Archive for the ‘Exercise Assessment’ Category
Low back pain is nasty!
It’ll hit you where it hurts…
…It can bring you to tears
It’ll get you down
But, I’ve got a secret 1-2 Punch–er, exercise–to KNOCK-OUT lower back pain fast!
Give it a go and let me know how it goes by leaving a comment below (hey, I could’ve been a poet…:)
Now you see it…
…Now you don’t
See what you ask?
The difference between the 2 photos on the left depicting the plank exercise.
Ok, so either I’m one apple short of a fruit salad or there’s not a difference right?
While it’s true that there is no visual difference (it’s the same photo) there can be a difference in what 2 clients FEEL even though they appear to perform the exercise the same way.
And, the muscles they feel can improve core strength, muscle balance and function or they can reinforce existing compensation strategies that contribute to shoulder, lower back and knee problems…
So, how can you tell if your clients are getting it right or if they’re just reinforcing pain patterns?
Watch the video below where I share an often over-looked problem that 9 out of 10 people are doing leading to pain and how to correct it.
Oh, and don’t forget to leave me a comment below after you watch:
When I first started training clients I had a horrible time with corrective exercise programming.
I remember sitting in front of my computer…staring…racking my brain for ideas about which corrective exercises to use for my clients.
I would often sit there for hours…no kidding–HOURS!
On more than a few occasions I would sit at the studio I worked for on a sunny Saturday afternoon practically pulling my hair out by the roots trying to come up with something to help my clients with injuries.
And, the only reason I would leave was usually because of a phone call from my wife telling me to get my A** back home so we could go have some fun together.
One of my BIGGEST frustrations back then was the lack of information on exercise assessment, post-rehabilitation exercise and program design.
Sure, there was all the run-of-the-mill info on basic gym exercises but there just wasn’t anything for Personal Trainers who trained clients with nagging injuries.
The cool thing is that after a number of years I finally have a model for designing effective corrective exercise programs and I’d like to share it with you in hopes that it helps you put together awesome, results producing programs for your clients.
It’s called my ’3-A Corrective Exercise Model’.
Check it out and let me know how it works for you:
One of the biggest challenges we face as Personal Trainers is mastering the art of client assessment. 
There’s this BIG debate in the fitness industry that many of us (Personal Trainers) are getting too caught up in trying to ‘fix’ our clients…
…That we treat our clients like rehab patients and how many of us are stepping outside of our ‘scope of practice’ when assessing clients.
And, while I agree that we should not perform anything beyond what we are qualified to do I have a problem when I hear or read about how Personal Trainers should stick to ‘conducting exercise programs for apparently healthy individuals’ and leave the assessment part to Physical Therapists.
Our job as Personal Trainers is to develop and implement fitness program to help our clients achieve their fitness goals.
But, in order to develop an exercise program we need the necessary information that allows us to do this.
And, that’s where the importance of assessing clients comes in.
There are a few problems I see with how most Personal Training courses teach client assessment.
Look, I’m all for measuring body composition, taking girth measurements, testing flexibility and cardiovascular fitness and the like but these assessments are pretty much useless for the majority of our clients who deal with shoulder, lower back or knee problems that are keeping them from achieving their fitness goals.
If we’re assessing a client’s posture and notice upper cross syndrome (forward rounded shoulders, protracted shoulder blades, etc) it’s easy to assume the client has tightness of the pectorals, the internal shoulder rotators and weakness of the scapular stabilizers.
And, typically stretching those tight muscles along with some foam rolling might be in order.
But, how do you know for sure?
What if this client really only had tight lats? That would make all those pec stretches and rotator cuff stretches ineffective.
Assessments often seem to be thrown in with no specific order or system for applying them.
I don’t think it’s a case of Personal Trainers needing to become Physical Therapists to perform more specific assessments.
But, let’s be honest here…the majority of clients do not fit the classification of ‘apparently healthy’ or ‘without physical limitations’.
And, it’s not realistic nor practical to refer every client with nagging shoulder, low back or knee pain to their doctor or Physical Therapist.
This is backed up by organizations like the American Council On Exercise who offer their Post-Orthopedic Rehabilitation program for Personal Trainers…
..And the NASM who’s Personal Training model is one of the most widely used (if not THE most widely used) in the fitness industry. Oh yeah, and that model was created by Michael Clark, one of the top Physical Therapist’s in the country!
