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Essentials of Integrated Training - Part 3B


This article is a continuation of Mike Clark’s Essentials of Integrated Training series and makes up the second half of the Part 3 of the series. It is therefore essential that Part 3a is read prior to this one.

Movement Observations

Movement observations are often the quickest way to gain an overall impression of a client’s functional status. As posture is a dynamic quality, these observations show postural distortion in a dynamic setting. Movement observations should relate to basic functions such as squatting, walking, bending, lifting, rotating, pulling, pushing and balancing in a multi-planar environment.

The observation process should serve as a search for imbalance in anatomy, physiology or biomechanics that may decrease a client’s results and possibly lead to injury both in and out of the fitness environment. With the limited time that most fitness professionals have for observation, incorporating movement observations into a “first workout” provides a quick and effective means for reviewing a client’s functional capacity. The National Academy of Sports Medicine suggests the following Integrated Fitness Profile for the fitness professional (This assessment process is on video and can be purchased at our online store www.NASM.org).

Movement Observation (General Warm-up)

A simple checklist of observations is provided specifically for each movement in the Integrated Fitness Profile. Once an observation has been made, please refer below for a review of the possible causes and corrective strategies.

Gait: Treadmill Walking

Kinetic Chain Checkpoints
Foot and Ankle
  • Feet flatten (pronate): Y / N
  • Externally rotate (turn out): Y / N
Knees
  • Knees buckle inward: Y / N
  • Knees bow outward: Y / N
Lumbo-Pelvic-Hip Complex
  • Asymmetrical weight shifting: Y / N
  • Low back arches: Y / N
  • Abdomen protrudes: Y / N
Shoulder Complex
  • Shoulder protraction: Y / N
  • Shoulder elevation: Y / N
Head
  • Forward Head: Y / N
Exercise:

Self Myofascial Release (Foam Roll Tenderness Scale)

Overall Tenderness Scale: 1-2-3-4-5-6-7-8-9-10
Gastrocnemius / Soleus R #:_______ / L #:_______
Hamstrings R #:_______ / L #:_______
Gluteus Maximus /
Piriformis
R #:_______ / L #:_______
Quadriceps R #:_______ / L #:_______
Adductors R #:_______ / L #:_______
Thoracic Spine R #:_______ / L #:_______
Latissimus Dorsi R #:_______ / L #:_______

Bodyweight Squat with Overhead Press (Total Body Profile)

Kinetic Chain Checkpoints
Foot and Ankle
  • Feet flatten (pronate): Y / N
  • Externally rotate (turn out): Y / N
Knees
  • Knees buckle inward: Y / N
  • Knees bow outward: Y / N
Lumbo-Pelvic-Hip Complex
  • Asymmetrical weight shifting: Y / N
  • Low back arches: Y / N
  • Low back rounds: Y / N
  • Abdomen protrudes: Y / N
Shoulder Complex
  • Arms fall forward (arms overhead): Y / N
  • Elbows flex (arms overhead): Y / N
  • Shoulder abduction: Y / N
  • Shoulder protraction: Y / N
  • Shoulder elevation: Y / N
  • Scapulae winging: Y / N
Head
  • Forward Head: Y / N
Exercise:
Core/Balance Exercises Sets Repetitions
1. Crunch: Short Lever Arm 1 Up to 10
2. Bridge: Two Legs 1 Up to 10
3. Multi-Planar Single-Leg Balance Reach 1 2 each leg/plane

Short Lever Arm Crunch

Kinetic Chain Checkpoints
Lumbo-Pelvic-Hip Complex
  • Low back arches: Y / N
  • Abdomen protrudes: Y / N
Head
  • Forward Head: Y / N
Exercise:

Bridge: Two Legs

Kinetic Chain Checkpoints
Foot and Ankle
  • Feet flatten (pronate): Y / N
  • Externally rotate (turn out): Y / N
Knees
  • Knees buckle inward: Y / N
  • Knees bow outward: Y / N
Lumbo-Pelvic-Hip Complex
  • Asymmetrical weight shifting: Y / N
  • Low back arches: Y / N
  • Low back rounds: Y / N
  • Abdomen protrudes: Y / N
Head
  • Forward Head: Y / N
Exercise

