Lindsay Tyburski
Movement Analysis Project
Kinesiology
Fall 2012
Dr. Biren
Demographics:
Name: Melanie Wittenberger
Age: 21
Gender: female
Height: 5’2; 157 cm
Weight: 125 lbs; 56 kg
BMI: 22.9
Sports Participated in : soccer
Physical Goals: Hopes to regain full stability and strength from most recent knee surgery which occurred
in December 2012. Plans on working on agility, quadriceps and hamstring strength to limit pain and
increase mobility.
Physical History:
Injuries:

2 right ACL tears

2 right meniscal tears

Left ACL tear

Numerous quadriceps pulls

Numerous hamstring pulls

Umbilical hernia
Orthopedic Surgeries:
2008: left acl reconstruction. Patellar autograft
2010: right acl reconstruction, and meniscal tear. Patellar autograft
2011: right acl reconstruction, and meniscal tear. Cadaver allograft.
Limits: Can no longer compete competitively. Also, has to be extremely careful cutting and running.
Pain limits her activity occasionally.
Summary:
Based on the demographics I found that Melanie is in good physical condition. She has a healthy body
weight for her age and appears to be in good physical shape. She is athletic, but due to injuries she has
had to cut down on the intensity of certain sports and the frequency in which she can participate in
these activities. Melanie has already had three major knee surgeries which already have a negative
impact on her daily life. From these surgeries she has to physically limit herself from performing at her
best. Because she has knee injuries it is possible that there are other injuries which may occur, due to
the kinetic chain. These injuries could affect other body parts and prevent her from reaching her goals if
the pain continues. From what I have learned about her so far, I would say that there are some things
she can begin to do to help reach her goals. She can begin another rehab program to strengthen her
knee muscles. During this program she should focus on her knee range of motion in all three aspects,
active, passive and resistive. Also she should strengthen her hip and ankle muscles to prevent injuries to
the other body parts which could be negatively impacted by the kinetic chain.
Range of Motion:
Cervical spine (sagittal plane & mediolateral axis):
75°

Cervical flexion: 50°

Cervical extension: 75°
50°
 Cervical flexion is a little less than normal range
Cervical spine (frontal plane & anteroposterior axis):
45°
45°

Lateral flexion right: 45°

Lateral flexion left: 45°
 Normal
Cervical spine (transverse plane & vertical axis):

Cervical rotation right: 80°

Cervical rotation left: 80°
80°
80°
 Normal
Shoulder (frontal plane & anteroposterior axis):
150° 145°

Flexion right:150°

Flexion left:145°
 Both sides are lower than the normal range
Shoulder (sagittal plane & mediolateral axis):

Flexion right: 170°

Flexion left: 170°
170°
170°
 Normal
Elbow (transverse plane & vertical axis):

Internal rotation right: 80°

Internal rotation left: 95°

External rotation right: 110°

External rotation left: 100°
100°
110°
 Both sides are slightly hypermoble
95°
80°
Knee (sagittal plane & mediolateral axis):

Extension right: 0°

Extension left: 0°
0°
0°
 Normal
Hip (sagittal plane & mediolateral axis):

Flexion right: 80°

Flexion left: 70°
70°
80°
 Both sides are slightly under the normal range of motion
Hip (frontal plane & anteroposterior axis):

External rotation right: 45°

External rotation left: 45°

Internal rotation right: 30°

Internal rotation left: 30°
45°
45°
 Normal
30°
30°
Knee (sagittal plane & mediolateral axis):

Flexion right: 130°

Flexion left: 120°
120
°
130°
 Both sides are slightly under the normal range of motion
Summary:
Melanie for the most part had normal range of motions throughout each segment that
was evaluated during the lab. Where she did have deficits it was usually only lower by 10 °,
which isn’t terrible. She has had many injuries in the past and that is most likely why she has some range
of motion issues. By increasing her flexibility and stretching the joints on a regular basis she will be able
to increase her range of motion and get all of them to normal limits. The places where I saw not normal
range of motion was cervical flexion, shoulder flexion on the left and right side on the frontal plane, hip
flexion, and knee flexion. Because of her previous injuries that could explain why she has limits with the
knee and even hip flexion. The other range of motions could be due to lack of flexibility or using the joint
in certain ways. These could easily be improved by focusing on the specific joint and stretching them. I
believe that if she improves this range of motion that she will be able to reach her goals of getting her
knee back to normal conditions since her surgeries and also getting full range of motion in her
quadriceps and hamstrings.
Postural Assessment
Frontal View:

