Should Trainers Assess?

Gray Cook

Introduction
Debate around the topic of assessment
Should fitness professionals assess
Clearly defining what we’re talking about
Defining Movement appraisal, screening and assessment
Is assessment diagnosis?
Staying within your scope of practice
Interacting with the medical professionals in our community
Knowing why vs. what to do
A faulty movement pattern is not the result of an isolated muscle or joint problem
Assessment is used when something is wrong
Movement screen is what we do for people who are “normal” wishing to increase their activity level
Medical history the practitioner determine the gap between the client/patients perception and reality
The first order of business is to determine the adequacy of the clients movement patterns
The biggest problem with the science in fitness is that all the research have given us quantitative data
Defining appraisal, screening and assessment
Appraisal is simply an estimate of quality of movement
Movement patterns are much bigger than the muscles underneath them
Screening helps you to determine quality of movement and observe movement patterns to assess predictors of injury
The first predictor of a problem is if the client has had a previous problem
Left/right asymmetries and movement limitations are the second and third predictors of whether your client or athlete is going to have an injury
Summing it up
Organized appraisal is the first thing you do with a client
The movement screen helps you determine risk, asymmetry and limitation
An assessment is done by a fitness professional when they look at all the data and try to build an exercise program
A medical assessment is diagnostic in nature

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COMMENTS

Clark, Michael | 03 Mar 2011, 15:29 PM

I have been a fan of Gray Cook since he wrote "Athletic Body in Balance" and I agree with most of what he said, but there were a few points that he made that just didn't cohere with reality.

1. "Assessment is used when something is wrong".

This statement presupposes that clients know when something is wrong. It is incontrovertible that clients don't know everything that is wrong with them. Cook says this is the "kiss of death". I can name numerous success stories of my referring clients to physical therapists and other medical professionals and them getting the help they needed because I didn't presuppose anything, but I took the time to assess the client, with the background information from what the client has told me. I can also name horror stories from other trainers who presupposed that a client was fine to begin being put through the ringer and the trainer damages a muscle or joint because he or she didn't take the time to properly assess the client. There is danger in presupposing normal function in clients. This also goes for what Cook was talking about with compensations, so I see his points about trainers not crossing the line. I do recommend clients to physical therapists and medical professionals. I work very closely with a medical center less than a mile from me. Therefore, respectfully, Cook asks trainers to presuppose too much before working with clients.

2. Clients are no more interested in the breakdown of how muscles work together, than looking at the trainer's vacation pictures.

I am a little surprised and appalled at this statement. As professional trainers it is our job to educate clients on posture and movement. Sometimes it is necessary to discuss forced-coupled relationships and describe the effects lordosis and kyphosis can have on other muscles and structures throuhout the kinetic chain (you don't even have to use $20 words with them like "kinetic chain"). Are we to assess our clients and leave them in the dark about their bodies? Or is it our job to educate our clients on proper movement and posture? I probably work with a different clientele than Cook is referring to, but most of my clients are doctors, engineers, and rocket scientists and they want to understand why I am doing movement and postural assessments. Therefore, when we perform movement assessments we aren't moving out of a personal trainer's scope of practice to explain anatomy and kinesiology, it actually holds us accountable as professionals to study to show ourselves approved, rather than looking like someone who doesn't understand what he or she is even doing or looking for. The industry needs less psuedo-science and more evidence-based approach. We can't do that if we aren't educating our clients, period.