In a previous article (See Aug 19), I talked about the office portion of the assessment. Basically this is the question and answer part, where I am looking for general medical history, physical problems, any aches and pains as well as discussing your exercise history and your fitness/health goals. Once that is completed, we will head into the gym for the physical part of the assessment. In this article I am going to go through the whole assessment process and hopefully help you to see what I am looking for and how we are going to address any issues that make themselves known.
The first part of the assessment is 1-2 minutes on the treadmill. This is for gait analysis only. It is not intended to gauge your fitness level, but merely to watch how your walk and your overall posture. A lot can be deduced by just watching someone walk in the door or how they sit in my office. Walking with feet turned out, knees not tracking over the 2nd toe, rounded shoulders or forward head posture all are clues to what we will need to address in the workout. Pelvic position is important, as the positioning of the pelvis is due to weak and tight muscles. An anterior pelvic tilt (common in females) is usually due to and sustained because of the tight hip flexor muscles, tight quads as well as tight spinal erector muscles. Weak muscles that go with APT are rectus abdominis, external obliques (side of waist), glutes and hamstrings. The goal with the anterior pelvic tilt is to strengthen the abs (reverse crunches), strengthen the glutes and hamstrings (romanian deadlifts, sumo deadlifts, good mornings). Stretches for the tight muscles must also be included. The posterior pelvic tilt on the other hand could indicate tight abdominals and external obliques, tight hamstrings and glutes. Weak hip flexors, weak quads and weak spinal erectors are also present. The goal with the posterior tilt is to strengthen the quads and spinal extensors (squats, back extension, lunges, bulgarians, conventional deadlifts). Stretching for the glutes, hamstrings and abs must be done as well.
The next part of the assessment is the use of our blue foam rollers. These rollers are used to determine muscle tightness or presence of scar tissue. We test primarily the lower body. As various parts from the hips down are rolled on the foam there may or may not be pain/soreness present. If the rolling elicits only a feeling of pressure that is good, telling us we don't have any major issues to address. If, however on a scale of 1-10, we get a reading of 3 or more we will then need to address this in the workout portion.
Ankle range of motion is tested next. The ability of the knee to move past the toe 4" or more in a lunge position tells us the ankle has good mobility through the joint. As we normally do ankle mobility drills as part of our regular warm ups at our facility, any deviations from this norm is addressed. But, it is necessary for us to have a baseline ROM reading so we are prepared for any problems that may occur when we start to integrate squats and lunges into the workout. The next two assessments are squat related. One is the Overhead squat. A squat is performed while holding a wooden dowel overhead. A wide grip is taken on the bar and elbows are aligned with ears. A squat is then performed. We watch for a host of issues to show with this movement. This is due to the need for the body to have good flexibility, a good ROM through all joints and core strength and stability in order to perform this movement. Movement of the arms forward or bending at the elbow tell us that we probably have some tight back (latissimus dorsi) and chest pectoralis major) muscles as well as weak trapezius (back) muscles. The Overhead squat also requires a strong and stable core in order to stay upright and not lean or fall forward.
The next squat exercise is a single leg squat. This requires strength and stability through the pelvis and knee as well as down into the ankle and foot. This is usually when we will see major compensations in movements. Tight adductor (inner thigh) muscles along with weak glutes (gluteus medius and gluteus maximus) will allow the knee to move inward and the hip outward as you descend into the squat. Along with this we will usually see the foot roll inward possibly indicating weak calf muscles. If a weak core is present the opposite shoulder to the squatting leg will usually roll forward and inward as the body attempts to stabilize itself. The single leg squat should be able to be performed with an upright and straight upper body. Minimal deviation of the knee and hip is preferred.
The last part of the physical assessment is the push up. Ladies do push ups on the Smith machine; men on the floor. What I look for besides the ability to push oneself up, is the position of the body. Again without a strong core (deep abdominal muscles, spinal extensor and stabilizers) the lower back will usually start to sway. That is why I prefer ladies do push ups off the bar on the Smith machine, as knee pushups put very little demand on the core. I also look for head position, scapular positioning and naturally any presence of pain or discomfort. If a client has a history of shoulder or rotator cuff issues this part of the assessment is not done.
The body is designed to move in a certain way and how it deviates from the ideal tells us as trainers what is out of sync (muscles imbalances, tightness, weakness, dominant, etc). We all have muscles imbalances, asymmetries or weaknesses present. The body will ultimately move because that is what life requires. And the body is very proficient at compensating for muscles imbalances, etc by calling on other muscles groups to perform a function or firing muscles out of sequence.
What I strive for in the assessment is to determine overall or gross movement patterns, compensations that may be present and from there design a program that will address all the issues seen in the assessment. How we go about that is what comprises for the most part, the bulk of the training programs. Naturally, we try to make the workouts as fun as possible so we include such activities as rope bulgarians, sled pushes and pulls as well as all the myriad of lunges and push ups that we can think of.
I hope this helps to explain the assessment process and why I feel it is imperative that a thorough assessment be done prior to any strength training program being introduced. Please feel free to ask any questions.
Til next time,
“Monitoring, Mentoring, Motivation”