Upper-Extremity and Lower-Extremity Corrective Strategies
Upper-Extremity and Lower-Extremity Corrective Strategies
This domain tests region-specific patterns: scapular control and shoulder mechanics; hip, knee, and ankle alignment. Expect you to match a common dysfunction to an ILEA plan and to avoid chasing pain.
Core rules
- Upper extremity: scapular dyskinesis, forward head, and rounded shoulders often pair with tight pectorals, upper trapezius, levator scapulae, and lats; weak lower trapezius, serratus anterior, rhomboids, and deep cervical flexors. Corrective work includes thoracic mobility, scapular retraction and depression, and external-rotation control.
- Shoulder impingement precautions: avoid painful overhead end-range until scapular control and thoracic extension improve; refer for night pain, weakness, or loss of range.
- Lower extremity: knee valgus, patellofemoral pain, and pronation often pair with tight calves, TFL/IT band, adductors, and hip flexors; weak gluteus medius and maximus, tibialis posterior, and intrinsic foot muscles.
- Ankle dorsiflexion is a common limiter; test it in a half-kneeling position with the heel down.
- Corrective plan should include proximal control (hip and pelvis), local mobility (ankle or thorax), and the exact task that failed.
Worked example
A client with rounded shoulders and overhead reaching pain. Reasoning: the scapula cannot upwardly rotate because thoracic extension and serratus/lower trapezius control are poor, while pectorals and upper traps are overactive. Inhibit pecs and upper traps, lengthen pecs and lats, activate serratus and lower traps, integrate a wall slide or overhead reach with rib control. Do not just stretch the shoulder into painful range.
Traps
- Stretching the painful joint as the whole plan.
- Ignoring the ankle when the knee collapses.
- Using open-chain activation only and never integrating the failed task.