Movement Assessment and the Fitness Coach

Movement Assessment and the Fitness Coach

This blog was written by OPEX Ambassador and CCP Coach, Kornwit Damrongwisetpanit. As the owner of Kinetic Lab in Bangkok, Thailand, Korn combines his interest in physiotherapy and movement science with individual program design. Follow Korn on Instagram here

Introduction

It’s always puzzled me, the so-called “customised program” that “insta-famous” trainers are selling without any mention of movement assessment. How can they program customised exercise without knowing how the client moves in the first place? 

OPEX CCP provides essential tools for assessing 6 movement patterns; squat, bend, lunge, push, pull and core, using 8 simple tests. 

OPEX Programming: Movement provides additional tools to assess locomotion and to investigate movement dysfunction by breaking down the movement pattern using additional 37 tests.

The assessments included in these two courses are ones I use consistently in my coaching practice to ensure the programs I design are truly customised.

Why do we assess movement?

1) To identify movement strategy

Human movement is extremely complex. Since birth, we naturally find a strategy to fight against gravity, from laying, rolling, crawling, sitting, kneeling and finally standing and walking. Each of these developmental stages provide an opportunity to develop the anatomy structure (bone, muscle, and ligament) and motor control (brain and nervous system). 

However, when we are growing up, we develop an alternative strategy for movement, some of which may not be optimum. Using the assessment tools, we can gather information to help us identify if movement dysfunction stems from the structure or motor control. We can then use this information to help us translate into program design.

2) To create intention for program design

There are so many exercise variations. Which one will you choose and why? 

Movement assessment helps us create a reason for choosing a particular exercise variation and explaining why to the client. The client may want to do a muscle up, but the movement assessment has demonstrated they can’t do the shoulder internal rotation required for such a movement to be performed without the potential of injury - so maybe we need to work on that first. 

Along with additional assessment tools, OPEX Programming Movement also provides principles for exercise selection and some exercise examples for common movement flaws.

3) Screening for risk and potential need for referral

Movement assessment can give us an idea of where potential risks may lay. We can keep track of these risks and if some movements cause pain to the client and it is out of the coach’s scope, we can consider referring the client to a specialist. 

4) To spend time and build trust with the client

There is an additional psychological benefit for doing movement assessment—we can show that we care. By putting the client in front of us and assessing their movement, we are putting the client at the centre of our attention. It’s a time to show the client that our programming will be all about them. 

Limits of movement assessment

1) It’s not the whole picture

Movement assessment is not a perfect tool. In order to try to understand human complex movement, we have to create order and simplify it. In this view, we have to be aware that we are not looking at the whole picture, as real life movement is more than just 7 basic movement patterns.

2) Understand the context

We need to understand that movement assessment is not a be all end all tool. We need to apply it with the context for each individual. Some movement tests are designed to be hard, so they can expose the weak area in that pattern. 

For example, the overhead squat, for a 50 year old who doesn’t care about Olympic weightlifting, there is no reason for him/her to be able to do a perfect overhead squat. But performing the overhead squat test may show weakness in other areas which may need to be addressed. 

Movement assessment case studies

In the two case studies below, I will explain how I used a systematic approach to assessment to identify movement dysfunction and incorporate this in program design, relative to each client’s goals. 

Case study 1

Case study 1 is a 30 year old female who wants to look and feel good for her wedding in 5 months. 

Her overhead squat shows hip shifts from left to right but no pain. 

Breaking down the movement into a heel elevated air squat still shows the dysfunction pattern, but less than the overhead squat. Changing the line of gravity by asking her to squat while she laying in supine shows no dysfunction pattern. 

This means that she may have a weak left gluteus. Checking this assumption with the core and lunge pattern confirmed that this is the problem area.

However, since she doesn’t have any pain, I asked her what she would like to do and she decided she would like to fix it but it’s not her priority. Therefore we decided to do one corrective exercise session per week. 

For exercise selection in these sessions, I choose the RNT split squat, hand supported single leg RDL, single leg glute bridge and core exercises. In these sessions, I filmed her squat before and after the session to make sure that the exercises were effective. 

Case study 2

Case study 2 is a 50 year old female who wants to keep doing what she loves and be healthy.

Her overhead squat shows hip rotation from left to right and she felt pain at her right piriformis and left quadratus lumborum. 

Other movement patterns show that she may have a leg length discrepancy. This is beyond my scope of practice so I referred her to a physiotherapist who sent her to get an X-ray which confirmed the leg length discrepancy. 

The physiotherapist allowed her to continue exercise with me and we are working together to design an exercise program to help the client become pain-free. 

At first, the main exercises we selected for her were diaphragmatic breathing exercises to teach her to engage her core and take load off her lower back. 

Then, we selected more exercises to strengthen her gluteus such as clamshell, reverse clamshell, and glute kickback. I work with her to make sure that she doesn’t over-engage her lower back during these exercises. 

Currently, we are moving her toward more functional exercises such as air squat and hip hinge.

Conclusion

Movement assessment is not a perfect tool, but it is an essential tool to start to understand our clients better. 

We can use it to create an intention for program design, to identify potential risks and to create an opportunity to spend time and develop trust with the client.

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