Late last week, my buddy Nick Tumminello made the follow comment that some folks, unfortunately, took out of context:
“Everyone is talking about assessments (and that's cool). But, no one seems to talking about simply not allowing poor form in training. If you can't keep good form in a certain exercise (movement pattern), simply don't do that exercise until you've improved the movement or decided that you're simply not built for it to begin with. Not sure why things need be any more complicated than that!”
For the record, I agree 100% with Nick and understood what he meant, but it would have been easy to assume that he was referring to “trainers train, and therapists assess.” In other words, many folks assume that as long as you aren’t symptomatic in some way, then you’re safe to start exercising because you can simply “feel” things out as you go and, if something hurts, you don’t do it.
While you obviously shouldn’t do something if it hurts, just because something doesn’t hurt doesn’t mean that it’s not harmful long-term – and to me, that’s the difference between “working someone out” and provided them with an optimal training experience. As physical therapist Mike Reinold has said, “Assess; don’t assume.”
To illustrate my point, here are a few examples.
Let’s say you have someone with a chronically cranky acromioclavicular joint or osteolysis of the distal clavicle that might only be apparent upon reviewing a health history, palpating the area, or taking someone into full horizontal adduction at the shoulder. While direct over-pressure on the area (as in a front squat) would surely elicit symptoms, my experience is that most folks won’t notice a significant amount of pain until the next day if the strength exercise selection is inappropriate (e.g., dips, full range-of-motion bench pressing). You might have avoided what “hurt” during the session (presumably because the individual was warmed up), but you find out after the fact that you just set an individual back weeks in their recovery and fitness program.
How about right scapular winging? It’s not easily observed if a client has a shirt on, and if you simply throw that individual into a bootcamp with hundreds of push-ups each week, you’re bound to run into trouble. Here’s the thing, though: even if you observed that winging and wanted to address it in your training, you really have to consider that it can come from one or more of several factors: weak scapular stabilizers, a stiff posterior cuff, insufficient right thoracic rotation, faulty breathing patterns, or poor tissue quality of pec minor, rhomboids, levator scapulae (or any of a number of other muscles/tendons). Just doing some rows and YTWL circuits will not work.
Also at the shoulder, a baseball pitcher with crazy congenital and acquired shoulder external rotation may have a ton of anterior instability in the “cocking” position of throwing (90 degrees of abduction and external rotation), but be completely asymptomatic. Back squatting this athlete would exacerbate the problem over the long haul even if he didn’t notice any symptoms acutely.
Finally, in my recent article, Corrective Exercise: Why Stiffness Can Be a Good Thing, I spoke about how someone can have crazy short hip flexors and still manage a perfect squat pattern because his stiffness at adjacent joints is outstanding. If I don’t assess him in the first place and just assume that he squats well, I’m just waiting for him to strain a rectus femoris during sprinting or any of a number of other activities. Gross movement in a strength and conditioning program wouldn’t tell me anything about this individual, but targeted assessments would.
The point is that while Nick’s statement is absolutely true – demanding perfect form is corrective in itself – you’ve still got to assess to have a clear picture of where you’re starting. Otherwise, many cases like this will slip through the cracks.
To that end, I’m happy to announce that my long-time friend and colleague, Mike Robertson, recently released his Bulletproof Knees and Back Seminar DVD Set. This comprehensive product covers anatomy, assessments, program design, and coaching. In fact, almost the entire second day is focused on coaching, and that’s an area in which most trainers really do need to improve. All in all, this isn’t a collection of bits and pieces; it’s Mike’s entire philosophy on training someone who is suffering from knee or low back pain (and how to prevent it in the first place). Effectively, Mike covers what both Nick and I are getting at in the paragraphs you just read.
This is tremendously valuable information that fitness professionals need to hear, so be sure to check it out.
Sign-up Today for our FREE Newsletter and receive a deadlift technique tutorial!
| 
