When people hear the word, “muscle imbalance“, they think “tight muscle” so let me stretch it.

This is kind of right, you need to stretch it but why does the muscle imbalance come back after you stretch it?

Because there is much more to eliminating muscle imbalances permanently than just stretching tight muscles.

That is mistake #1 when it comes to muscle imbalances.

Let me go through a few more that you or your clients might be making.

#2 – Not Looking at Fascia

We all know someone that has plantar fasciitis.

There is a good chance what they have been given to address their plantar fasciitis is stretches.

Many times this will provide temporary relief but the pain comes back.  The reason why, is people try to address plantar fasciitis like it is a muscle issue even though it is fascia issue.

This is one example but there are numerous other examples in the hamstrings, biceps and IT band.

In order to address muscle imbalances, you need to address fascia in the body like it is fascia and not muscle.

#3 – Not Taking Breathing Serious

Only focusing on breathing out during exertion and breathing in during relaxation phases of exercise are important to keep a steady blood pressure in clients but breathing is so much more than that.

Proper breathing assists in spinal extension and flexion and helps pump cerebrospinal fluid up to the brain and back down through the (central) spinal canal.

Proper breathing is also needed to properly stabilize the spine and trunk during functional movements which helps to reduce the likelihood of injuries to the lower back or extremities.

Most people do not breathe properly and as a result overuse the muscles of the chest and neck which leads to chronic neck pain and stiffness, decreased blood supply to the brain, headaches and other more serious problems.

Proper breathing needs to be integrated into core exercises in order to relax the diaphragm, the accessory muscles of the chest and neck.

It needs to be integrated into dynamic exercises in order to assist in movement efficiency and proper movement patterns.

Breathing also needs to be incorporated into stretching and self massage in order to get the maximum benefit from the stretch or self massage plus relax surrounding muscles and fascia.

#4 – Core Training Is More Than Just Abdominal Training

Over the last 13 years, core training has evolved tremendously.  With more research being done on the continuum of core training when it relates to clients that are rehabilitating an injury, improving fitness results or maximizing performance goal.

Core training has become synonymous with abdominal training. And, abdominal training has become narrowly focused on crunches and other non-functional movements that lead to poor posture, decreased core stability, muscle imbalances and injuries.

The core is the body’s center of gravity and origin of movement made up of approximately 35 muscles that attach to the spine and/or pelvis.

In order to achieve optimum core function it is vital to identify which core muscles are imbalanced and employ a targeted program to address these muscles and integrate them within functional movements.

There area a lot more examples of mistakes exercise enthusiasts and health & fitness professionals make when it comes to muscle imbalances but I think you get the point from just these four examples.

What are some other mistakes you’ve noticed when it comes to addressing muscle imbalances?

Leave me a comment below.

Next time you come across a tight muscle, remember, there is more to just stretch it out in order to get rid of it for good.

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I recently received a question on my YouTube channel asking my thoughts on squatting and deadlifting with lower back pain and kyphotic posture.

This person mentioned their physiotherapist had advised against all squatting saying that the pressure of the bar would promote kyphosis and that deadlifting was out because it would increase lordosis of the lumbar spine.

This reminded me of my own experience with lower back pain.

About 10 years ago I was working for a physical therapy clinic and at the time I was dealing with a nagging bout of lower back pain.

After trying several unsuccessful ways to get rid of the pain I asked the head therapist if he could have a look at me.

This therapist LOVED using the ol’ pull-the-leg-technique for patients with low back pain.

If you’re unfamiliar with this it’s when one leg appears shorter than the other due to rotation of the pelvis and the therapist basically uses a quick, sharp pull at the lower leg on the short side to ‘lengthen the leg’ so it’s even with the other.

I remember this therapist was once working on a patient in a private room and all was quiet in the clinic until a giant scream was heard.

Turns out he was using this technique but the patient had no idea what was coming and it completely freaked her out.

So, after looking me over he determined my left leg was shorter than my right and he did his favorite technique and pulled my leg quickly and VOILA!

Both legs were even length again.

I have to admit it felt funny walking since I had become accustomed to being uneven.

Then he laid the news on me…

…’Don’t do any squatting for 2 weeks’.

‘What! You mean I can’t squat down at all?‘ I asked.

