Understanding LPHC Compensations in the Overhead Squat Assessment: Addressing Imbalances with NASM’s Corrective Exercises.

The lumbo-pelvic-hip complex (LPHC) is often referred to as the “core” of the body and serves as the foundation for nearly all functional movements.  When imbalances or dysfunctions exist within the complex, they can significantly impact performance, increase the risk of injury, and lead to compensations in other areas of the body.

Understanding the Overhead Squat Assessment (OHSA)

The overhead squat assessment (OHSA) is a cornerstone of the NASM’s assessment protocols.  It is a dynamic movement assessment that provides insight into the client’s overall movement quality, revealing potential muscle imbalances, joint dysfunctions, and compensations.  During the OHSA, the client performs a squal while holding a bar overhead.  The movement is observed from the anterior, lateral and posterior views to identify any deviations from ideal alignment.

Common LPHC Compensations in OHSA

When assessing the LPHC during the OHSA, several common compensations may appear:

1. Excessive Forward Lean
   • Description: This occurs when the torso leans to far forward during the squat.
   • Possible Causes: Tightness in the hip flexors, abdominal complex, or calves; weakness in the glutes, hamstrings, and core stabilizers.
2. Low Back Arches (Anterior Pelvic Tilt)
   • Description: The lower back excessively arches, creating an exaggerated lumbar curve.
   • Possible Causes: Overactivity of the hip flexors and erector spinae; underactivity of the glutes, hamstrings, and core stabilizers.
3. Low Back Rounds (Posterior Pelvic Tilt)
   • Description:  The lower back rounds excessively, leading to a flattening of the lumbar spine.
   • Possible Causes: Tightness in the hamstrings and rectus abdominals; weakness in the erector spinae and hip flexors.
4. Asymmetrical Weight Shift
   • Description: The client shifts their weight to one side during the squat.
   • Possible Causes: Muscle imbalances between the left and right sides of the body such as tightness in the adductors or quadratus lumborum, and weakness in the gluteus medius.

Addressing LPHC Compensations with NASM’s Corrective Exercises

The NASM Corrective Exercise Continuum (CEx) offers a systematic approach to correcting thse compensations by focusing on the four phases: Inhibit, Lengthen, Activate, and Integrate.  Each phase targets specific aspects of the muscular and neuromuscular systems to restore proper function and improve movement patterns

1. Inhibit Phase: Releasing Overacting Muscles

The Inhibit phase focuses on reducing tension in overactive muscles through self-myofascial release (SMR) techniques such as foam rolling.  By inhibiting the overactive muscles, you allow the underactive muscles to function more effectively, setting the stage for proper muscle balance.

• Excessive Forward Lean: Overactive muscles include the hip flexors, abdominal complex, and calves.  Foam rolling these areas can help reduce tension and improve movement patterns.
• Low Back Arches: Overactivity is commonly found in the hip flexors and erector spinae.  SMR on the muscles can help alleviate the excessive arching.
• Low Back Rounds: The hamstrings and rectus abdominis are typically overactive.  SMR can help reduce tension in these muscles.
• Asymmetrical Weight Shift: Overactive muscles might include the adductors and quadratus lumborum on one side.  Foam rolling these muscles can help balance out the muscle activity.

2. Lenthen Phase: Stretching Tight Muscles

The Lengthen phase involves static stretching of the overactive and tight muscles identified in the Inhibit phase.  Static stretching helps improve the flexibility of these muscles, allowing for greater range of motion and improved movement patterns.

• Excessive Forward Lean: Static stretching of the hip flexors, calves, and abdominal complex can ehlp correct the forward lean by improving flexibility in these areas.
• Low Back Arches: Stretching the hip flexors and erector spinae can reduce the excessive arch in the lower back.
• Low Back Rounds: Focus on stretching the hamstrings and rectus abdominis to reduce the rounding of the lower back.
• Asymmetrical Weight Shift: Stretching the adductors and quadratus lumborum on the dominant side can help address.

