MOVEMENT ANALYSIS PROJECT MORGAN MENDE PARTNER: KELLIE CAMPBELL KINESIOLOGY DR. BIREN MW 12:05- 1:30 2. Demographics Name: Gender: Age: Morgan Mende Female 20 Height (in&cm): 6’0 & 182.88 cm Weight (lbs&kg): 160 lbs & 72.5748 BMI: 21.7 3. Review of Physical History Medical Conditions: Do you have any existing or pre-existing injuries that will affect your movement? Yes, had ankle surgery July 2011 on my right ankle (OCD of talus), bad lower back that has been bothering me since February 2013. Family History: Do you have any family history that might affect the way you move? N/A Current Exercise: Briefly explain your level of exercise as of now. (Number of days you workout per week, intensity of workout, what the workout consists of.) Play varsity volleyball at Rowan, play/practice 6 times a week at a very high intensity. Weight training full body 2 times a week with some restrictions due to my back. Ankle/back strengthening program 4 times a week. Does your current job and/or daily activities affect your movement patterns? Sometimes, if I am sore from volleyball or lifting the next day I will not perform to my maximum ability. Is there any other concerns that you have that might affect the way you move? N/A 4. Movement Goals Increase Flexibility for my Hamstrings, Quadriceps. o Increasing my flexibility in these areas will help me tolerate my lower back pain. Increase Vertical Jump o Being a middle blocker in volleyball I need to jump high to hit and block. Increasing my vertical with increase my Increase lateral speed o I want to increase my lateral speed so in volleyball I can get to the outside from the middle faster to set up the block. Strengthen Ankles o Having to get my right ankle taped everyday for volleyball is weakening my ankle. o I have been doing strengthen exercises with the athletic trainers before practice to strengthen both ankles o Need to strengthen both ankles so it is harder to roll my ankles while jumping and moving laterally Strengthen Core o Having a bad lower back and knowing I will be living with it forever, I need to strengthen my core so the pain will decrease and more controllable. 5. Summary After finishing the first four steps of this project I have a better understanding of where I stand as an active person and what I need to work on. Reviewing my demographics I realized that I stand at a normal weight for my height according to the BMI calculation. With my medical conditions I know I have a few set backs but I can somewhat control how much these set backs affect my life. Having ankle surgery was the biggest fitness set back I have went through, I was out of volleyball for eight months and having to miss my freshman year season was not the way I wanted to start college. Keeping my ankles strong is one of my top priorities when it comes to volleyball. With my back injury the doctor said it was all muscular so I can play through the pain as long as it doesn’t get out of hand. I need to take rehab seriously so I can control the amount of pain. My goals are mostly related to my injuries, I never want to go through the stress and pain of my past injuries again. I also don’t want to sit out of any more volleyball or fitness. I want to increase flexibility in my hamstring and quadriceps, increase my vertical jump, increase my lateral speed, strengthen ankles, and strengthen my core. All my goals are very important to me, they all will help me become a better volleyball player and even a better physically active person. I am doing a good job when it comes to strengthening my ankle, and core. I do need to spend more time working on my flexibility, just because my back is feeling okay now I don’t want the pain to come back. I’m excited to work at my goals and improve my movement. 6. Range of Motion Assessment 1) Cervical Spine Neutral Position- Sagittal View Neutral Position- Frontal view Cervical Spine Flexion 45 Cervical Spine Extension 65 Neutral Position Cervical Spine Rotation 85 Cervical Spine Rotation 85 Neutral Position Lateral Flexion (Right) 40 Lateral Flexion (Left) 45 2) Glenohumeral Joint Neutral Position Abduction 180 Abduction 175 Neutral Position Shoulder Flexion (L) 175 Neutral Position (L) Internal Rotation (L) 80 Neutral Position (R) Internal Rotation (R) 75 Shoulder Flexion (R) 175 External Rotation (L) 80 External Rotation (R) 85 Neutral Position Leg Extension (R) 85 Hip Flexion (R) passive 100 Leg Extension (L) 85 Hip Flexion (L) passive 90 Knee Flexion (R) 140 Neutral Neutral Position (L) Knee Flexion (L) 140 Internal Hip Rotation 30 Internal Hip Rotation 25 External Hip Rotation 45 External Hip Rotation 40 Neutral Position Hip Flexion (R) 110 Hip Flexion (L) 105 Knowing that I have lower back pain I need to concentrate on increasing my hip flexion and leg extension flexibility due to the fact that I cannot afford to sit out any more time in volleyball, and post-volleyball life the doctors told me I will be living with this pain the rest of my life. It is my choice how much I want to work on strengthening my core and increasing my flexibility now to decrease the amount of pain I will have in the future. Not only as an athlete now but later on in life being flexible will help my body ease through the “getting old” pains. I cannot only increase my flexibility in my hamstrings but also my quadriceps so I don’t have an imbalance in my leg flexibility. Along with many other females my hips are not the strongest, and strength comes with flexibility. Having bad