Assessing Your Client for the Loss of Stability

by Evan Osar, D.C. |   Date Released : 20 Mar 2013
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Evan Osar, D.C.

About the author: Evan Osar, D.C.

Dr. Evan Osar is the developer of the Integrative Movement Specialist™ certification designed specifically to aid the fitness professional establish themselves as an invaluable part of their client’s health care team. In addition to his chiropractic degree, Dr. Osar has earned national certifications through the American Council on Exercise (ACE), National Academy of Sports Medicine (NASM), National Strength and Conditioning Association (NSCA), and The Soma Institute – National School for Clinical Massage Therapy.

He is the founder of Fitness Education Seminars, DBA: The Institute for Integrative Health and Fitness Education, an education company with the mission of helping trainers and therapist recognize their role as a part of the solution to the health care crisis. An internationally renowned speaker, Dr. Osar presents for several national and international organizations including American Council on Exercise, Club Industry, SCW ECA 360, IDEA, NSCA, Perform Better, Medical Fitness Association, Asia Fit, FILEX, AECC, British Chiropractic Association and Norwegian Chiropractic Association.

He specializes in bringing advanced training and rehabilitation strategies to the fitness and bodywork professional that works with the pre and post-rehabilitation and general population client. Additionally, he has developed over a dozen resources including courses, manuals, and DVD’s to support the educational needs of the next generation of health care professional. His mission is to help fitness professionals think bigger about their role in the lives of their clients.

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Comments (5)

Houck, Michael | 07 Jun 2016, 22:05 PM

Very helpful information loved the video!

Osar, D.C., Evan | 09 Apr 2013, 13:22 PM

There are a couple things I look for in particular when assessing the pelvis and hips.Remember that when the pelvis is in neutral, it is in a slight anterior pelvic tilt. I use pubic symphysis to ASIS to determine neutral pelvis. I will have the client slide their own hand from their belly button down until it lands on the pubic symphysis and then have them place their other hand on the ASIS - their two hands should be in the same plane. If the ASIS is in front of the pubic symphysis they are in an anterior pelvic tilt and if the pubic symphysis is in front of the ASIS they are in a posterior pelvic tilt. You will have to look at both halves of the pelvis to ensure that they are not in a pelvic tilt. Then I will look at modified Thomas test to determine the length of their hip flexors. Rarely do I find the psoas to be short - generally it is over-lengthened and the tensor fascia latae and/or rectus femoriis are the short muscles.

Stamos, Peter | 05 Apr 2013, 14:07 PM

Thanks! I have one last question. In the video the woman you accessed demonstrated (in my eyes) an anterior pelvic tilt and a left pelvic/hip rotation. Each person has different reasons why the demonstrate this type of posture, but what are some of main factors that you look for?

Osar, D.C., Evan | 04 Apr 2013, 15:54 PM

Thank you for your question. Many of our clients are in a posterior pelvic tilt from excessive sitting. Most clients sit in a posterior pelvic tilt and end up with lumbar spine flexion - hence the reason for so much low back pain associated with the seated posture. Many of these individuals then exercise and are cued to 'squeeze the glutes' or 'contract their tushies' and a variety of other colorful analogies to get them to activate their posterior hip complex. Unfortunately many of these clients are already 'butt grippers' meaning they have too much activation in the posterior hip.They tend to over-clench or over-grip with the superficial gluteus maximus fibers as well as some of the deep external hip rotators which causes a de-centration of the femoral head within the acetabulum. This is what leads to the anterior femoral glide which is what we are looking for in the assessments above. For the clients that have a true anterior pelvic tilt, then some activation of the gluteals can help restore the pelvic position however even in these individuals, you have to be careful not to over-activate the posterior hip musculature because it ends up over-compressing the hip joint. Most pelvic tilt issues are related to faulty stabilization strategies (how the client is breathing and using their core muscles) of the trunk and pelvis and if this is not corrected, simply squeezing the glutes will just add to more dysfunction. Hope that helps.

Stamos, Peter | 03 Apr 2013, 13:46 PM

Can you explain why the gluteus maximus or external rotators of the hip would be the root of the problem for an anteriorly rotated hip? Also, which muscles from this example would need to be re-activated? Thanks

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