If we truly want to earn the respect and recognition we deserve as true fitness professionals we need to step beyond ‘ordinary’.
The same old ‘run-of-the-mill’ assessments like curl-up tests, push-up tests and sit and reach tests will do very little to help the majority of clients reach their fitness goals.
Teaching our clients how to perform movements they use on a daily basis like squatting, balancing and lifting overhead without the nagging aches and pains associated with those movements will do much more in helping them reach their fitness goals.
Create a better assessment system and get better results for your clients.
Go beyond ordinary…Be extraordinary!
Here’s a new podcast on “5 Simple Steps To Correcting Your Clients’ Posture”
Some of the topics covered on the podcast are:
NOTE: If you want to download the podcast I suggest using Internet Explorer. Other web browsers like Firefox may not allow downloading so if you run into problems just try using Internet Explorer and that should solve it
Or Click The Icon Below To Listen On My Official Podcast Page
Want to know which exercises really work for muscle imbalances? Click HERE
The fitness training industry is constantly changing and because of this we’re always learning new things
Take for example, most of what we know about assessing muscle imbalances
We know that a tight agonist usually is accompanied by a weak antagonist
This is obvious in the classic “bench press posture” that commonly exists in many of our own clients where tightness of the muscles involved with internal rotation and protraction of the shoulders results in weakness of the muscles involved with external rotation and retraction of the shoulders
But, have you ever wondered if a muscle can be both weak AND tight at the same time?
Is it even possible?
I’ve chased this thought around and around in my head a number of times over the years after assessing clients who present what appears to be BOTH muscle tightness and muscle weakness in the same muscle(s)
Huh?
You’re probably thinking right now…”Here he goes again with one of his off-the-wall philosophies”
But, as odd as it sounds I have to admit that a lot of times I notice muscle weakness and tightness in the same muscle(s)
Before you think you’re lost in a bad twilight zone episode here (music cue here) I’ll try to explain what I mean…
…Tight muscles are usually thought of as dominant muscles
However, with extreme muscle tightness there are much fewer actin-myosin cross bridge attachments available (and less space for the joint segment to move) which results in decreased force production capability
The result is often decreased mobility and muscle weakness
And, it’s the same for severe muscle weakness with a slightly different twist…
…Weak muscles are less capable of generating proper force production and, therefore, lack the ability to produce sufficient force to create movement.
Over time the decreased ability to move the limb or segment the weak muscle(s) controls results in muscle stiffness as the muscle adapts to the same length
As you can see, it’s not always an either or situation when assessing a client as we have thought for so long
Now, this isn’t to say that EVERY tight muscle is weak and vice-versa, but it does lend some insight into how both muscle tightness and muscle weakness can occur together
Here’s where I would like to hear YOUR feedback
Do you have a client who presents both muscle tightness and weakness of the same muscle(s)? If so, I’d like you to briefly describe it below and let me know what special training techniques or exercises you’ve used to address it
The fitness industry and personal training is always evolving…
always progressing…
…what we know today, we gain a better understanding of tomorrow and by sharing what we learn as fitness professionals with each other makes us stronger
It helps us expand our knowledge and lifts us beyond the common perception that we just “take people through workouts”
By improving the art of client assessment and program design we have the power to help change lives
I hope you’ll share your feedback below
Most of the textbook guidelines we’re taught for performing the squat exercise are pretty similar
Keep the upper back straight, keep the feet about shoulder width apart, bend at the hips and knees, etc..
