The Real Rules of Assessment
The topic of assessment can be a daunting subject to tackle given there have been hundreds – if not thousands – of books, ebooks, manuals, DVDs, tapes (ha – remember those!?), brochures (and whatever other form of media you can think of) that have dissected and scrutinized every nook and cranny.
What else is there to say? Certainly writing a blog post on the subject isn’t going to enlighten anyone – especially considering there really isn’t anything new to say. Likewise, it’s unlikely I’m going to say anything profound or revolutionary that will bring me accolades, a ticker tape parade, or in the event I really blow people’s minds, a Nobel Prize for Being Awesome.
Giving full disclosure, when it comes to assessment, there really is no set protocol I follow. In the fitness world there are undoubtedly a bevy of phenomenal procedures or “systems” to utilize (FMS, NASM, Assess and Correct, to name a few) – but if I’m going to be honest, there is no ONE that I prefer over the other.
I think Eric Cressey (my good friend, and business partner) said it best: at Cressey Performance, with regards to assessment, we take a bit more of a “broad” approach and then dig a little deeper if need be.
Well I should clarify that statement to a degree. With a large part of our population – specifically all of our baseball guys – we definitely start with a more targeted approach. With them we’ll immediately delve into nitpicky things like total range of motion (IR + ER) between throwing and non-throwing sides, check their scapular upward/downward rotation, shoulder flexion, and the like.
After placing them under the microscope, we’ll then start to incorporate more generalized screens like the Thomas Test, adductor length, lunge and squat pattern, so on and so forth.
With such a specialized group of people, it only makes sense to start in that capacity.
On the flip side – with a more generalized population (those looking to lose some fat, increase their general level of badassery, or to look better neked), we’ll usually start with a more “broad” approach and then dig a little deeper if need be.
In the latter scenario, a perfect example would be someone who walks in with a history of chronic lower back pain. In that case I’m definitely going to want to take a closer look at things and try to see if any red flags pop up that will give me more pertinent information.
The more info I have, the clearer picture I get, and the more likely I am to better ascertain what their needs are and come up with a plan of attack from a programming standpoint.
It’s in this type of scenario where having a “cherry picking” attitude towards assessment comes in handy. I’ll take bits a pieces from the FMS, from some of Dr. McGill’s stuff, Gray Cook, Mike Boyle, Mike Robertson, Charlie Weingroff, Papa Smurf. It’s all fair game.
Like I said: I’m not married to one train of thought over the other.
Regardless, I do feel there are some overlying rules or “code of conduct” when it comes to assessment that I’d like to share. And with that I’d like to share what serves as an umbrella of sorts to my general philosophy when it comes to assessment.
Rule #1: Actually, You Know, Do an Assessment
It still boggles my mind that there are still some fitness professionals out there who don’t even perform an assessment with their clients. While I know it’s a cliched saying: if you’re not assessing, you’re guessing.
As I alluded above, I don’t care what type of assessment you follow – everyone has their own preferences train of thought, and I’m not here to state who’s right and who’s wrong, which systems are worthwhile and which ones are bogus.
BUT: you’re an a-hole if you’re idea of an assessment is to just show a client the Cybex circuit. If you’re not taking your clients through an assessment, you might as well use a dartboard to write their programs. Good luck with that.
I am by no means saying that what we do at CP should be considered the gold standard, but just to give everyone an inkling of what an assessment entails:
– Thomas Test, Seated Hip IR/ER, Supine Hip IR/ER, Adductor Length, Hamstring Length, Prone Quad Test, Prone Hip IR/ER, Shoulder IR/ER (total ROM), GIRD?, Shoulder Flexion, Say the Alphabet Backwards (for time)
This takes all of 5-10 minutes (tops) and provides a gulf of information. For example, if I’m working with a right-handed pitcher coming in with some elbow pain, the first inclination is to look at the elbow (which we obviously do).
But if that’s all I did, and I didn’t test his lead hip IR (which we find is woefully deficient, which means he’s probably opening up on his delivery too soon, which mean’s he’s placing waaaay more valgus stress on his elbow), we’d be barking up the wrong tree.
From there, we like to get people moving. Testing them on the table is cool and all, but when we train, we move, and I like to see how people move.
– Squat Patern
– Lunge Pattern
– Teach Em’ How to Dougie
Using a general fitness enthusiast as an example, there are several squat “screens” I’ll take people through which I highlighted in THIS article.
But if all I did was a simple overhead squat screen – which most people fail miserably at – and I didn’t dig any deeper, I may just assume that the reason why he or she can’t get to depth is because their hips are tighter than a crow bar. This is what they’ve been told from several other trainers, so it must be true!
