What the Hell Are We Assessing?
A commentary on utility and efficacy of assessments in personal training.
When I first started my career as a personal trainer, I was really into assessments. What that really means is, I was really into “fixing” people.
I mean...I was REALLY into it.
Into is so much in fact, that I would spend an entire hour laying you on a table, twisting your limbs every which way, “hmm-ing and ha-ing” to myself as I would test and compare one hip range of motion to another and see one hip moved some degrees less than the other. I would then proceed to inform you we needed to correct that or ELSE….
...DUN DUN DUN...
You could hurt yourself in the future. That’s right, no specific time frame, just “in the future” - some time - that isn’t NOW - you could eventually hurt yourself and it will all be BECAUSE you didn’t fix that ONE HIP.
It sounds ridiculous now, looking back at it, but believe it or not there is still a lot of this going on in my profession.
There are people and organizations that continue to promote some kind of assessment protocol as a means to prevent injury and predict risk, and the truth is, there just isn’t any evidence to confidently make that claim.
Let me state that again…
THERE ARE NO METHODS, CURRENTLY, THAT CAN, WITH ANY CONFIDENCE, PREDICT AND THEREFORE, CONTRIBUTE TO THE PREVENTION OR MITIGATION OF INJURY.
Now, I am not saying that I am totally against assessing, I just don’t think we have any viable method to use for what screens and assessments are intended for.
Assessments, in the medical profession, are tools meant to give the practitioner information about a potential disease or serious abnormality. If something during an assessment seems awry, then further evaluation is conducted which may likely lead to a diagnosis.
In this way assessments are sensitive to the inherent flaw that may be causing the problem.
And herein lies the problem for assessments used with professions dealing with movement and trying to predict the risk of injury.
Assessments tools such as the FMS, SFMA, FRA, Y-Balance, Trendelenberg, etc aren’t sensitive to anything in particular. And this is no fault of the test themselves, it’s mostly because...
WE DON’T KNOW WHAT MOVEMENT LIMITATIONS/ FREEDOMS ARE INDICATIVE OF FUTURE INJURY.
And so if we don’t know what causes injury then how the hell do we screen for it???
If movement assessments are to be accurate they must first be able to indicate where and why a “dysfunction” occurs, otherwise we are just shooting fish in a barrel - trying every corrective intervention with little to no semblance of whether or not what we are doing is useful or beneficial.
A Wrong Way to Move?
Another problem with movement assessments is they assume there is a “right” way to move.
But if we look at movement through the lens of dynamic systems theory (DST), then another picture emerges.
DST basically says in a system where there are numerous contributors to the completion of task, if one participant alters its role or its contribution the others will do so, in turn, to ensure the task is completed. In this way, dynamic systems (i.e the human body) develops MANY solutions to the same problem.
So if this is the case, why is squatting with increased lumbar flexion a “dysfunction” and not just another “solution” to the task of squatting?
It could very well be a movement option a person has developed and adapted to, and since we have no evidence that squatting with increased lumbar flexion is indicative of future injury, then who’s to say it’s wrong?
But What About Biomechanics?
Biomechanics has its place, but we know that faulty biomechanics is not enough to predict risk of injury, or future pain.
These things are multifactorial and complex. Involving factors outside the scope of a personal trainer or strength coach.
So as movement professionals we have to be careful about the claims we make when informing clients of their ability to move and exercise.
Yes, biomechanics matter, just not as much as we think.
Is it still good practice, to adhere to good form? Of course it is.
But the reasoning may be more-so because we would like the exercise, we have chosen, to have its intended effect, and NOT because it prevents us from getting hurt.
Stop Making People Scared to Train
All this blathering is to make a point which is...
You can train just fine and you can move more than adequately. You don’t have to be perfect.
Can we improve on the quality of your movements? Of course we can.
Do we need to in order for you to train, and train hard? Probably not.
Now maybe I should make a disclaimer here, and say if you are an elite athlete and you are pushing the limits of your physical capacity…ok there may be an argument there for edging out every little bit of efficiency we can.
But for the majority of us…you don’t need to move “perfectly” in order to get a good workout in.
When it comes to assessments, I think as training professionals we can potentially be doing our clients a huge disservice.
By suggesting people have to adhere to form for the sake of preventing injury, is not only incorrect, but harmful.
We make people sensitive to pain, fearful of getting hurt, and therefore, make it more likely that they will be because they BELIEVE they will if they do something “wrong"
We are effectively making it so people are scared to exercise!
The exact OPPOSITE of what we are trying to accomplish.