Eyes Aligned: Yes

Acromioclavicular Joint Aligned: Yes

Anterior Superior Iliac Spine Aligned: Yes

Patella Height: Even

Patella Forward: Yes

Genu Valgum: No

Genu Varum: No

Feet Face Forward: Yes
Sagittal View:

Head Protruded: No

Protracted Shoulder Girdle: No

Kyphosis: No

Excessive Lordosis: Yes, slight

Reduced Lordosis: No

Genu Recurvatum: No
Posterior View:

Winged Scapula: No

Feet Evert: No

Feet Invert: No
Summary:
Melanie overall has very good posture. From analyzing all of the basic body landmarks
for posture, they all appeared to be in line. This is very beneficial to her, proving that there are
no structural issues that will be presented to increase her chance at injury, the only thing that
could be problematic would be if she has functional issues. She does have a slight excessive
lordosis, but because it is sight, it will not cause her a big problem. Because of her good posture,
it will be easier for her to reach her initial goals of regaining her strength and flexibility of her
knee and increasing her quadriceps and hamstring strength and mobility. The only correction I
would give to her would be to increase her flexibility of her hip flexors which would decrease
her excessive lordosis.
Overhead Squat Assessment
Frontal View:

Knees Align with Foot: Yes

Feet Face Forward: No
o
Slight abduction of the right foot
Sagittal View:

Normal Forward Flexion: Yes

Normal Lumbar Lordosis: Excessive lordosis

Arms Remain in Line: Yes
Posterior View:

Feet Evert: No

Heels Rise Off Floor: No

Asymmetrical Shift: No
Summary:
Overall Melanie had very good posture during the overhead squat analysis. During the anterior
view I did notice a slight abduction of her right foot; this could be caused by an over-active soleus or
lateral gastrocnemius muscles or an under-active medial gastrocnemius muscle. Additionally from the
sagittal view I noticed an excessive lordosis. This could be caused by tight hip flexors and a weak inner
core. By saying this, I would conclude that her erector spinae, hip flexors, and latissiumus dorsi are overactive and her hamstrings and anterior core is under-active. I would recommend her doing calf raises to
strengthen her gastrocnemius muscles. I would say that she should be able to complete her goals she
had set at the beginning of this assignment and should not have any complications due to overhead
squat dysfunctions.
Gait Analysis
Postural View:
Stance Phase:

Hip Position: proper position, goes from flexion into extension during proper time

Knee Position: flexes and extends during proper time

Ankle Position: goes from plantar flexion into dorsiflexion at proper time
Foot Flat:

Hip Position: Flexion

Knee Position: Extension

Ankle Position: Neutral position, flat foot
Mid-Stance:

Hip Position: Slight flexion

Knee Position: Extension

Ankle Position: Neutral Position, flat foot
Heel-Off:

Hip Position: Extension

Knee Position: Extension

Ankle Position: Plantar Flexion
Toe-Off:

Hip Position: Extension

Knee Position: Extension

Ankle Position: Plantar Flexion
Sagittal View:
Swing Phase:
Initial Swing:

Hip Position: Extension

Knee Position: Slight flexion

Ankle Position: Plantar flexion
Mid-Swing:

Hip Position: Extension

Knee Position: Flexion

Ankle Position: Plantar Flexion
Terminal Swing:

Hip Position: Flexion

Knee Position: Flexion

Ankle Position: Plantar Flexion
Summary:
After doing a gait analysis on Melanie I observed she had a very good gait cycle. All of
her joints were doing the correct mechanism during the right stance. Her foot during the initial
heel contact began with supination and then rolls into pronation with her leg externally
rotating. During the midstance her foot moves into pronation and leg into internal rotation
which helps her to have proper movement. Additionally her foot moves into supination and leg
external rotates during toe off allowing her to properly finish her step. Because she has strong
hip flexors the swing phase is easily completed with proper mechanics. I did not notice any
abnormalities within her cycle that would contribute to negatively affect her gait cycle. Because
she has no dysfunctions I feel as if she will be able to reach her initial goals at the beginning of
this assessment.
Corrective Exercise Program
Improve Range of Motion:

Cervical Flexion
o Neck Rolls: standing with feet shoulder width apart begin by putting neck into
flexion, then put back into the neutral position and begin rotating your neck in
slow circles progressively making the circles larger

By doing these daily, it will help to use the neck muscles which then will
help stretch and strengthen them. By strengthening her sternoclavoid
mastoid it will increase her range of motion. This will improve the flexion
range of motion and hopefully get Melanie back to normal range of
motion of her neck

Shoulder Flexion on Frontal Plane
o Shoulder Flexion Stretch: standing I doorway flex shoulder joint by placing
extended elbow on door frame, move truck forward to position shoulder joint as
close to 180 degrees of flexion, then flex the elbow and attempt to externally
rotate shoulder joint.