Multi-Planar Single Leg Balance Reach

Kinetic Chain Checkpoints
Foot and Ankle
  • Feet flatten (pronate): Y / N
  • Externally rotate (turn out): Y / N
Knees
  • Knees buckle inward: Y / N
  • Knees bow outward: Y / N
Lumbo-Pelvic-Hip Complex
  • Asymmetrical weight shifting: Y / N
  • Low back arches: Y / N
  • Low back rounds: Y / N
  • Abdomen protrudes: Y / N
Head
  • Forward Head: Y / N
Overall
  • Dominant leg L / R
  • Dominant plane of motion S / F / T
Exercise
Reactive Exercises Sets Repetitions
1. Multi-Planar Hop with Stabilization 1 2 each Leg/Plane

Multi-Planar Hop with Stabilization

Kinetic Chain Checkpoints
Foot and Ankle
  • Feet flatten (pronate): Y / N
  • Externally rotate (turn out): Y / N
Knees
  • Knees buckle inward: Y / N
  • Knees bow outward: Y / N
Lumbo-Pelvic-Hip Complex
  • Asymmetrical weight shifting: Y / N
  • Low back arches: Y / N
  • Low back rounds: Y / N
  • Abdomen protrudes: Y / N
Overall
  • Dominant leg L / R
  • Dominant plane of motion S / F / T
Exercise
Integrated Strength Exercises Sets Repetitions
1. TOTAL BODY: Step, Curl & Press 1 Up to 15
2. CHEST: Push-Up or Standing Cable Chest Press 1 Up to 15
3. BACK: Standing Cable Pull-Down 1 Up to 15
4. SHOULDERS: Standing DB Scaption 1 Up to 15
5. LEGS: Multi-Planar Lunges

Step, Curl & Press

Kinetic Chain Checkpoints
Foot and Ankle
  • Feet flatten (pronate): Y / N
  • Externally rotate (turn out): Y / N
Knees
  • Knees buckle inward: Y / N
  • Knees bow outward: Y / N
Lumbo-Pelvic-Hip Complex
  • Asymmetrical weight shifting: Y / N
  • Low back arches: Y / N
  • Low back rounds: Y / N
  • Abdomen protrudes: Y / N
Shoulder Complex
  • Arms fall forward (arms overhead>: Y / N
  • Elbows flex (arms overhead>: Y / N
  • Shoulder abduction: Y / N
  • Shoulder protraction: Y / N
  • Shoulder elevation: Y / N
  • Scapulae winging: Y / N
Head
  • Forward Head: Y / N
Overall
  • Dominant leg L / R
  • Dominant plane of motion S / F / T
Exercise

Push-Up or Standing Cable Chest Press

Kinetic Chain Checkpoints
Foot and Ankle
  • Feet flatten (pronate): Y / N
  • Externally rotate (turn out): Y / N
Knees
  • Knees buckle inward: Y / N
  • Knees bow outward: Y / N
Lumbo-Pelvic-Hip Complex
  • Asymmetrical weight shifting: Y / N
  • Low back arches: Y / N
  • Low back rounds: Y / N
  • Abdomen protrudes: Y / N
Shoulder Complex
  • Shoulder elevation: Y / N
  • Scapulae winging: Y/N
Head
  • Forward Head: Y / N
Exercise

Standing Cable Pull-Down

Kinetic Chain Checkpoints
Foot and Ankle
  • Feet flatten (pronate): Y / N
  • Externally rotate (turn out): Y / N
Knees
  • Knees buckle inward: Y / N
  • Knees bow outward: Y / N
Lumbo-Pelvic-Hip Complex
  • Asymmetrical weight shifting: Y / N
  • Low back arches: Y / N
  • Low back rounds: Y / N
  • Abdomen protrudes: Y / N
Shoulder Complex
  • Shoulder elevation: Y / N
  • Scapulae winging: Y / N
Head
  • Forward Head: Y / N
Exercise