I’ll take people through 3-4 squat screens to see what shakes free. With the last one I’ll have them hold a counterbalance out in front of their body, and it’s almost profound how much of an improvement you’ll see.
By holding the weight out in front of you as a counterbalance, you’re forced to engage your anterior core musculature, which in turn gives the entire body the stability it needs to allow for more squat depth.
Without performing this last screen, many would automatically assume that the reason they can’t squat to depth is because of a mobility issue, when in fact, as Alwyn Cosgrove has noted on numerous occasions, it’s a stability issue.
Without this differentiation, we can see how many people would be barking up the wrong tree, and doing themselves a massive disservice on the training side of things.
Think what would happen if we omitted or neglected to perform the last squat screen – we’d assume that we have a mobility deficit somewhere and just focus on that one component, rather than address the real issue at hand, namely lack of stability.
Rule #2: You’re Objective Isn’t To Make Them Feel Like a Walking Ball of Fail.
The objective of an assessment is to give you information, not to point out every dysfunction that the person has and make them feel like a loser.
I remember one of the biggest mistakes I made as an upcoming trainer was to try to prove to people who much smarter I was than them. When I’d start with a new client, I’d take them through an assessment, use big words like synergistic dominance, reciprocal inhibition, and adductor aponeurosis, and try to wow them with my infinite wisdom, intelligence, and witty banter.
Really all I did was come across as a walking douche.
I’d go out of my way to point out every single dysfunction – OMG, your left pinky toe doesn’t dorsiflex 17 degrees! – and honestly, it would turn many of them off.
Don’t get me wrong: I think it’s important (wand warranted) to point out any concerns or red flags that may appear, but it also doesn’t hurt to have some sort of social filter and tone it down on the first day. Try not jump at every chance to tell them how much of a train wreck they are.
Rule #3: It’s Still Important to Achieve a Training Effect
Pigging backing on the point above, many trainers get a little too overzealous with assessment and fail to realize that it’s still important to give people a training effect (even if they are banged up).
Think about it this way: would YOU want to spend an entire hour on a table getting poked and prodded like a piece of meat? Indeed, there are cases where that’s warranted – particularly when someone presents with a unique injury history. But you might as well just toss in an episode of Army Wives and bore them to tears if all you’re going to do is test hamstring length for an hour.
GET THEM MOVING!!!!!!!!!
At CP we’ve designed our initial assessment to be half table work/showing them how to foam roll/taking them through a general dynamic warm-up and half lets-get-them-on-the training-floor-and-see-what-shakes-free hodgepodge.
Actually SEEING whether or not your client can perform a proper hip hinge or whether he or she can perform a push-up without compensating willl provide a heckuva lot more information, in my opinion, than testing breathing patterns for 45 minutes.
Rule #4: Make Them Prove You Wrong
And lastly, this is the crux; the creme de le creme if you will.
The REAL point of an assessment is for them to prove to me that they CAN do “stuff.” Listen, I think as fitness professionals (or just general fitness enthusiast) we all know that exercises like squats, deadlifts, rows, pull-up variations, single leg work, etc are going to make the “bulk” of most training programs.
My goal is to get all of my clients squatting, deadlifting, bench pressing, and kicking ass.
What TYPE of squat or deadlift or whatever is where the assessment comes in. If someone comes in with FAI, I’m sure as shit not going to squat them (at least not past parallel). But I can more than likely have them perform trap bar deadlifts and single leg work without much fanfare.
Additionally, if I’m working with someone dealing with a shoulder impingement problem, I’m probably not going to have them bench press, but I can probably have them perform dumbbell floor presses (and a crap ton of horizontal rowing) and progress them from there.
The point is: they must demonstrate to me – through the assessment process – that he or she can perform the things I want them to do in a safe manner, with flawless technique, and without pain.
More importantly (and this can’t be glazed over): will said exercises point them in the right direction with regards to helping them attain their goals?
In many ways, this is the REAL rationale behind an assessment. To prove to you – the fitness professional – that they can perform “x” exercise(s) without causing injury or harm.
And That’s That
The above certainly isn’t an exhaustive overview on my thoughts with assessment, but more along the lines of a quick brain dump that (hopefully) sheds some light on things I’ve learned, experienced, and adapted throughout the years.
I think at the end of the day, no one is really right or wrong when it comes to assessment. There are certainly many, many ways to approach it.
I’d love to hear everyone else’s thoughts. Agree? Disagree?