‘That’s right‘ he replied.

Now, I can take some time off from squatting or deadlifting in the gym but in every day life this was asking a lot.

If you think of everything you do that involves squatting like sitting down in a chair, getting in and out of bed, getting in and out of a car, picking up things around the house or the yard, sports activities…

…Hell, how can you take a dump without squatting?

Squatting is a fundamental movement required to exist in our world and without it a whole host of problems would occur.

Think of what your life would be like if you couldn’t squat?

Imagine how you would lift objects around the house or the yard.

And, consider that most squatting movements we perform are loaded from the front so this includes deadlifting and front squatting.

In the video below I addressed a few questions regarding whether or not squats, deadlifts and posterior chain exercises are bad for your lower back.

I also share some key insights on the BIGGEST MISTAKES most people make when performing posterior chain exercises and how those mistakes can make a back injury worse and the most important thing to consider when performing exercises for the posterior chain.

I discuss how hamstring stretches can compound low back pain, when they’re appropriate and for whom.

And, finally I reveal whether or not it’s safe to lift weights with lower back pain.

This video is a bit lengthy but it’s loaded with useful information that I hope will help others who are dealing with similar issues.

So, you might need to grab your favorite beverage and sit back for this one but I’m sure you’ll gain LOTS of new insights.

By the way, if you like this video go ahead and hit the share buttons below.

And, feel free to drop a comment below if you have any feedback.

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This can happen for several reasons and one of the most common is sedentary jobs and lifestyles which can have a HUGELY negative impact on mobility of the spine particularly in rotation.

Thoracic spinal rotation is a requirement for so many movements and a lack of mobility often results in injuries to the spine, lower back muscles, hips, knees and the list goes on…

…There are techniques that can help improve mobility of the thoracic spine like foam rolling, stretching, massage therapy, and manual joint mobilizations performed by a chiropractor or physical therapist.

However, while these techniques can help they are often short-lived unless new motor programming is used to help your client teach their body how to actively mobilize their spine during functional activities.

In the video below I reveal 1 highly effective exercise to instantly improve thoracic spine mobility

:

Leave a comment below and let me know how this works for you or your clients and if you’re eager to learn more corrective exercises to help your clients overcome injuries or training plateaus then you’ll definitely want to check this out:

Go here to learn how to help your clients overcome LOWER body injuries

Go here to learn how to help your clients overcome UPPER body injuries

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Nearly 5 years ago I was working at a private personal training studio.  The owner was a guy who really enjoyed training clients and helping them reach their fat loss and fitness goals.

He was good at getting results with his clients as long as they fit the ‘apparently healthy’ category.

The thing is that for some reason we got a LOT of clients who wanted to either lose weight, build muscle or improve sports performance but weren’t reaching their goals because nagging injuries were getting in their way.

If you or anyone you know has dealt with one of these injuries before then you know how annoying it is when you can’t figure out why it’s there, what caused it or how to get rid of the damned thing.

Then one day I was in the office catching up on updating some programs for my clients while the owner was training one of his clients.

The client was a rather petite female in her early 50′s who wanted to lose some body fat so she could fit in the bikini she bought for her summer vacation which was a few weeks away.

She was so excited about this trip and really wanted to look her best.

And all was quiet in the studio until I heard a sound so loud I almost dropped my pen.

This did NOT sound good so I made my way down the hallway to the training room in the back of the studio. As I got closer I could hear the sound getting louder ‘OUCH!’

It was coming from the owner’s client who was obviously in pain and I wanted to know why (call me nosey but hey that’s just me

When I peeked into the training room it took me about 3 seconds to see why she was in pain.

The owner had her on the floor doing superman’s…

…Now you might be wondering what’s wrong with doing Superman’s?

Normally nothing except for the fact that his client suffered from chronic lower back pain.

Now, here’s where the real problem was…

…The owner thought that her problem was due to weak lower back muscles and he figured doing Superman’s would help strengthen her lower back.

And, as she was finishing the exercise she asked him ‘Is this supposed to hurt?‘

To which he replied with a grin from ear to ear ‘Yep! Your back is weak.’

Now, I’m not a physical therapist or doctor but the one thing I realized having worked with her during a few sessions when the owner needed me to cover for him was that the last thing she needed was to strengthen her lower back muscles.

