When you evaluate using the principles of Diagnostic Motion Evaluation (DME) you understand at the point at which there is non fluid motion or when there is a compensation occurring, that is the location of a dysfunction.
In observing this video of Nadal's preparation for return of serve, you will see that when he shifts his body in the direction of his forehand, there is immediate compensation of movement at his Right pelvis/ hip and knee immediately followed by the movement the Right foot.
Using DME principles I hypothesize that his thoracic dysfunction contributed to his back injury in the Australian Open and is causing stress to his Right knee. Since the compensation in his pelvis/hip occurs immediately upon movement toward his Left side and movement begins at the Trunk, the location of his first dysfunction is in his trunk. Because the compensation occurs at the Right pelvis/hip and the shared connective tissue attachment that is most proximal to this location is at the level of Rib 6 via the attachment of the iliocostalis lumborum provides further evidence that the first place to treat Nadal would be to identify the dysfunction located at the level of Rib 6.
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It is important to note that there also appears to be a number of subsequent dysfunctions down the kinetic chain.
When you observe the still photos above you will see the difference in the position of Nadal's trunk with his forehand and backhand photos. Again his first compensation occurs at the mid thoracic spine at about the level of Rib 6, this is why his back appears unlevel.
When comparing the still photos above you should notice several other locations of dysfunction. In my classes I tell students that wrinkles in clothes are an indication of movement.Where the wrinkles stop are often areas of restriction or dysfunctional tissue.
In comparing the wrinkling of the clothes in the above photos and in the video, when Nadal is moving toward his forearm there are fewer wrinkles at; the level of his lower back and his Right pelvis and thigh. These dysfunctions may too have contributed to his back injury and should be addressed.
Lastly, in the video and the photo above you will notice premature and excessive Right femoral (thigh) internal rotation and in the forearm photo you can even see his part of his Right knee cap. (to compare femoral internal rotation you will compare the Right leg in the forearm picture with the Left leg in the backhand picture). This would not be a problem if Nadal's Right lower leg would move into internal rotation as well, but in the video you will notice that it does not and there is immediately compensation with his Right foot moving. Therefore there also seems to be a dysfunction at the level of the Right knee. This is why I feel that his Right knee will continue to be a problem for Nadal.
Over the weekend one of the commentators predicted that Rafael Nadal would beat the record for all time Grand Slams. Unless his team resolves these dysfunctions, I foresee continued health problems and a decline in his performance in the future.
I hope that I am wrong about this.