This will increase her latissiumus dorsi muscle which is a big contributor
to the shoulder in means of flexion. It will also stretch her
inferior/posterior capsule. By incorporating this exercise into her daily
routine, it will slowly improve her range of motion because if these
muscles are strengthened it will allow for her range of motion to return
to its normal positioning. By focusing on these three specific aspects
during shoulder flexion it will allow her to have greater flexibility in her
shoulder joint.

Hip Flexion
o Straight Leg Raise: Laying supine on table, slowly raise leg 45°and hold to 2
seconds then bring back to table

This exercise focuses on strengthening the hip flexors which are essential
in flexing the hip

Once Melanie stretches her hip flexors it will increase her flexibility of her
hip which in turn will positively affect her range of motion. If she focuses
on exercises similar to this, she will be able to increase her hip flexor
strength.

Knee Flexion
o Single Leg Dead Lifts: standing on one foot with the knee slightly flexed, flex the
hip and reach downward to the floor and return, focus on keeping the knee in
proper alignment

This stretch will train the proprioceptors to maintain the proper knee
position. It also focuses on hamstrings which will help with her ACL
strengthening. Additionally, if she stretches her quadriceps and core it
will help her increase her knee flexion. Because she did have an injury to
her knee, if she does this exercise it will help to increase her strength of
her knee and hamstrings which in turn will improve her range of motion
of her knee.
Improve Posture:

Excessive Lordosis
o Lunge Stretch: Stand with feet shoulder width apart then step as far forward
with one leg as possible shifting weight to that leg keeping the foot flat on the
floor. Place hands on knee and bend knee further to the floor.

This will help to increase flexibility of the hip flexors which will allow the
hip to be in proper alignment decreasing the anterior tilt of the pelvis.
When the hip flexor is tight it pulls the pelvis forward. The hip flexor is a
huge contributor to excessive lordosis; because when the hip is
anteriorally tilted it is a sign that hip flexors are tight. So if she can
improve her hip flexor strength it will help to decrease the pelvic tilt
which will eliminate her excessive lordosis.
o Pelvis Tilt: Lying on back with knees bent and feet flat place hands under your
lower back, squeeze abs tight and roll pelvis backward as if trying to flatten your
lower back

This will help to stretch the erector spinae which if tight causes an arch in
the lower back. This also will strengthen her core which is necessary to
improve her proper lordosis. During excessive lordosis it is common that
the core is weak, so if she does this exercise it will improve her core
strength which will allow for her pelvis to be in correct alignment, which
will eliminate her excessive lordosis.
Improve Overhead Squat:

Foot Abduction
o Standing Wall Calf Stretch: Stand toward the wall with foot on the wall at a
slight angle, keeping heel on the floor turn that foot so toes are pointing inward,
lean towards the hip to the side and forward until feel a stretch

This exercise focuses on stretching the medial gastrocnemius which when
under-active causes abduction of the foot. If this muscle is stronger then
it will reduce her foot abduction when squatting. It will allow her foot to
stay in a neutral position if her medial gastoc is strengthened.

Excessive Lordosis
o 90/90 Stretch: Flex the hip to 90° then slowly extend the knee making sure
contra lateral leg is flat on the floor with the knee in extension. Extend the knee
until end range making sure the hip stays at 90°.
o If she stretches her hamstring it will help to keep the pelvis in line and will
eliminate any lordosis of her back. It will increase the strength of the hamstring
which will allow for a normal pull of the muscle which will eliminate lordosis
issues.
o Plank: Place elbows on the floor underneath shoulder and toes on the floor with
legs shoulder width apart. While keeping back straight lift body off the floor and
pull in stomach toward spine.
o By strengthening her core it will help keep her spine in a neutral position. The
core plays a major role in the position of the spine and if she can strengthen her
core it will pull her spine forward and in line which will eventually eliminate any
lordosis problems.