IW: Volleyball Player with history of shoulder and knee problems

Physical Exam Findings on 12-10
- Standing Postural Assessment
  - Moderate pronation bilateral slightly more so on the L
  - Increase in R hamstring resting muscle tone
  - Increase hypertrophy( Muscle mass) lateral quad compared to medial quad
  - Increased L scapular winging compared to R
- Standing Active Motions
  - Forward bend to back bend with increased weight bearing on the L
  - Mild restriction noted in L overhead shoulder motion
  - Excessive lumbar arch with lack of movement through the mid back
  - Increased L trunk rotation compared to R
  - Increased L sidebend compared to R
  - Squat
    - Valgus and increased pronation with increase in weight shift onto the toes with audible crepitus in bilateral knees
  - Dynamic single leg balance with front to back reach
    - Moderate instability more so on the L with inward collapse of the knee
- Laying assessment
  - Significant flexibility deficits in bilateral quad flexibility, more so on the L
  - Restriction in posterior hip mobility bilaterally
Daily Movements that can be used as a warm up/cool down pre/post volleyball
- 10-20reps of each lightly
- H-31 Heels to Butt on Floor Phase 1 VIDEO
- Quad stretch options (Pick One)
  - H-6 Seated Quad Stretch Foot Under Chair VIDEO
  - H-7 Standing Foot in Hand Quad Stretch VIDEO
- M-9 Shoulder Flexion Laying->Wall Sit->Seated Against Wall VIDEO
  - Try 3 hand positions start wide and move closer together
  - Lying on your back is obviously easier then standing back to wall
    - Start on your back and progress to wall as able
- M-10 Sidelying Thoracolumbar Rotation Stretch VIDEO
  - Another thoracic and pec mobility option
- Seated (Pick One)
  - The back of your hip was pretty stiff and can contribute to some difficulty getting into deep squat
  - Choose the movement below you feel works the best for you
  - H-12 Cross Leg Contract Relax Posterior Hip VIDEO
  - H-13 Cross Leg Posterior Hip Stretch VIDEO
  - H-14 Cross Leg Pigeon Pose Regression VIDEO
Strength Circuits
- These sequences are some options to mix into your strengthening routine
- I would try to put one of these at the end of a workout. You can try a different one each time.
- I set a goal for each movement of 8-20 reps SLOWLY
- If you are getting to 20 reps then you are ready to progress that movement
- Each circuit do the first set trying to get 8-20 reps of each movement, then do a second time through doing 1/2 as many reps as the first set.
- Circuit #1
  - H-18 Laying on Back Weighted Pull Over VIDEO
  - Bridge Progression Physio Ball (Pick One, they are in order easy to hard)
  - H-46 Upper Body Assisted Squat VIDEO
    - do it slow on the way down
    - Can progress to:
      - H-46H Reverse Lunge VIDEO
  - Side Plank Progression (Pick One)
- Circuit #2
  - H-48A Sidelying Leg Raise Progression to a Stretch VIDEO
  - Step Hip Extension with Push Off Progression (Choose 1)
  - S-27B Wall Sit Active/Band Abduction VIDEO
    - Pay attention to shoulder position
  - Bosu Balance Progression (30-2min each, then progress once you get to 2 min to next movement)