Her problem wasn’t that her lower back was weak but quite the opposite.

It was actually strong and that was the problem.

See, her lower back had developed its’ strength as a way of compensating because her abdominals and hips were extremely weak. In other words, she had muscle imbalances that needed to be addressed.

Unfortunately, after that episode she left the studio never to return.

So, what’s my point to all of this?

It’s simply that the owner could have avoided losing a client (he’s lucky she didn’t file a lawsuit) if he understood the nature of her injury which was muscular imbalances.

But, despite having over 20 years of experience and multiple certifications to his credit what he did not have was a system for identifying and addressing muscle imbalances.

Had he developed a system he would have been able to understand the cause of his client’s injury and how to select the most effective exercises to help her recover from it.

Unfortunately, when it comes to addressing muscle imbalances many fitness professionals are stretching tight muscles and strengthening weak muscles without seeing their clients improve much.

It’s even more frustrating when you send a client off to their doctor and they can’t figure out what’s going on either.

To gain some insight on addressing muscle imbalances I recently interviewed Rick Kaselj.

Rick is a kinesiologist and personal trainer in Canada who specializes in teaching fitness professionals and his clients the FASTEST exercise methods to recover from injuries.

I’ve known Rick for several years and every time I get the chance to talk to him he never ceases to amaze me with his knowledge of injury rehabilitation.

So, I thought I’d pick his brain again to see what he could tell me about addressing muscle imbalances for upper body injuries.

And, he had plenty to say about:

• The biggest muscle imbalance issue in the upper body

• How to assess muscle imbalances in the upper body

• What people can do about muscle imbalances in their upper body

• A huge trend that is happening with clients in the gym

• How poor breathing can lead to muscle stress and pain

• Great example of integrating breathing with exercise

And, lot’s more…

Click Here To Listen To The Interview

(if you want to download the interview just right click your mouse and click ‘save link as’ to your desktop)

If you’re anything like me then you’ll stop at nothing when it comes to learning the fastest injury recovery methods.

If this describes you then you might want to take a look at this.

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Does this guy need to stretch his hamstrings?

What if he has chronic low back pain?

Does that change your answer?

As you already know tight hamstrings can not only make you or your clients look the hunch back of notre dame but can also contribute to lower back pain.

But does that mean hamstring stretches will help relieve lower back pain?

The answer may just lie in identifying the person’s physical profile…

…I’ve discovered that people fit into 1 of 2 types and identifying their physical profile is the KEY as to whether or not hamstring stretches will help or make an existing low back problem worse.

In the video I share the 2 profile types, a simple way to identify which one you or your clients are and which profile hamstring stretches might help and which one they might hurt.

If you found this video helpful and want to learn more about identifying muscle imbalances and the most effective way to correct them then be sure to check out Muscle Imbalances Revealed Upper Body.

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When I first began working with clients I focused on helping my clients improve strength, endurance, flexibility, cardiovascular fitness and performance to get them from where they were at the time to where they wanted to be.

And, I got some pretty good results but nothing worth shouting from the roof tops if you know what I mean.

One of the biggest problems was that so many of my clients had nagging injuries that were getting ‘in the way’ of them achieving their goals.

So, I became obsessed with learning as much as I could about rehabbing these nagging injuries so I could help them.

One thing about me is that if I become determined to do something I’ll move heaven and earth to do it.

Over the years I learned a lot and helped a lot of people along the way.

I’m STILL learning…

…I’ll ALWAYS be learning…

…Because I’m a STUDENT first and foremost!

And, as students we often make mistakes. I’ve made so many mistakes I could definitely write a novel on the topic. But, I’ll leave that for another time

But, it’s mistakes that are our most valuable teachers.

I know my mistakes when assessing and working with clients have taught me quite a bit and I thought I’d share 5 of those lessons with you today.

Here are 5 things to NEVER do when addressing (and assessing for that matter) muscular imbalances:

1) NEVER Assume A Muscle Is Tight Or Weak Based On Posture- While this may be the case its best to use deeper specific assessments to determine muscle tightness or weakness.

Sometimes a client may exhibit visible signs of muscle tightness or weakness however it may simply be due to a lack of awareness rather than true tightness or weakness.