But, there’s another guideline that’s taught by most textbooks and even health & fitness professionals but it can be the #1 squat exercise mistake in those who suffer from nagging lower body injuries
It’s something that isn’t particularly obvious either…
It has nothing to do with the upper back, bar placement nor the hips…
…It is assuming squat position with the toes pointed out
While this may not be problematic for apparently healthy individuals, it can have a few drawbacks for those dealing with lower back, hip, knee or ankle pain:
For example: running or jumping with the toes pointed out decreases force production during acceleration, negatively affects deceleration mechanics and develops poor alignment and joint stability of the lower extremities
Most individuals prefer squatting with the toes pointed out because it feels stable and as if the feet are straight
In most cases, if you ask a client who squats this way to point their toes straight ahead they will feel as if they are ‘pigeon-toed’ and will have difficulty keeping the knees and ankles from collapsing inward
Because of this, it’s often assumed that squatting with the toes straight is ‘bad for the knees’…
…But, if we look at it from more of a lower body assessment perspective what we’re REALLY seeing is inefficient hip mechanics…it’s the lack of hip stability that causes the real problems
When the hip extensors and/or abductors are weak the integrity of the lower extremities becomes compromised often resulting in pain or injuries to the hips, knees, ankles or even the lower back
And, although the squat gets a bad rap for causing injuries to the knees and lower back, the reality is that the movement itself is something our bodies are designed to perform…
…it’s one of the first movements we performed as babies learning to stand
Unfortunately, as we get older (and technology advances) we drive, sit at computers, perform desk jobs, watch television and without proper conditioning of the hip musculature function is lost which leads to a growing list of nagging pain and injuries
The squat isn’t a bad movement but a lack of physical conditioning to squat efficiently is
Here’s an unlikely core exercise assessment for shoulder or lower back pain
It’s not some fancy, secret underground exercise from outer space…But, it’s not an exercise that is associated with assessing muscle imbalances of the shoulder or lower back
So, just what is this core fitness assessment?
It’s one word…THE PLANK–ok, it’s technically 2 words–
Now, before you think I’m the name many of my clients call me (crazy), I’d like to share with you the wealth of information this simple core exercise test can reveal about shoulder and lower back pain
Here are 3 things to look for when performing a core training assessment using the plank exercise:
1) Lifting the upper body first-This is when the the shoulders and chest come off the floor before the hips and is often a subtle occurrence that shifts emphasis away from the abdominal stabilizing muscles because the lumbar extensors become overactive and is a sign of lower back compensation which often contributes to lower back pain
2) A kyphotic upper back-Most of the time this occurs in conjunction with #1 and involves an overcompensation pattern of the neck and shoulder muscles. The client often will feel significant fatigue in the shoulders, neck and triceps and usually struggles to hold this position for 30 seconds. This is often a sign of weakness or inhibition in the upper/mid-back muscles and contributes to neck and shoulder pain
3) The hips are lower than the shoulders-This usually indicates weakness of the abdominal stabilizers and increases stress to the lower back. In fact, the client will often feel as if the lower back is “working” which can easily be mistaken for a weak lower back when this is not the case
Keep in mind that the plank is just one exercise that can be used in a core exercise assessment and other specific core fitness tests should be performed to confirm or dismiss what the plank reveals
Leave me a comment below and tell me about any core exercise tests you use
“Hey, John would you mind doing a simple lower body exercise assessment for me” I asked.
“Sure, what do you want me to do?” he answered.
“I want you to squat down and back up about 5 times”
“Like this?” John asked while easily descending down into a full squat and back up with a grin on his face as if to say ‘That’s it…What else you got?’
“Great job John!” I complimented him.
“Now, let’s try one more test. Try standing on one leg.”
John lifted his left foot a few inches off the floor balancing on his right leg.
I pulled my ball-point pen out of my pocket and placed it on the floor about a foot and a half in front of him.
He looked at me confused.
“Ok, John I want you to use one hand and pick up that pen while maintaining balance on your right leg.”
“Are you training me to be some circus elephant or something?” he asked.
“Seriously, I’d like you to try to pick up the pen” I said.
