Single Leg Stance

What to look for

- Foot position – Pronated/Supinated
- Weight Shift – Will be greater to side of supination, less to pronated side
- Medial Malleolus height – Lower in pronation
- Keep it simple – don’t go searching for individual foot bone movement, look at the big
picture. How do they carry themselves on one leg?

Common findings – Supinated side

- Tibialis Posterior (primary driver of supination) facilitated for ipsilateral medial hip (psoas,
medial rec fem, adductors)
- Put the movement into your body. As you move your weight to the outside of the foot your
lateral hip will switch on as it loads, your medial hip will be pretty quiet.

Common findings – Pronated side

- Peroneals longus or brevis facilitated to lateral hip (Glute Max, Med, Min and TFL)
- Put the movement into your body. As you move your weight onto the inner foot your medial
hip will light up and your lateral hip will go quiet.

Common Findings – Bilateral pronation

- Multifidus or Lumbar Erectors facilitated to TVA/RA
- Put the movement in your body – to get both feet to pronate you need to anterior tilt your
pelvis, which shortens the lumbar spine and lengthens the abs

Common Findings – Bilateral Supination

- RA facilitated to Lumbar Erectors or Multifidus
- Put the movement into your body – to get both feet to supinate you need to posterior tilt
your pelvis, which shortens the abs and lengthens Lumber Erectors and Multifidus

Other tips
- Start on the supinated side – psoas is PH5. Pronated side may correct itself or may still
require correction
- If in doubt remember that if the weight is on the outside of the foot you need to look at
medial leg and if the weight is on the inside of the foot you need to look at the lateral leg
- These findings are really common and a great place to start but you don’t need to stop here.
Spend some time mimicking what you see in your clients and feel what happens around your
whole body. Does your breathing change, what does your head and neck do, how does you
hip, pelvis, spine move to accommodate the position?
- Level 2s should also consider subsystems and rotations

Case Breakout – Shinya

- Supinated left with big weight shift left
- Pronated right with very little weight shift
- WIC L psoas and adductor longus, R Gmax distal and Gmed
- Left Tib Post facilitated to Left psoas and adductor longus
- Still some dysfunction on left requiring further work
Long Head Biceps Tendon
Finding the Bicipital Groove
- Slightly cup your hand with your thumb tucked slightly in front of your palm. As you place
your hand over the deltoid your thumb will land roughly on the bicipital groove. You may
need to tweak your position depending on the size of your hand relative to your clients
shoulder
- Feel for whether everything feels level and relatively smooth or is the a hollow space in the
groove
- Hollow space = Biceps tendon medially displaced
- DON’T START BY LOOKING FOR THE TENDON. Look for the groove and if the tendon’s not
there expand your search to find the tendon.

Correcting medial displacement of the tendon

1. Test biceps long head at the shoulder to confirm WIC – caused by displacement of the
tendon NOT motor control pattern at this stage
2. Manually move the tendon laterally back into the groove and hold it there while repeating
the biceps test to confirm now SIC (not neural lock because you’re not TLing)
3. Palpate around the Coracoid process to look for high tone that could be pulling the long
head medially
4. TL any high tone spots and test for Neural Lock in long head biceps
5. Once you find a Neural Lock look for another shoulder or scapula muscle to pair it with.
Particularly with Pec Minor you will usually find it in a dysfunctional relationship with
something else around the scapula – mostly with antagonists. In other words disregard the
biceps tendon for a moment, go back to scapula/shoulder assessment and look for a
dysfunction involving the high tone muscle that gave you the neural lock on biceps
6. Use the rest of your protocol to resolve that dysfunction
7. Check the bicipital groove to see if the tendon is back in. If not mobilise it back in manually
by pressing it laterally while moving the arm from flexion, external rotation and supination
into extension, internal rotation and pronation
8. Retest long head biceps for SIC. If it’s still WIC and the tendon is where it should be then
move onto finding another TL the gives a lock and run the protocol

Other things to look for

- Medially displaced long head biceps tendon usually goes hand in hand with a WIC subscap. If
you’re not getting the results you want from the coracoid go after subscap. Find a TL and run
the protocol
- Check everyone’s bicipital groove for a while and get a feel for correct position and
malposition of the tendon.

Case breakout – Nathan

- L biceps L/H slightly out of groove – tested WIC
- Holding tendon laterally in groove gave SIC
- TL L pec min gave neural lock
- Found WIC upper and lower Serratus anterior – TL pec min gave NL
- Directional test – pec min facilitated to upper and lower serratus
- Release pec min, activate serratus – SIC
- Biceps tendon back in groove and testing SIC
Scar vectoring
- Use this when you find global WIC in an area where there’s a scar
- Palpate and mobilise scar (slide up/down, left/right, diagonal, twist and stretch/compress) –
directions of bind likely dysfunctional
- Hold direction of greatest bind as TL – if there are multiple check each of them and find the
best lock
- Once you find the best lock directional test by strumming the scar on that vector and retest
the WICs
- If still WIC release the scar on the vector of best TL then activate WICs
- If a muscle goes SIC on directional testing look for another muscle to pair that to or enlist the
help of a Level 3

Case Breakout – Shinya

- Left knee scar at top of patella
- WICs – VM, VL, distal rec fem, medial hamstrings, popliteus as medial rotator (Shinya had a
lot of difficulty internally rotating his tibia)
- Inferior vector of scar felt most restricted and gave solid NL on all WIC
- Directional test – all stayed WIC
- Release scar on inferior vector (feel for a give followed by a very subtle rebound)
- All now SIC with improved internal tibial rotation