Have you ever had an aha moment with a long-time client that left you slightly embarrassed?
A moment where you realized, after coaching this person for two years, that the reason he has a massive forward lean on his squat isn’t because his hamstrings are tight, but because of a motor control and bracing deficiency.
All this time, you could have provided different cues and accessory work than you did.
While assessing a person’s squat seems simple on the surface, it’s definitely not. The saying, the more you know, the more you realize you don’t know, couldn’t be more true in this case.
OPEX Coach Georgia Smith admitted, prior to going through the OPEX Coach Certificate Program (CCP), she often inaccurately assessed what was going on during her clients’ squats.
1. Trying to fix knee valgus by cueing “knees out,” versus taking a joint-by-joint approach and looking at the ankle and hip function.
2. Treating a big torso lean as a mobility issue, versus looking at bracing and motor control and failing to recognize that anthropometrics (different body measurements) mean some people will always lean forward more than others.
3. Trying to fix tight hip flexors and hip impingement through stretching, versus working on strengthening hip extension and bringing them out of anterior pelvic tilt with proper bracing motor control.
Learning how to assess movement, like the squat pattern, more accurately is one of the fundamental goals of OPEX’s Programming: Movement course.
Step one comes down to learning a few basic principles for movement assessment:
Principle 1: Decide whether you will assess from the top down or the bottom up: Whatever you choose to start with, you must stay in that order every time you assess that client.
Principle 2: Acknowledge there’s a repeating pattern of mobility and joint stability in the entire body and that pattern starts from the ground with stability and moves up to the neck.
Principle 3: We are all bound to the laws of physics. Understanding the basic influence of gravity, be it standing up or lying down, will also help you assess the quality of movement.
Principle 4: Understand the joint-by-joint approach to movement, meaning we look at mobility and movement, joint-by-joint. Starting from the bottom up: The big toe has to have mobility, the arch of the foot has to have both stability and mobility, the ankle for dorsiflexion, plantar flexion, has to have stability and mobility, the knee should be stable, the hip should be mobile, the low back should be stable, the thoracic spine mobile, and on and on.
Once the above principles are understood, you will be way further along in accurately assessing your clients’ movements than your current trial and error and then take an educated guess approach.
Learn a detailed principle approach to assessing movement here.
Step 1: Set your client up in the anatomic position—middle of the foot is hip width apart. Have them take their shoes off and put their hands directly overhead. This is essentially the hardest position—with the hands overhead—so it will likely force an error, at which point you can check for further patterns.
Step 2: Ask your client to squat down as deep as they can. Don’t demonstrate to them how to squat. Just let them do it on their own. As they attempt to squat, check to see if their tibia matches the angle of their torso. They should be parallel with one another.
Side note: As you continue to assess, it’s important to look at the person from the front, the side and from behind, as each will provide a different viewpoint. For example, rotational faults can be seen from the front, and limited motion can be seen from the side.
Step 3: Return your client to the anatomical position, with both their feet pointed straight forward. Adjust the width of their feet to be outside of their hips. Give them the PVC pipe to hold overhead. Standardize this overhead position by asking them to place the pipe on their head, with their arms at a 90-degree elbow bend, then raise their hands overhead. From here, have them squat three times as deep as they can with their feet anchored to the ground, all the while trying not to let the PVC pipe deviate forward. Look for any type of rotation from the front, such as with the feet or a forward lean.
Step 4: Move them so you have a lateral view and can see flexion and extension. Have them squat three times. Look for whether the greater trochanter (where the femur meets the hip) in this standardized position gets to be in line, or below, the fibular head.
Step 5: Turn your client again, this time away from you, so you can view from behind. Here, you’ll be watching the TL junction, sacrum, and the calcaneus. At the TL junction, note that whatever the curve in their back is at the start position, that curve is maintained until the knees and hips get to at least 90 degrees. After that, if some flexion occurs or that curve changes, that’s normal. If it occurs before reaching 90 degrees, then it’s a compensation, meaning this person does not pass the most aggressive form of the squat assessment (probably the case for most people).
So your client failed the aggressive squat test. Now what? Now it’s time to start to break down why this is happening in a joint-by-joint approach, starting with the ankle joint.
Place a roll at the far end of a yoga mat and have the client place their heels on the roll and keep the ball of their foot on the mat. Cue them to place their hands overhead and squat as deep as they can.
Look for big changes in the quality of their movement. If they still have various flaws as they squat, this means a lack of ankle dorsiflexion might not be their biggest deficiency, as the heel is now elevated to reduce dorsiflexion, yet they’re still making movement flaws.
On the other hand, if their heels being off the floor a couple inches allows them to squat perfectly, or considerably better, then their main concern might very well be lack of dorsiflexion in their ankle.
In short, assessing the squat—and movement in general—comes down to a deliberate, systematic, joint-by-joint process of elimination, where you look at what’s going on in each joint.
This is just one example of how to troubleshoot when a client fails a movement pattern screen.
Learn how to assess all movement patterns following scientific principles of assessment in the Programming: Movement course.