Standing DB Scaption

Kinetic Chain Checkpoints
Foot and Ankle
  • Feet flatten (pronate): Y / N
  • Externally rotate (turn out): Y / N
Knees
  • Knees buckle inward: Y / N
  • Knees bow outward: Y / N
Lumbo-Pelvic-Hip Complex
  • Asymmetrical weight shifting: Y / N
  • Low back arches: Y / N
  • Low back rounds: Y / N
  • Abdomen protrudes: Y / N
Shoulder Complex
  • Shoulder abduction: Y / N
  • Shoulder protraction: Y / N
  • Scapulae winging: Y / N
  • Shoulder elevation: Y / N
Head
  • Forward Head: Y / N
Exercise

Multi-Planar Lunges

Kinetic Chain Checkpoints
Foot and Ankle
  • Feet flatten (pronate): Y / N
  • Externally rotate (turn out): Y / N
Knees
  • Knees buckle inward: Y / N
  • Knees bow outward: Y / N
Lumbo-Pelvic-Hip Complex
  • Asymmetrical weight shifting: Y / N
  • Low back arches: Y / N
  • Low back rounds: Y / N
  • Abdomen protrudes: Y / N
Overall
  • Dominant leg L / R
  • Dominant plane of motion S / F / T
Exercise

Compensations, Muscle Imbalance and Corrective Strategies

Table 1
Abnormal Movement Tight Muscles Weak Muscles Corrective Strategy
Foot and Ankle Complex
Feet Flatten Gastrocnemius, Peroneals Gluteus Medius, Anterior Tibialis, Posterior Tribialis
  • Foam Roll + Static/Active Stretch: Peroneals & Gastrocnemius
  • Core Stabilization: Tube Walking, Ball Bridges
  • Single-leg balance progression: Single-leg balance reach, Single-leg Squat
Feet Externally Rotate Soleus, Biceps Femoris, Piriformis Gluteus Medius
  • Foam Roll + Static/Active Stretch: Soleus, Biceps Femoris, Piriformis
  • Single-leg balance progression: Single-leg balance reach, Single-leg Squat
  • Core Stabilization: Tube Walking, Ball Bridges
Knees
Knees Adduct Adductors, Iliotibial Band Gluteus Medius, Gluteus Maximus
  • Foam Roll + Static/Active Stretch: Adductors & Iliotibial Band;
  • Core Stabilization: Tube Walking, Ball Bridges
  • Single-leg balance progression: Single-leg balance reach, Single-leg Squat
Knees Abduct Biceps Femoris, Iliopsoas, Piriformis Gluteus Medius, Gluteus Maximus
  • Foam Roll + Static/Active Stretch: Biceps Femoris, Iliopsoas, Piriformis;
  • Core Stabilization: Tube Walking, Ball Bridges
  • Single-leg balance progression: Single-leg balance reach, Single-leg Squat
Lumbo-Pelvic-Hip Complex
Asymmetrical Weight Shifting Gastrocnemius, Soleus, Biceps Femoris, Adductors, Iliotibial band, Iliopsoas, Piriformis Gluteus Medius, Gluteus Maximus, Transversus Abdominis, Multifidi
  • Foam Roll + Static/Active Stretch: Biceps Femoris, Iliopsoas, Piriformis;
  • Core Stabilization: Tube Walking, Ball Bridges
  • Single-leg balance progression: Single-leg balance reach, Single-leg Squat
Increased Lumbar Extension Iliopsoas, Rectus Femoris Erector Spinae, Latissimus Dorsi Gluteus Maximus/Medius, Lumbo-Pelvic-Hip Complex Stabilization Mechanism
  • Foam Roll + Static/Active Stretch: Iliopsoas, Rectus Femoris, Erector Spinae, Latissimus Dorsi;
  • Core Stabilization: Tube Walking, Ball Bridges, Ball Crunches
  • Single-leg balance progression: Single-leg balance reach, Single-leg Squat
Increased Lumbar Flexion External Obliques, Rectus Abdominis, Hamstrings Gluteus Maximus/Medius, Lumbo-Pelvic-Hip Complex Stabilization Mechanism
  • Foam Roll + Static/Active Stretch: External Obliques, Rectus Abdominis, Hamstrings
  • Core Stabilization: Tube Walking, Ball Bridges, Ball Crunches
  • Single-leg balance progression: Single-leg balance reach, Single-leg Squat
Abdomen Protrudes Iliopsoas Lumbo-Pelvic-Hip Complex Stabilization Mechanism