As John began to bend down his eyebrows scrunched, his lips tightened, his concentration level rose as he stared with laser focus at his target…the pen laying just in front of him on the floor
About a quarter of the way down with his hand closing in on the pen his leg began to wobble, then his upper body…his arms began flapping uncontrollably until he lost control and his left foot hit the ground to stop him from collapsing on the ground
John was baffled as to why he couldn’t do something that sounded so simple…to pick that damn pen up off the floor
But, this wasn’t some attempt at making John feel silly and I didn’t have some trick ninja pen with mysterious Jedi mind powers nor was I planning on training John for Cirque du Soleil
I was using the most valuable exercise testing tool for the lower body…
…As fitness professionals we perform various exercise assessments to gather information which we use to design fitness programs for our clients
These assessments provide feedback about areas such as flexibility, endurance, strength and cardiovascular conditioning 
One of the most commonly used tests for assessing the lower body is the overhead squat. However, looking at the big picture of human functional movement reveals that we are asymmetrical in nature
We all have dominant upper and lower extremities and perform most of our standing movements in a single leg dominant environment…
…walking, dropping and picking up your keys off the floor, getting in and out of the car, going up and down stairs, running & playing sports are some examples of the single leg dominant environments that play an important part of our everyday lives
Many lower body injuries occur during single leg activities involving deceleration. This is often due to weakness, instability, overuse and poor flexibility
In fact, there are a number of single leg movements that we perform outside of the gym and yet most traditional exercise programs either fail to train these movements or train these movements with inefficient muscular recruitment patterns
For example, a runner or tennis player who only uses squats or deadlifts to train the lower body will see minimal improvements in performance at best and is vulnerable to an injury to the hips, knees or ankles since the single leg demands of the activity are not adequately addressed
Or, performing lunges and emphasizing activation of the quadriceps is a knee injury waiting to happen
Because of this, I always include dynamic single leg exercise assessments that give me instant feedback about which areas need to be addressed to improve strength, stability and/or flexibility
I perform the test differently than the typical multiplanar reach as I’ll share with you
Dynamic Single Leg Exercise Assessment
I use this to test 2 functional movements: internal and external stabilization of the hips & lower extremities
How To Perform
What To Look For
You want to watch for proper hip, knee and ankle movement and note any breakdowns that occur at either of these areas
To keep things simple I use 3 categories during the single leg fitness assessment:
The category provides the appropriate training level for the client:
Stable-Dynamic single leg exercises in various planes (ex: multiplanar lunges)
Unstable- Modified single leg exercises is various planes (ex: reaching lunges to bench)
Falls-Static single leg conditioning exercises (ex: single leg rows, presses)
Incorporating single leg exercise testing is probably the most important lower body assessment tool for identifying muscular imbalances, strength deficits, joint instability and designing fitness programs to help prevent or rehabilitate injuries to the hips, knees and ankles.
Give this test a try on yourself or your clients and leave me a comment about what you noticed.
Manual muscle testing is a skill that takes time and practice to perform with reliability. However, it is a valuable tool for fitness professionals.
There are visual and verbal cues that can be used to perform an exercise properly but looks can be deceiving.
Let’s use the squat exercise as an example.
If you were to instruct a client on how to properly perform the squat you would probably explain the proper stance width, foot, trunk and head position, staying back on the heels, etc.
And, from what you can see, it appears that they’re doing the exercise correctly but they feel lower back pain. Now, you could simply modify the exercise or substitute an alternative.
But, what if the pain wasn’t caused by the exercise itself but from the inability to activate the core stabilizing muscles?
Since this isn’t something that can actually be seen, and verbal feedback from the client can be misleading at times, manual muscle testing can help to determine whether or not an exercise is achieving its main purpose.
This is particularly true when performing core stabilization exercises for the abdominals because many times the client will recruit the rectus abdominis but fail to recruit the deep abdominal stabilizing muscles (ex: transverse abdominis).
The client might feel their abs working however without manual muscle testing it’s difficult to know if the right muscles are being activated.
Below are 2 manual muscle tests for assessing abdominal stability:
Modified Deadbug:
Instruct the client to try to hold this position for 30 seconds and ask them what area or part of the body they feel most. During the test, palpate the area of the transverse abdominis (TVA) with your middle finger and feel for contraction. A good rule of thumb to use is if you can easily push your finger to first knuckle depth. If so, this is an indication of weak or inhibited abdominal stabilizers. Also, if the client feels mostly the thighs and/or just below the ribcage the abdominal stabilizers are most likely weak or inhibited.
Sitting ‘V’ Position
Instruct the client to hold this position for with a slight backward lean of the trunk for 60 seconds and notice any changes. If the chest drops, they feel burning in the thighs, cramping in the hips and/or the lumbar extensors this indicates weakness or inhibition of the abdominal stabilizers.
Also, palpatation of the quadriceps will provide important feedback. If you feel the quadriceps contract strongly this is an indication of the quadriceps compensating for weak or inhibited abdominal stabilizers.
These tests take time and practice to learn but manual muscle testing is a valuable skill for fitness professionals that can help correct muscle imbalances, prevent injuries and improve the effectiveness of an exercise program.
Unfortunately, muscle testing isn’t taught in most personal training certification courses however there are some excellent resources available on muscle manual testing and core stabilization exercises
