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  • JH Backcountry Health

What to Expect on Your First Visit!


Curious what we do before we adjust? How do we pick what muscles to work on? Today we run through the upper body and lower body screens we often use in our clinic to identify how joints are moving and muscles are firing. From here, we move into more detailed exams depending on what we see and your symptoms. We consider myofascial release and a variety of therapies, we adjust (if you want to be adjusted; we will never pressure you), and we set you up with rehab stretches and exercises.


Check out the video, or read on below, to understand what we look for during patient assessment on your first visit. There will be more details on all of our treatment modalities in upcoming videos!


Upper Quarter Exam


First, we start by looking at the patient’s shoulders from behind them (posterior view). We like to go through a checklist for the upper quarter.

  1. Look at the level of the shoulders

  2. Look at the level of the scapulae

  3. Are the shoulders rounded forward?

  4. Do the scapulae adhere to the rib cage or wing out?

Next, we like to check the activation of the muscles as the patient raises their arms overhead. The patient typically starts with their arms out and thumbs facing towards the sky, and they raise their arms up overhead as if they are trying to touch their thumbs together.


Continuing to watch for muscle activation, we have the patient bring their arms out in front of them so that we can check for scapular dyskinesis. This means we are looking at how the scapulae move, and if there is any lag or delay in muscle activation.


The next step in this process is seeing what muscles activate when we tell patients to pull their shoulders down and back. If a patient’s body is accustomed to using their upper trap to move their shoulder blade, then we typically see a lot of upper trap activation during this test.


Lower Quarter Exam


For the lower quarter exam, we start by going through a checklist related to the patient’s natural standing position (postural exam).

  1. What does the arch in the foot look like?

  2. Is there any rotation of the foot in or out?

  3. Is there any rotation in the pelvis?

Next, we have the patient pick up one leg about to their beltline, and hold that position as we go through another quick checklist.

  1. How much is the ankle wobbling around for stability?

  2. Does the patient lean in one direction or the other for balance, or stay straight up and down?

  3. Does the pelvis stay level?

Finally, we go through a variation of squat tests, starting with a deep squat. Here are the things we look for:

  1. Is there pelvic tucking at the bottom of the squat?

  2. Does the lumbar spine round during the squat?

  3. Can the patient go lower than thighs parallel to the floor?

  4. Does the knee position track over the third toe?

The final variation in our standard assessment is similar to a single-leg pistol squat, which we use for certain patients who have the stability and muscular strength to execute this move safely. Again, we are evaluating form, posture and movement:

  1. Does the knee rotate?

  2. Does the heel come off the ground?

  3. Does the pelvis rotate?

As mentioned, this is just the start. Find out more about what we do at https://www.jhbackcountryhealth.com/services or call us with questions at (307) 203-2138.

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