hip stability and flexibility has also lead to my lower back pain. There is always room for improvement, which will help more in the long run than right now. No one wants hip replacements but they are becoming more of an option to women with hip pain when they get older. I do not want to even think about having this surgery done, so that gives me motivation to work hard on hip flexibility and strengthening the hip area. 7. Postural Analysis Neutral Position Sagittal View Posterior view While analyzing my posture I was actually surprised, I thought I was going to have more of a kyphosis than what is shown. This can be caused by a lot of different things including working at a computer all day for my summer job, and volleyball. In volleyball when we play defense we are told to “roll our shoulders forward” (protracted shoulder girdle) which will create a kyphosis and upper cross syndrome. Looking at the sagittal view picture I can tell I have an excessive lordosis because my lumbar spine has a large arch, which will cause my pelvis to anteriorly tilt. Having an excessive lordosis in my lumbar spine is definitely a key factor as to why I have low back pain. Moving down to my knee joint, I can asses that I have a minor genu valgum. This is because I have a larger Q angle, having genu valgum will put more force on my medical collateral ligaments and anterior cruciate ligaments that help support my knee. Playing on a high-level volleyball team, I am constantly jumping and rotating so my MCL and ACL need to be strong. Looking at my feet you can see that I have high arches which causes my ankle to evert. Not only do my feet evert I have bunions on both my right and left feet, this causes instability while doing anything including just walking. By doing the postural assessment I can conclude that my posture is a main component as to why I have pain in my lumbar spine, and by knowing this it will help me reach my goals. I know I need to work on my flexibility and strength of my core so there is less stress put on my lumbar spine. 8.) Overhead Squat Assessment Neutral Position Anterior view Sagittal view (right) Posterior view Sagittal view (left) When performing the overhead squat my knees move medially so a valgus force is created. Knowing that, I can conclude that my hip adductors are overactive, and my gluteus medius along with my hip external rotators are under active. Looking at the sagittal view pictures it is shown that I have and excessive lumbar lordosis, having this means my erector spinae and hip flexors are overactive, and my rectus abdominus, anterior core, and hamstrings are underactive. In the sagittal view my arms extend out in front more so than up. This infers that my latissimus dorsi and pectoral muscles are overactive, and my middle and lower trapezius and posterior deltoid are underactive. The posterior view shows that my feet evert so my peroneal muscles are overactive and my tibialis posterior and anterior are underactive. There is a difference between my left and right foot, my right ankle is more everted than my left. This is because I had surgery two years ago for osteochondral dissecans of my right talus. Along with that I rolled my right ankle three times in the past two weeks and sprained a ligament in it last Saturday during my game. I need to be careful when I squat because of all the set backs I talked about in this section, including my low back pain, after every time I squat my lumbar spine will be sore for a few days. I try and switch out squats and do leg presses instead. The leg press machine helps me keep my knees in line and takes pressure off of my lumbar spine. Knowing what I need to fix when I squat will help me reach my goals by not allowing myself to squat incorrectly, and concentrate on working on my underactive muscles. 9.) Gait Analysis Posterior View Walking: Heel Strike Midstance Toe off Posterior View Jogging: Heel Strike Midstance Toe off While reviewing my pictures for the posterior view of walking and running, I noticed that my knees are moving medially so a valgus force is created. With that I now know my hip adductors are overactive, my gluteus medius, and hip external rotators are under active. This view also shows that my feet evert which means my peroneal muscles are overactive and I need to work on my tibialis posterior and anterior. My Heel Strike shows that I have some pronation occurring which will affect my whole kinetic chain. During the midstance phase my tibia internally rotates and my foot goes into pronation. For the Toe Off phase my tibia moves into external rotation and my foot moves into supination. Sagittal View Walking: Heel Strike Loading Phase Midstance Toe Off Sagittal View Jogging: Heel Strike Midstance Loading Phase Toe off Looking at the Sagittal views I can tell in the heel strike that my tibia doesn’t have a large angle of external rotation, this is due to the fact that my foot goes into pronation instead of supination. My arches are weak which makes them collapse with every step, this affects my whole kinetic chain. During the Loading Phase my tibialis posterior is over-pronated which causes a valgus force on my knees. With the valgus force on my knees it will lead to weak gluteus medius causing my pelvis to tilt. Same thing with the midstance, my foot goes into pronation. For the Toe Off phase my foot is over pronated and that will cause a decrease in propulsive force. My tibia goes into external rotation during the Toe Off phase.