2) NEVER Rely On Static Stretching As The Only Method For Improving Flexibility & Decreasing Muscle Imbalances-

Static stretching  offers some benefits however other methods such as dynamic flexibility techniques are more important since injuries occur while we are moving with muscles contacting.

3) NEVER Just Avoid Certain Movements & Activities As A Means Of Rehabbing An Injury- Movements involving squatting, twisting and lunging are  part of our everyday lives and therefore avoiding these without preparing to perform these movements safely and effectively is an open invitation to injury.

4) NEVER Limit Core Training To ‘Abs Only‘ Exercises-The core consists of 29-35 muscles that attach to the spine and/or pelvis.

Core training has been ‘dummied‘ down to mostly abdominal exercises which is a big mistake.
The core includes  not only the entire abdominal complex but muscles such as the glutes, thoracumbar fascia and the lats as well.

5) NEVER Rely Only On Basic Exercise Assessments For Identifying Muscle Imbalances- Assessments like the trunk curl-up, push-ups, leg press, bench press and cardiovascular fitness testing are too general and apply to those who fit the ‘apparently healthy’ fitness category.

These and other basic fitness assessments won’t provide enough information as to why a client suffers from chronic shoulder, lower back, hip or knee pain.

Effectively and accurately assessing muscular imbalances requires specific tests that go beyond basic fitness tests.

I’m not saying you need to be a doctor and try and diagnose injuries or perform tests beyond your scope of practice.

What I am saying is that using your knowledge of human anatomy, kinesiology and biomechanics will go a long way toward accurately identifying muscular imbalances in your clients and being able to design effective exercise programs to help restore muscle balance, overcome nagging injuries and chronic pain as well as improving performance.

One of the BEST programs that teaches you this type of stuff is the Muscle Imbalances Revealed Upper Body Edition by Rick Kaselj.

I’ve know Rick for several years now and the guy is an absolute genius when it comes to addressing muscle imbalances.

Plus he’s assembled an amazing team of experts (Tony Gentilcore, Dean Somerset, Dr. Jeff Cubos) to share their tips, tricks and exercises when it relates to muscle imbalances in the upper body.

Now you can save 47% off his extremely popular program and effective program until Friday. After that the price is going to double.

Here’s the link again if you’re interested==>Get The Muscle Imbalances Revealed Upper Body Edition At 47% Off (until Friday)

CLICK HERE TO ORDER

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One of the BIGGEST contributors to shoulder problems is poor mobility resulting from muscular imbalances.

One of the most common muscular imbalances of the shoulder exists when there’s dominance of the levator scapulae and upper trapezius along with inhibition of the middle and lower trapezius.

A tight levator scapulae elevates the scapula causing the humerus to butt up against the acromion leading to shoulder impingement and rotator cuff injuries.

A tight levator scapulae can also create tension along the cervical spine and decrease the space of the intervertebral foramina which can cause irritation of the passing nerves.

If left unaddressed the natural upward rotation of the scapula is thrown off during overhead movements and over time can cause pain and dysfunction to the neck and shoulder.

The mid and lower trapezius which assist with the upper traps in upward scapular rotation become weak or inhibited.

So, the goal to re-establish proper upward rotation of the scapula is to engage the mid and lower traps.

In the video below I show you a highly effective exercise with a unique twist to help improve upward rotation of the scapula in just minutes.

If you’re like me and enjoy learning and using this kind of stuff and would like to know more about addressing muscular imbalances of the upper body then I strongly recommend taking a serious look at the new Muscle Imbalances Revealed Upper Body Edition.

It’s something like 50% off if you grab it before this Friday.

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Whether your goal is to lose weight, gain strength or improve athletic performance there’s just no way you can optimize either without proper upper body flexibility.

Some of the most problematic areas of the upper body for most people involve limited range of motion at the neck, shoulders, throacic spine (rotation deficit) and lumbar spine.

Now, if you’ve tried all kinds of static stretches and various techniques like self-myofascial release without impressive results then here’s a simple but highly effective upper body mobility routine I’ve designed that will improve active flexibility of the upper body quickly.

I call it my Medball Mobility Circuit and it can be performed in less than 8 minutes.

All you need is a light weight medicine ball (2kg-3kg) and the circuit is ideal for anyone from the beginning trainee to more advanced.

