis with posterior displacement Lumbar spine: Reduced lordosis (flattening) Pelvis: Posterior tilt Hip joints: Extended Knee joints: Hyperextended Ankle joints: Neutral Muscle Activity Overactive/shortened Cervical extensors Upper trapezius and levator scapulae Pectoralis minor Intercostals Abdominals (upper fibers) Internal obliques (upper fibers) Hip extensors (hamstrings) Underactive/lengthened Cervical flexors Thoracic extensors 51 | P a g e Trapezius (middle and lower) Abdominals (external obliques) Hip flexors (iliopsoas) Kyphosis-Lordosis posture Static Positions Head: Forward Cervical spine: Extended Thoracic spine: Excessive kyphosis Shoulders: Rounded, elevated Lumbar spine: Excessive lordosis, possible lateral shift Pelvis: Anterior tilt Hip joints: Flexed Knee joints: Flexed or hyperextended Ankle joints: Neutral or plantar flexed Muscle Activity Overactive/shortened Cervical extensors Upper trapezius and levator scapulae Shoulder adductors Intercostals Pectoralis minor Internal obliques (upper and lateral) Hip flexors (iliopsoas) Lumbar extensors Underactive/lengthened Cervical flexors Thoracic extensors Trapezius (middle and lower) Anterior abdominals (external obliques) 52 | P a g e Hip extensors (hamstrings) Pes Planus distortion syndrome Static Positions Pelvis: Anterior tilt Hip joints: Internally rotated Knee joints: Valgus, flexed Ankle joints: Pronated (flattened, pes planus) Muscle Activity Overactive/shortened Gastrocnemius and soleus Peroneals Adductors Iliotibial band Iliopsoas Hamstrings Underactive/lengthened Posterior and anterior tibialis Vastus medialis Gluteus maximus and medius Hip external rotators Hip flexors Thoracolumbar paraspinals Excessive pronation Look for the arch of the foot to collapse and flatten, eversion of the heel, or malalignment of the achilles tendon 55 | P a g e Excessive forward trunk lean Look for the trunk to lean forward and beyond ideal parallel alignment with the shins. Trunk rotation Look for the trunk of the body to rotate internally or externally during single-leg movements. Scapular elevation Look for the shoulders to move up toward the ears. Scapular winging Look for the scapulae to protrude excessively from the back, seen most prominently in a push-up position (specifically during the dynamic Davies test or when pushing). Arms fall forward Look for the arms to fall forward to no longer be aligned with the torso and the ears 56 | P a g e Excessive cervical extension (forward head) Look for the head to migrate forward, moving the ears out of alignment with the shoulders Bones of the knee Knee motions Proximal bones affecting the knee Distal bones affecting the knee 57 | P a g e Key muscles associated with the knee * Adductor complex * Gastronemius/soleus * Gluteus maximus and medius * Medial and lateral hamstring complexes * Tensor fascia latae (TFL)/IT-band Q-angle Patellar Tendinopathy (Jumper's Knee) Risk Factors *Knee valgus and varus *Increased Q-angle *Poor quad and hamstring complex flexibility *Poor eccentric deceleration capabilities *Overtraining and playing on hard surfaces Patellofemoral Syndrome Iliotibial Band (It-Band) Syndrome (Runner's Knee) 60 | P a g e RESULT: Greater number of muscle fibers involved SYMPTOMS: Moderate or severe pain, mild swelling, and possible discoloration. FUNCTIONAL ABILITY: Noticeable weakness Grade III (severe strain) RESULT: Complete tear of muscle fibers SYMPTOMS: Pop or ripping sensation and severe pain, swelling, and discoloration. FUNCTIONAL ABILITY: Loss of muscle function Normal shoulder joint Posterior shoulder girdle with markers Anterior shoulder girdle with markers Glenohumeral joint Major ligaments of Glenohumeral joint 61 | P a g e Scapulothoracic articulations Force-couple shoulder example Rotator cuff muscles SITS: Supraspinatus Infraspinatus Teres mino Subscapularis Shoulder impingement syndrome Acromioclavicular separation 62 | P a g e