3. Activate Phase: Strengthening Underactive Muscles

The Activate phase is centered around strengthening underactive muslces that are not functioning optimally.  This phase often includes isolated strengthening exercises to specifically target these muscles.

• Excessive Forward Lean: Strengthening the glutes, hamstrings, and core stabilizers can help correct the excessive forward lean.
• Low Back Arches: Focus on strengthening the glutes, hamstrings , and deep core stabilizers to support the lower back and reduce arching.
• Low Back Rounds: Strengthening the erector spinae and hip flexors can help reduce the posterior pelvic tilt and rounding of the lower back.
• Asymmetrical Weight Shift: Strengthen the gluteus medius and core stabilizers on the weaker side to correct the imbalance.

4. Integrate Phase: Reinforcing Proper Movement Patterns

The Integrate phase focuses on re-establishing proper movement patterns by incorporating the newly balanced muscles into functional movements.  This phase uses exercises that mimic real-life activities to ensure that the corrections carry over into everyday movements.

• Excessive Forward Lean: Incorporate exercises that reinforce proper squat mechanics, such as goblet squats or overhead squads with a focus on maintaining an upright torso.
• Low Back Arches: Use exercises like bridges, planks, and deadlifts to reinforce proper pelvic alignment and core stability.
• Low Back Rounds: Incorporate exercises that promote proper lumbar alignment, such as bird dogs or stability ball rollouts.
• Asymmetrical Weight Shift: Use single-leg exercises like step- ups, single-leg deadlifts, and lateral lunges to reinforce blance and proper weight distribution.

Detailed Breakdown of LPHC Compensations

1. Excessive Forward Lean

Inhibit Phase

• Focus Areas: Hip flexors, abdominal complex, calves.
• SMR Techniques: Foam rolling the hip flexors, calves, and thoracic spine to improve spinal extension.

 

Lengthen Phase

• Stretching Techniques:  Static stretches for the hip flexors (kneeling hip flexor stretch), calves (standing calf stretch), and the abdominal complex (cobra stretch) to increase the range of motion.

 

Activate Phase

• Strengthening Exercises:
  • Glute Bridges: Focuses on activating glutes to counteract the hip flexors.
  • Plank Variations: Strengthens the core stabilizers.
  • Leg Curls: Strengthen the hamstrings, particularly in isolation.

 

Integrate Phase

• Functional Exercises:
  • Goblet Squat: Reinforces proper squatting mechanics with and emphasis on maintaining an upright torso.
  • Overhead Squat with Light Resistance: Focus on maintaining a neutral spine and avoiding forward lean.

 

2. Low Back Arches (Anterior Pelvic Tilt)

Inhibit Phase

• Focus Areas: Hip flexors, erector spinae.
• SMR Techniques: Foam rolling the hip flexors and lumbar spine to reduce tension in the lower back.

 

Lengthen Phase

• Stretching Techniques: 
  • Kneeling Hip Flexor Stretch: Targets hip flexors and quads.
  • Child’s Pose: Stretches erector spinae and promotes lumbar function.

 

Activate Phase

• Strengthening Exercises:
  • Glute Bridges: Activate the glutes to counteract anterior pelvic tilt.
  • Dead Bugs: Strengthens deep core stabilizers like the tranverse abdominals.
  • Hamstring Curls: Further strengthen the posterior chain.

 

Integrate Phase

• Functional Exercises:
  • Bridge March: Focuses on maintaining pelvic stability.
  • Deadlift Variations: Reinforces proper hinge mechanics, preventing lumbar hyperextension.

 

3. Low Back Rounds (Posterior Pelvic Tilt)

Inhibit Phase

• Focus Areas: Hamstrings, rectus abdominals.
• SMR Techniques: Foam rolling hamstrings and lower back to reduce tightness.

 

Lengthen Phase

• Stretching Techniques: 
  • Standing Hamstring Stretch: Increases flexibility of the hamstrings.
  • Cat-Cow Stretch: Promotes spinal flexibility.