If you like how well this circuit works and want to learn more about identifying and correcting specific muscle imbalances of the upper body then you’ve got to check out Rick Kaselj’s Muscle Imbalances Revealed Upper Body System. As a loyal subscriber to my blog Rick is offering the entire upper body system at 52% off the regular price (a measley $77!)

But, the offer is only good until Friday August 26. After then you’ll have to pay $147 smackeroos to get your hands on this system.

If you’re a SERIOUS fitness pro who’s committed to getting the best results possible for your clients while helping them overcome the nagging problems that are holding them back then do yourself a favor and invest in yourself. By the way, Rick is so confident you’ll love his upper body system that he’s offering a complete 100% money back guarantee if you’re not completely satisfied with the level of expertise and results you’ll get with the Muscle Imbalances Revealed Complete Upper Body System.

>>Click HERE To Get The Muscle Imbalances Revealed Upper Body System At 52% Off (Offer Expires Friday Aug 26)<<

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Push-up tests, trunk curl-up tests, bench press tests, leg press tests sure these are fine if you only want to get average results for your training clients.

But, if you want the BEST results possible you need to get really awesome at assessing posture, muscular imbalances involving the upper and lower body, functional movement and flexibility.

It’s too bad because this is where most certification programs drop the ball.

They either don’t teach these kinetic chain assessments at all and instead remain lost in the stone-age of generalized fitness assessments and traditional gym exercises or they only teach a small handful of more advanced assessment techniques that often leaves trainers still wondering how to implement them.

Last year I had the privilege of hanging out with strength coach Elliott Hulse for a couple of days in Florida and it was like a huge breath of fresh air for me to know how much knowledge Elliott has in using advanced client assessments and training methods to get results for his clients and athletes.

Elliott’s holistic approach is flat out cool and highly effective and I think it’s something that every personal trainer and athletic coach should be incorporating into their assessments.

I have to warn you…

…If you are a personal trainer who thinks you should leave advanced assessments to ‘better qualified’ medical professionals then do not watch the video below.

Just understand that you will forever struggle take your skills from good to great and you’ll always be seen as just another trainer who sits around counting reps and  ‘taking clients through workouts‘.

You will never set yourself apart from your competitors which means potential clients will only hire you if you’re the cheapest option in your area.

But, if you want to take your skills to the next level then check out Elliott’s video where he shows you exactly how to assess your training clients and what you need to know to design seriously effective programs that get results fast.

If you thought that was cool then be sure to take a look at how to design superior training programs for your clients.  

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“Unrealistic about the role of an athletic trainer and borderline offensive to other medical professionals at times. Information is usually objective but Kevin gets very personal on a very public posting which I think is unprofessional at times. It has it’s place when it shows passion about the field or clients, but not about personal beliefs of other medical professions.”

Now, I can completely understand when someone has a difference of opinion but when someone calls me out saying that I am basing my knowledge and teachings on ‘personal beliefs’ it’s just ridiculous.

I would think he would have actually mentioned specifically what information that is ‘borderline offensive to medical professionals’ particularly when I have medical professionals on my e-mail list who have complimented my work.

It has NEVER been my intention to offend or in any way be disrespectful to medical professionals.

And, before inviting me to contact him to ‘explain further and discuss this’ with me it would have been nice to know what in the WORLD he was talking about.

I’m still not sure what is ‘unrealistic about the role of an athletic trainer’ as if this guy really followed my blog and videos he would know I’m not–nor do I ever refer to myself as an–athletic trainer.

But, I do base my information on principles of human anatomy, physiology, biomechanics and kinesiology.

I’m not saying I’m perfect or that my methods are the ONLY ones that work. I’m simply offering information I have come to learn along my journey toward empowering others to achieve their lifelong fitness goals.

And, to say that what I do is not about passion–seriously now–don’t even get me started on that as I have nothing but passion for both the fitness industry and personal trainers.

My intention has never been to offend anyone but to do my best to help my fellow fitness professionals earn the level of success, respect and recognition they deserve and not to be looked down upon or made to be less than those in the medical industry.

I believe that a bridge must exist that unites the medical and fitness industry rather than a one vs the other mentality as I feel this person has displayed.

