Assessment Protocols: There’s No One Right Way
We had a new crop of interns start up this week at the facility, and last night I had the opportunity to spend a little time with them to go over some “big rock” coaching cues and assessment protocols on the squat.
I only had 30 minutes with them and there’s obviously a lot to discuss with regards to the squat. I mean, people pay good money to spend entire weekends geeking out over squat mechanics, lever arms, and arguing over whether it’s better to squat with a low-bar position or high-bar.
So I did my best with the time given. I huddled them up in the corner of the facility, in front of a squat rack, and told them to KNEEL BEFORE ZOD!
Okay, that didn’t happen. But it may very well in the future…;o)
However, the whole 30-minute squat tutorial did happen, and one of the very first things that came out of my mouth was:
“There’s no such thing as one right way to squat.”
Some people do better with a high(er) bar placement on their back, some people will squat with a wider stance compared to others, and yes, contrary to what some blowhard coaches on the internet subscribe to…some people, due to their anatomy/hip structure, will not be able to squat past 90 degrees of hip flexion (or ass-to-grass in brospeak).
To hold everyone to such a standard is unrealistic at best, entirely ignorant at worst. That’s like me saying, “everyone should deadlift Sumo style” or “everyone should bench press with their heels down” or I don’t know, “everyone should be right handed.”
The conversation got me thinking about the topic of assessment and how, oftentimes, some coaches and trainers will marry themselves to one protocol or “one way” to assess their athletes and clients.
Now, don’t get me wrong: I wholeheartedly understand (and appreciate) that some demographics require specific assessment strategies to best ascertain what they’re unique needs are as it relates to the demands of their sport or profession.
I work with a lot of overhead athletes (baseball players) so it makes sense that, within the realm of their assessment and what’s important for them to be successful in their sport, I place a lot more scrutiny on their ability to upwardly rotate their shoulder blades, how much shoulder flexion they have, and whether or not they have ample segmental rotation.
However, how you go about assessing and what you look for in a gymnast will differ (in some regards) with how you assess a football player. And how you assess your everyday office worker/computer guy will most likely, in some ways, differ with how you assess a bomb sniffing dolphin trainer. It’s science.
In addition, there’s more of an onion to peel back and factors to consider once we start talking injury history (flexion based back pain vs. extension based back pain), training history, and goals.
In all, we could make the argument that no one assessment is the same given the plethora of sports, activities, hobbies, injuries, aberrant movement patterns, and training goals which exist amongst different populations.
Head, Shoulders, Knees Over Toes
I for one use and implement several assessment methodologies. You can plug in just about anything – FMS, PRI, SFMA, NASM – and I’ve likely used snidbits of each with the over thousands of assessments I’ve done throughout my career.
I think all are important, and all have their advantages and disadvantages. And, honestly, one of the advantages of working in the private sector is that I’m able to implement more of a smorgasbord approach to assessment if I so choose.
My assessments are more of a two-part show anyways:
1. The Poking and Prodding Part (which, not coincidentally, and unfortunately, is where many fitness professionals stop).
This is more or less the non-exercise static & dynamic assessment – testing things like shoulder flexion, scapulohumeral rhythm, hip IR/ER, glenohumeral ROM, toe touch, push-up, bodyweight squat, and, if need be, given a unique injury, performing more provocative tests to see what exacerbates their pain/symptoms.
The poking and prodding part (don’t be creepy about it) is an important part. It provides a lot of valuable information. I can implement screens that test passive ROM which essentially gives me feedback on their total ROM; but then it’s equally as important to include screens which test one’s active ROM which gives feedback on their available/usable ROM.
Lack of ROM isn’t always a mobility issue.
And while it’s not the case for everyone, many fitness professionals stop their assessment there – at the poking and prodding part.
Giving credit where it’s due: it’s amazing if they actually do this part. Many don’t even bother. It’s unfortunate, though, that this is the point where some stop. It makes me sad.
It’s only half the equation. It’s important to include the second part, too.
2. The “Lets Go Move Around and Lift Stuff” Part.
At CSP we’ll do the poking and prodding part and then go out on the gym floor and see what shakes free. I’ll often stay a fly in the wall and just see what people do without giving them much coaching. I want to see what their default movement patterns are when I say “deadlift that weight,” or “go pick that up.” It’s often uncanny how, what was perceived as wonky movement on the table, clears right up once someone is under load.
Too, the “pick stuff up” part serves as a way to give someone a little flavor for what to expect moving forward and get them excited to train.
How excited would you be walking into a new facility where, on day #1, all you did was stand there while a complete stranger “hmmm and ahhhh’d” for 60 minutes over your Thomas Test, told you how your left big toe doesn’t dorsiflex enough, your Zone of Apposition is all off, and that you’re going to perform a bunch of breathing drills?
Spending all that time telling someone how much of a walking ball of fail they are isn’t going to impress.
So yeah, get them moving!
Assuming they’re in the clear why not take a look at their deadlift (ability to hip hinge)? Or maybe take a look at their squat pattern with a barbell? You don’t need to go heavy, of course. But it stands to reason loading people up will offer a bevy of additional information.
