My thoughts and perspectives on health, science, and logic… Keep an open mind!


“You’re only as strong as your weakest link!”

We’ve heard that expression a thousand times.  These days, it’s repeated ad nauseum by well-intentioned trainers, coaches, and other fitness professionals who are trying to find new ways to analyze the movements of their clients and athletes. The fitness industry is filled with certifications, tools, tricks, and toys.  Look around at any local gym, and you’re likely to find trainers who have all sorts of letters after their names.

A continuing trend in many cases is the move toward “corrective exercise”  coupled with movement screens and assessments that are used to analyze the quality of a client’s movement.  These are thought to give the trainer powerful insight that will help him or her take better care of his/her clients.  In essence, these tools should help to tease out a client’s/athlete’s “weakest link” so it can be addressed.  Cool, right?

Many screening and assessment tools abound -- one of the most widely known being the Functional Movement Screen (FMS). I wonder what this guy's

Many screening and assessment tools abound — one of the most widely known being the Functional Movement Screen (FMS).
I wonder what this guy’s “weakest link is”…

Unfortunately, I’m of the opinion that many people are expecting too much out of these tools and, in some cases, just plain wasting their time.  I felt I’d share a few of my thoughts on movement assessments (not exhaustive at all, but something to start with).

You see, people get caught up in different “screens” and “assessments” that are supposed to give some reasonable indication of movements that a person can or cannot do safely and/or without pain. The trouble is, most of these methodologies operate from a very presumptuous position. That is, they make a number of assumptions that I think are unjustified (the first 3 items on my list). While not all screening/assessment methods are guilty everything I’m about to talk about, I think these are each common enough to warrant mentioning:

1) They assume there’s one universal version of “GOOD” movement. That is to say, there’s an idealized picture in many fit pros’ heads of how a “squat” or a “press” or a “lunge” is supposed to look. The trouble is that these visually based evaluations normally don’t take into account specific structural differences that might *require* one person to move differently from another. Furthermore, the reasons given for why “good” movement is “good” in the first place are often vague and, in some cases, flat-out wrong.  Who decides what the most “fundamental” or “important” movement patterns are?

2) They assume that we can automatically know if a muscle is “weak” or “tight” by looking at posture or gross movement. The trouble with this is that movement is a highly complex process that the body orchestrates from moment to moment, and a single “snapshot” (in the case of a posture evaluation, for example) gives us very limited meaningful information about the capabilities of the body. Further, specific muscular deficiencies take time to tease out, as NO movement in the body occurs in pure isolation. It’s a fantasy to think that you can ever completely isolate a muscle through voluntary contraction (or involuntary postural control).  The only way to know if there really is a “muscle imbalance” (itself a misnomer) is to test each and every function you’re curious about as directly as possible.  You don’t know what is dysfunctional just by watching someone move.

3) They assume they test things that they actually don’t. Put another way, these screening tools tend to carry little to no validity. Many of them fail to have reproducible results when put under scientific scrutiny. If the entire point of a screening tool is to test a person’s “movement quality” (whatever that means) and predict the likelihood that they can perform similar movements skillfully, then the selected “tests” being administered had better actually indicate that probability! Unfortunately, many movement-based screening tools don’t hold up.

4) Relating to the last point but warranting its own mention due to the implications — many of these methodologies aren’t particularly good at predicting injury risk. One of the biggest arguments that “movement quality” proponents hang their hats on is the idea that a “less dysfunctional movement pattern” is a safer movement pattern. Unfortunately, this is problematic — largely because 1) there’s no easy way to agree on what a universally “good” pattern would be in the first place, and 2) the movements as chosen and enforced in these screens/assessments often don’t predict injury risk at all! Put another way, they’re typically of little use for doing the thing that attract many people to them in the first place.

5) This is a catch-all bullet point for a bunch of other issues that I see. Not assumptions per se, but flaws in many screening methodologies that make it difficult to use these tools in the ways they are intended — These include vague definitions of the desired movements and how they should be executed, subjective “scoring” systems that could result in vastly different ratings given by different testers, and a lack of mention of/appreciation for the factors that might contribute to a perceived *improvement* in function or movement over time (e.g. was it something in the training? Did the person get better at the screen by practicing the screen? Is it something that the nervous system “sorted out” on its own without our intervention? Hard to tell with limited tools and sloppy testing).

***********************

Now this isn’t to say that screens and assessments are altogether useless. But we have to be mindful of what we can and cannot glean from them! Ultimately, the only thing you know with absolute certainty when you evaluate a person’s movement is how they can perform that *exact* movement at that *exact* moment in time. The hows and the whys will almost always require further investigation.

Which exact muscles might be responsible for issues with this motion?  Some of them?  All of them?  Just one?  Maybe NONE? (Image taken from Biology-Forums.com)

Which exact muscles might be responsible for issues with this motion? Some of them? All of them? Just one? Maybe NONE?
(Image taken from Biology-Forums.com)

Is their knee diving in because of “tight” adductors? Maybe. But how do you determine if that’s the case? And which adductors? And in what position? An externally rotated hip will have a different set of muscles as “primary” adductors than an internally rotated one. Are you really being “apples to apples” when you analyze the differences between one side of the body and the other?  And THEN how do you address this perceived “tightness” effectively and without negative effects?