 

Activate Phase

• Strenthening Exercises:
  • Back Extensions: Focuses on strengthening the erector spinae.
  • Hip Flexor Marches: Strengthens the hip flexors in a controlled manner.
  • Bird Dogs: Enhances spinal stability and strengthens the lower back.

 

Integrate Phase

• Functional Exercises:
  • Stability Ball Rollouts: Promotes core stability and proper spinal alignment.
  • Single-Leg Deadlifts: Emphasizes hip hinge mechanics while maintaining lumbar stability.

 

4. Asymmetrical Weight Shift

Inhibit Phase

• Focus Areas: Adductors, lower back.
• SMR Techniques: Form rolling the adductors and the lower back on the cominant side to alleviate tension (do not put foam roller directly on your spine).

 

Lengthen Phase

• Stretching Techniques: 
  • Adductor Stretch: Targets the inner thigh muscles.
  • Quadratus Lumorum Stretch: Promotes lateral flexibility and reduces overactivity.

 

Activate Phase

• Strengthening Exercises:
  • Side Plank: Strengthens the lateral core, including the gluteus medius and obliques.
  • Clamshells: Activiates the gluteus medius to improve lateral stability.
  • Lateral Band Walks: Enhances hip stability and corrects imbalances.

 

Integrate Phase

• Functional Exercises:
  • Step-Ups with Opposite Leg Lifts: Reinforces balance and proper weight distribution.
  • Lateral Lunges: Emphasizes equal loading on both sides, promoting symmetry.

 

Getting on With the Program

When moving forward with your workout program always keep in mind what your goals are, fitness level, and any existing conditions.  The NASM Corrective Exercise Continuum provides a structured approach, but each phase should be tailored to your needs.  Additionally regular reassessments using the OHSA is helpful to track progress and make necessary adjust ments along the way.

Progression and Adaptation

• Start with the Basics: Begin with each exercises in each phase, focusing on proper form and control.  For instance, start with bodyweight exercises before adding resistance.
• Increase Complexity: As a client demonstrates improved movement patterns, gradually increase the complexity and intesnity of the exercises.  this might involve progressing from static stretches to dynamic stretches or from isolated activation exercises to more complex, multi-joing movements.
• Monitor and Adjust: Regularly monitor your progress and adjust the program as needed.  If compensations persists, revisit earlier phases of the CEx to ensure the foundational issues are addressed before progressing.

Case Study

To illustrate the application of the NASM Corrective Exercise Continuum:

• Client Profile: A 35-year old ofice worker with a history of lower back pain and sedentary lifestyle.  During the OHSA, the client exibits excessive forward lean and an anterior pelvic tilt.
• Corrective Exercise Plan: 
  
  • Inhibit: Foam roll the hp flexors, calvs, and lumbar spine.
  • Lengthen: Perform static stretches for the hip flexors, calves, and erector spinae.
  • Activate: Incorporate glute bridges, plank variations, and hamstring curls.
  • Integrate: Practice goblet squats and deadlift variations with an emphasis o maintaing proper pelvic alignment.
• Progression: After 4 weeks, the client shows improvement in their squat form and reports reduced lower back pain.  the program is then progressed to include more dynamic exercises such as single-leg deadlifts and overhead squats with light resistance.

 

Conclusion

The overhead squat assessment is a powerful tool for identifying LPHC compensations and designing tarted corrective exercise programs.  By systematically addressing these compensations using the NASM 4 phases of corrective exercises– Inhibit, Lengthen, Activate, and Integrate– as a fitness professional I utilize this strategy for the prupose of helping my clients restore optimal movement patterns, reduce risk of injury, and enhance overall performance.

Whether your an athlete, office worker, or anyone in between, understanding and addressing LPHC compensations is key to prooting long-term health and functionality.  By implementing the strategies outlined, you can become empowered to move better, feel better, and achieve your fitness goals.

 

References

1. Clark, M.A., Lucett, S.C., & Sutton, B.G. (2014).  NASM Essentials of Corrective Exercise Training. Jones & Bartlett Learning.