I apologize for going on such a rant here but I was wondering if anyone else finds the information I put out to be offensive and unprofessional. I usually wouldn’t give a comment like this the time of day but this so-called ‘medical professional’ has said some things I consider to be completely out of line and completely disrespectful to not only me but to my fellow fitness professionals.

I admit I have my own methods which are based on over 11 years of study and hands-on hard work and not all of my methods are in agreement with most physical rehabilitation models but I stand behind them 100%.

I believe with every fiber of my being in what I do.

But, maybe I am offensive and unprofessional what do you think?

If you have any opinion on this feel free to post it here good or bad.

——————–UPDATE BELOW——————————————

Since I posted this I thought about it a bit and so I took the doc up on his offer and contacted him.

Not to badger him but because I was genuinely curious as to what he was referring to.  As it turns out he was referring to one of my previous posts ‘Why Fitness Assessments Tick Me Off’ .

He did reply back with a clear explanation of what he found ‘personal’ and ‘borderline offensive’ but also with his own case history of one of his patients.  He also asked at the end what I would have done if this patient came to me (please note that I replied back to him and explained that fitness professionals do not ‘treat patients’ but we work with clients).

I also made it clear that I have NEVER positioned myself or claimed to be an athletic trainer (I still do not know where he got this from, but oh well).

Now, I found some of what he said interesting and I have my response to this but I thought it would be even more interesting to hear about what my fellow fitness pros think and would do in this scenario.

So, I will post his reply (with his name withheld of course) in the hopes that many of you can add your thoughts and ideas to the discussion.

Here is his reply back to me (and my response below):

“Hey Kevin,

Absolutely. There was one posting specifically, a few moths ago where you talked about functional movement assessments or what I call movement screens.  You took the entire cover page of the e-mail and stated your anger about athletic trainers getting in trouble for doing assessments (personal in a public forum) and something to the extent of, “don’t get me started on why PTs and MDs shouldn’t be doing functional movement assessments!”. (offensive to other professions on your belief of their capabilities).

Role of an athletic trainer- correct me if I’m wrong, please, but the schooling for an athletic trainer does not consist of diagnostic training.  This in it’s simplest form is why athletic trainers should not be able to do assessments or evaluations.  As a PT we can, but we’ve had extensive training in out basic schooling on gait analysis, pathophysiology and differential diagnosis with image reading; not including specific differential and evaluation in each core orthopedic and kinesiology course we have to take. 

I only treat functionally, many therapists are trained that way.  I’ve worked extremely closely and well with many ATCs who have picked up my patients after therapy or transitioned to them, interdependence among disciplines is paramount for good patient care! 

Case and point, I had a patient with “hip pain,” early 40s, referral for Hx of R hip OA.  antalgic gait with a hip drop R on R stance phase.  Weakness and pain with hip flexion and abduction. Into groin (typical hip referral patten).  Glute med weakness/activation issues?  Absolutely possible.  Thats what my inital movement screen and gait analysis would show.  Through the rest of my evaluation, point tenderness at anterior hip, flexion to 85deg and locks out with a hard end feel…

Patient looks thin, upon further questioning, he’s not been hungry, lost a bit of wait but hasn’t done much lately, it’s his off season… He’s also HEP-C posative which could account for the weight and hunger. 

Then the big Q… History of cancer in the family?  Yes…  That coupled with the other factors especially hard end feel warranted an immediate referral back to his MD with a call that minute to explain the urgency. MRI showed a “lesion” in his right anterior hip capsule that turned out to be malignant. 

These are things that don’t come up in a normal movement assessment. But for an initial evaluation of a patient or client NEED to be considered. 

I have good friends and collegues who are ATCs don’t get me wrong about their vital role in healthcare, but evaluations aren’t in their practice act simply because they don’t have the training on it. 

As a PT, I’m trained to read diagnostic imaging as a tool in differential diagnosis… That does not mean I can order them, and I understand that, because I don’t have to training in blood work and other internal medical diagnostics that precede an imaging.

The only reason im writing now instead of a few months agois that I had just let it go, but I’m at a conference this weekend and we were discussing interdisciplinary work and this issue came up, sparked some memories and thought I would express this to you and see what your thoughts were.