^^^ As hinted at above, any piece of information you may get from a screen or movement assessment (particularly if it’s the kind that is typically “sold” to personal trainers and other fitness professionals) will need to be followed up by a series of more specific questions before you know what is really going on.

My personal experience and study (limited as they are) have led me to the conclusion that assessing a person’s movement for exercise purposes is going to change in accordance with the exercise we’re most concerned about. To most of my colleagues who really know body mechanics and exercise progression, this should come as no surprise. A “general” assessment is going to give you a “general” answer. As such, you’re going to need to do something that is more dialed into the movement you want to know about.

In my world, this means testing an unloaded (or slightly loaded) version of the exercise we’re about to do if I think the individual can handle that basic task. If I’m not yet sure of even that capability, I’ll probably look at active range of motion for any joint motion that the desired exercise requires. A thorough understanding of movement and mechanics can allow you to break any full exercise down into its component parts as needed. This means you can test in a way that is more specific to what you’re actually looking for.

For example — want to know about whether someone is competent to handle a bench press? Perhaps examine their active control in horizontal adduction and abduction. Look at scapular motions like protraction/retraction and elevation and depression (in isolation as well as with shoulder motion). You may even want to do positional strength/stability tests to make sure the person can handle force there. THEN you’ll hopefully have some idea of whether or not they can handle an actual load with those joint motions/positions.

what-does-it-mean

Maybe he’s got a point…

So what’s the point of this whole thing?  If you don’t take anything else away from my rant, hopefully this last bit will make some sense.

In a recent conversation with a friend, I summed up my thoughts on fitness movement assessments (rather bluntly):

—-

Try a movement. Is there pain? Don’t do that thing. Get checked out by a qualified specialist if that pain persists.

Try other movements. Can you do those? Cool. Now try loading them slowly. Notice issues? Okay, there’s your barrier.

Assess positional strength as desired (if you’re trained and qualified to do so), and this may help with teasing out movement issues. But you won’t know until you establish strength/stability and then recheck the movement. Additional learning/training of the previously “faulty” movement is likely still going to be needed.

And dammit, pay attention to how EACH person’s body seems to move best. Different mechanics + different motor learning histories = different ideal solutions. Everyone won’t look the same.  One person’s “best” isn’t the same as someone else’s.

* Furthermore, I threw in what is one of the central tenets to how I approach exercise:

Every movement in itself is its own “assessment.”

You can approximate that movement by doing slower/deloaded versions, versions with limited range, etc., but it’s always just an educated guess. You don’t know for certain how a person’s going to do a loaded front squat until you have them DO a loaded front squat.

—-

Furthermore, assessments don’t just happen at the beginning of a training session or at regular four-week intervals.  EVERY SINGLE REP gives you information.  A trainer should never stop evaluating how a client is executing an exercise.  Just because they did it great five minutes ago doesn’t mean it’s perfect right now.  Likewise, we as “exercisers” ourselves need to be aware that our muscles and nervous systems are in states of constant change.  If we pay close attention to them, we can get much more out of our training than we would by turning our “assessing” brains off and kicking into auto-pilot.

So ultimately, I feel that we need to take a step back.  We need to resist the temptation to buy into “screening” and “assessment” systems that hand us pre-selected criteria for “good” movement and promise that it’ll make us better at predicting the future.  We must understand that a test/assessment/screen is only as good as its validity, and —  If we don’t have confidence in that validity, we’re probably better off with breaking down exercises into components that make sense for us.

If you try out a particular tool and TRULY think that it is helpful to you, then by all means use it.  But be aware that many of these systems aren’t what they’re cracked up to be and, when you really scrutinize them, just don’t do what they set out to do.

We only get so much time in the gym, on the mat, or on the table.  Let’s use that time wisely.

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Comments on: "What are We Assessing?" (2)

  1. Geoff, great stuff again. Another perspective is that those who market their specific screening protocols are simply fishing for new clients. I see it all the time, particularly Chiropractors who have a “state of the art, scientific” postural analysis. Seriously, having most anybody stand is a static position at a health fair or clinic we can all point out significant “problems” that only our expertise can “fix”. I agree with you, in the right setting, with the right motives and truly objective view of the whole complex organism we may gain some insight into areas we can help clients improve. But, I am rarely a fan of static assessments, sometimes even “functional” assessments do not give a true, real life picture.
    After all, just like any study, if you observe, you therefore change behaviors, and not necessarily in a positive or real life way.
    Keep up the good work.

    Liked by 1 person

    • Good points, and I’m in agreement.

      I wish most of the posture-based dogma would die off already. Posture is often a result of choice that people can easily alter if requested (so are those muscles really “tight” or “weak” to begin with?), and it doesn’t even correlate well with pain or other sorts of “dysfunction” that we love so much to identify.

      As luck would have it, I happen to have just entered into the beginning stages of designing a back pain study. The neurologist we met with has a heavy postural bias, but I’m maintaining that posture is a bit of a red herring, and we’ll find better pain correlates if we look elsewhere. Isometric strength and fatigue rates, specific muscle firing patterns, and how those might integrate into a neural scheme that the brain perceives as unstable/unsafe and thus results in a “pain” response.

      I’ll probably make a post about it after things get farther along. In the meantime, I’ll be sharing my thoughts about some of the other silliness out there in the field 🙂

      Thanks again for the kind words!

      Like

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