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Under optimal circumstances, these systems work together to create neuromuscular efficiency (the ability of the neuromusculoskeletal system to produce force, reduce force and dynamically stabilize the kinetic chain in all three planes of motion.
The body compensates to these stresses through predictable patterns of dysfunction called Movement Impairment Syndromes.
Hyper-pronation may cause misalignment of the lower extremity, frequently leading to structural and functional deficits both in standing and gait. All too often the symptomatic joint becomes the focus during rehabilitation, when the joints above or below may be the cause of dysfunction. Hyper-pronation of the foot can affect  muscles, causing some to be overactive or short and others to be underactive or long.
Both Janda and Clark describe myofascial structures at the hip that would be lengthened and shortened as a result of hyper-pronation of the foot.
These are evident as part of the lower extremity postural distortion pattern and lumbo-pelvic-hip postural distortion pattern.

Injury patterns of lower extremity postural distortion: Plantar fasciitis, Posterior tibialis tendonitis (shin splints), anterior knee pain, low back pain. Injury patterns of lumbo-pelvic-hip postural distortion patterns: Hamstring strains, anterior knee pain, low back pain, trochanteric bursitis, piriformis syndrome and lumbar and hip mechanical dysfunction.
Clinicians  and patients should be aware that knee , hip and  lower back dysfunction can be a result foot alignment and that if the foot is not addressed, these problems will not resolve. Presentation "1 Muscle Imbalance Evaluation and Treatment of the Neck, Upper Back and Shoulder Areas Jose S. Presentation on theme: "1 Muscle Imbalance Evaluation and Treatment of the Neck, Upper Back and Shoulder Areas Jose S. 2 Objectives Review some concepts of muscle imbalances and the evaluation and treatment of key muscles as contributors to chronic musculoskeletal dysfunction in the neck, upper back and shoulder areas. 10 Upper Crossed Syndrome Forward head posture Straightening of the cervical lordotic curve Extension of the upper cervical spine Increased kyphosis of the cervico-thoracic junction Internal rotation of the shoulder girdles.

General Treatment Sequence 4.Stretching the tight muscles – manual stretches in the office (Dr.
Evaluate Asymmetry of Muscle Lengths Isolate to one muscle as best possible Find the tight muscles and treat them with manual stretching at the clinic. Pectorales Minor: Observe for Tightness Patient supine Operator observes for the relative anterior posterior position of the shoulders.

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