I do commend you on your work, you obviously have a great knowledge base of the body and can help a lot of people that way.  That’s what it’s about… Patient care, and that was my issues with your comments.  If that man came in for help with his hip pain and arthritis, would you have done the same?

Thanks Kevin, I look forward to your response.”

(name withheld) PT, DPT, CSTS
Doctor of Physical Therapy

Fair enough.

So, here is my response…

“Hey Dr.(name withheld),

Thanks for responding. Let me first commend you on taking a functional approach to assessing and treating your patients. I’ll touch briefly on what you said here:

First off the problem I am referring to in the article post is to those medical professionals who only address the area of injury as a means of physical rehabilitation.

For example, I have worked along side some very knowledgeable PT’s who I learned a lot from over the years. However, I did not and do not agree with a patient who say comes in with a history of chronic knee, shoulder or low back problems and only having treatment performed on the area of injury as you and I both understand in many of these cases the area of injury is a symptom and not the cause.

I simply stand by addressing the causes in order to help a client overcome the physical limitations that are holding them back and having devastating effects on their lives.

I do not agree that a person with knee pain should do exercises to strengthen the quadriceps IF the problem is that they have weakness in the hip extensors and are already overusing the quadriceps as a compensation pattern.

This is only 1 example I have seen.

This is not based solely on my personal beliefs. Sure I have my opinions (we all do don’t we) but they are based on facts of how our bodies work.

And, while doctors are experts at diagnosing disease and treating more serious injuries they are not experts in fitness assessments nor dealing with muscular imbalances unless they have has specialized training.

I realize that some may however I am referring to those who do not.

Unfortunately, not all PT’s do in depth assessments as I mentioned above. Again, I commend you for doing a more complete form of assessing your patients but not everyone takes your approach.

Secondly, I am not an athletic trainer and do not position myself as such. My position on assessing clients (fitness professionals do not treat patients) has much to do with the argument going on in the fitness industry (and perhaps in the medical industry) where some feel that personal trainers are not qualified to perform more specific assessments beyond the typical sit and reach, push-up, bench press, leg press or cardiovascular testing.

The problem I see is that as fitness professionals we have the majority of clients come to us who are dealing with some orthopedic issue. Now, when it’s a case of muscular imbalances causing the issue (which about 70% of non-contact injuries are according to statistics by the NASM) exercise is the appropriate remedy. And, I feel that fitness professionals can help.

But, fitness professionals should be taught more specific assessments in this regard. There are some certification courses that teach these but not all do.

More importantly is that I am not suggesting fitness professionals attempt to diagnose or treat medical conditions.  

I am saying that it is not beyond our scope of practice to assess our clients by using what we are required to know and that is our knowledge of human anatomy, physiology, biomechanics and kinesiology .

I also want to make clear that I am not blaming the medical industry. I believe the fitness industry must change. But, to say all fitness professionals are unqualified to perform functional movement assessments is incorrect.

In your example of your patient you ask if I would have done the same. Anytime an assessment goes beyond what I mentioned above and crosses into the need for medical intervention then absolutely I would refer out.

In your example things went from a movement assessment to a possible medical concern. This would obviously cross the line into the need for medical referral and I would have referred out.

The whole idea behind my post was to bring to light the reality that most training clients do not fit the ‘apparently healthy’ category anymore and that fitness professionals can do more than simply take people through workouts.

Our role is to help our clients improve their quality of life and to effectively perform this role fitness professionals should be taught to use more specific assessments (which should be taught by more certifying organizations) based on human anatomy, physiology, biomechanics and kinesiology to help design and implement exercise programs to help our clients reach their fitness goals.

Not to evaluate, diagnose or treat diseases or medical conditions but to simply provide more specific fitness assessments.

I agree with you the patient/client care is the #1 priority and that for fitness professionals to provide better care for our clients begins with better initial fitness assessments.

Thank you again for your reply,”

Kevin Yates

NOTE: After I had realized I forgot to mention one important detail and so I explained to him that I would have examined the patient’s health history PRIOR to performing a physical assessment which would have brought his health concerns to light and necessitated a medical referral and written clearance before beginning an exercise program.  I am unsure as to why he performed a physical assessment before asking the patient about his health history.

Now it’s your turn to share your thoughts on this topic.

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