Or maybe take a page out of Dan John’s latest book, Can You Go?, and implement some subtle performance based assessments/markers:
1. Plank – can they perform it (correctly) for two minutes? If not, well, they’ve got some work to do.
2. To the Floor and Back Up (I like this one a lot).
It’s just as it sounds. Tell someone to get down on the floor and back up. What do they do?
From Dan’s book:
Claudio Gil Araujo, who performed a study at the Clinimex Exercise Medicine Clinic in Rio de Janeiro, said being ablt to stand up from a seated position on the ground was “remarkably predictive” of physical strength, flexibility and coordination at a range of ages.
Araujo said, “If a middle-aged or older man or woman can sit and rise from the floor using one hand – or even better without the help of a hand – they are not only in the higher quartile of musculo-skeletal fitness, but their survival prognosis is probably better than that of those unable to do so.”
3. Farmer Carry
Have someone perform a loaded farmer carry for max time. Mark it down. When you re-assess a few weeks (or months) down the road and they’re able to carry a further distance, you know what you’re doing is working.
Dan’s Standards (from his Mass Made Simple book)
Bodyweight on left, load on the right:
– Under 135 pounds: 135 pounds.
– 136-185 pounds: 185 pounds.
– 186-205 pounds: 205 pounds
– Over 206 pounds: 225 pounds
For your “non-athlete” general fitness population clients the above suggestions are fantastic markers to get (and improve upon), and they probably won’t even realize you’re “assessing” them in the first place. Plus it adds more variety and fun to the overall process.
So in the end, there’s no ONE right way to assess. In addition there’s more to an assessment than having someone lie on a table and telling them how much their posture sucks.
Get people moving, people.
Comments for This Entry
Rob MulliganHey Tony! Very timely article, since I have been trying to proceduralize some general assessments myself lately. Regarding dynamic/movement based tests, do you stop the screen for a particular movement if it looks good, or do you still screen for more specific things? Using the squat for example - just because someone's BW squat looks OK doesn't mean you wouldn't find anything wrong if you tested for a stability deficiency or ankle ROM problem. Do you follow a general script or do you only delve deeper if you see a red flag? I am curious to hear your thoughts.
September 3, 2015 at 3:44 pm |
TonyGentilcoreOh, absolutely. We do have a general "script" we follow at CSP with our overhead athletes; as well as with our general fitness clients. I do feel it's important to be able to deviate from that script if needed, though. We need to be careful not to be TOO stuck in our ways. Make sense?
September 3, 2015 at 6:44 pm |
Rob MulliganYep, thanks for the response!
September 4, 2015 at 9:27 am |
ChristianTony love you work. As always Im very greatful for the quality of material you make so accessible to others. Few questions if you in the off chance have a spare minute to ponder How much do you look into lower limb version? Are you assessing hip ROM like glenohumeral Ax ie total ROM rather than comparing IR and ER individually to normative data? Everyone talks about lower limb set up specific to ones "neutral" but really do you think we can accurately measure acetabular, femoral,tibial version and accumulative effect of these without imaging? Is the AFIR PRI model simply just a fancy way of illuatrating functional limb length discrepancy or pelvic rotation we have always seen? Is PRI, Posturepro etc just further illustration that the average rehab pro cant think for themselves and needs a blueprint laid out for them?
September 3, 2015 at 7:43 pm |
TonyGentilcoreChristian - You're 100% right in that, without direct imaging, I can't 100% ascertain how someone's hip is shaped. But I can "scour" the hip to see what their ROM is telling me and to get an idea of how much hip flexion they have, and hip extension; plus get a pretty good idea of how much anteversion/retroversion they have (Craigs Test)
September 4, 2015 at 7:03 am |
RachelThey always have these studies that Japanese people are so healthy and I'm convinced one of the reasons is because they sit on the floor a lot. So basically people get up and down their whole lives and never lose that ability. Japan 1 America 0.
September 3, 2015 at 9:30 pm |
Peter"They always have these studies" said every typical personal trainer that ever lived. I know this isn't a positive nor overly productive post but seriously. Unless you take the time and effort to appraise research yourself rather than quoting some misquote from a health magazine, continue to preach what you believe in but don't discredit the value of actual, existing, sound, quality research by throwing out a generic reference to "research" when justifying your beliefs. For the record I am not an academic and in most instances find Academics impractical and overly opinionated, but if we are to advance in this field you must give research the acknowledgement it deserves
September 3, 2015 at 10:55 pm |
RachelInteresting viewpoint. I try to make it a point to do my due diligence but this was a joking response to a blog post. I was agreeing with Tony's point that getting up off the floor is of value. I didn't feel it necessary to cite studies in this case.
September 3, 2015 at 11:12 pm |
TonyGentilcoreUm, Peter, I don't think she was discrediting actual research in her comment. Just making a casual statement about something she read somewhere. No harm in that.
September 4, 2015 at 7:05 am |
TonyGentilcoreThat's a fair point!
September 4, 2015 at 7:04 am |
UP MY SHOPRead also http://www.up-myshop.com/2015/08/weight-loss-workout-program-success-secrets.html
September 7, 2015 at 10:28 am |