  • Foam Roll + Static/Active Stretch: Iliopsoas
  • Core Stabilization: Tube Walking, Ball Bridges, Ball Crunches
  • Single-leg balance progression: Single-leg balance reach, Single-leg Squat
Shoulder Complex
Arms Fall Forward (when overhead) or Lumbar Spine Hyperextends Latissimus dorsi, Pectoralis Major Middle/Lower Trapezius
  • Foam Roll + Static/Active Stretch: Latissimus dorsi, Pectoralis Major
  • Core Stabilization: Ball Prone Cobra, Ball Scaption, Ball PNF
  • Single-leg balance progression: Single-leg Windmill
Elbows Flex (when arms are overhead) Pectoralis Major Middle/Lower Trapezius
  • Foam Roll + Static/Active Stretch: Pectoralis Major
  • Core Stabilization: Ball Prone Cobra, Ball Scaption, Ball PNF
  • Single-leg balance progression: Single-leg Windmill
Shoulder Blade Abducted Upper Trapezius, Levator Scapulae, Pectoralis Major/Minor Rhomboids, Middle/Lower Trapezius
  • Foam Roll + Static/Active Stretch: Upper Trapezius, Levator Scapulae Pectoralis Major/Minor
  • Core Stabilization: Ball Prone Cobra, Ball Scaption, Ball PNF
  • Single-leg balance progression: Single-leg Windmill
Shoulder Blade Protracted Pectoralis Major/Minor, Latissimus Dorsi Rhomboids, Middle/Lower Trapezius, Teres Minor, Infraspinatus
  • Foam Roll + Static/Active Stretch: Pectoralis Major/Minor, Latissimus Dorsi
  • Core Stabilization: Ball Prone Cobra, Ball Scaption, Ball PNF
  • Single-leg balance progression: Single-leg Windmill
Shoulder Elevated Upper Trapezius, Levator Scapulae Lower Trapezius
  • Static/Active Stretch: Upper Trapezius, Levator
  • Core Stabilization: Ball Prone Cobra, Ball Scaption, Ball PNF
  • Single-leg balance progression: Single-leg Windmill
Shoulder Blade Winging Pectoralis Minor Serratus Anterior, Lower Trapezius
  • Foam Roll + Static/Active Stretch: Pectoralis Minor
  • Core Stabilization: Ball Prone Cobra, Ball Scaption, Ball PNF
  • Single-leg balance progression: Single-leg Windmill
Cervical Spine
Forward Head Sternocleidomastoid, Scalenes Deep Cervical Flexors (Longus Coli/Capitus)
  • Static/Active Stretch: Sternocleidomastoid, Scalenes
  • Core Stabilization: Ball Cervical Retraction

Summary

The primary responsibility of the fitness professional is to safely and effectively guide their clients to successful attainment of their clients’ goals. To do so, the fitness professional must have a comprehensive understanding of their clients’ personal and professional background as well as their physical capabilities and desires. The Integrated Fitness Profile designed by the National Academy of Sports Medicine provides fitness professionals with a comprehensive tool to systematically gather client information and utilize it appropriately.

The Integrated Fitness Profile provides the essential starting point for the fitness professional to begin personalizing the Optimum Performance Training™ model (a systematic personal training model that takes the guesswork out of program design). This is the foundation from which the entire program will be constructed. Most importantly, it provides the fitness professional with a systematic plan to progress their clients from start to finish.

To become a leader in the fitness industry, the fitness professional must gain an understanding of how the human body works and how it breaks down. By learning to observe the kinetic chain during common movement patterns and correlate that information with simple personal and medical questions, the fitness professional can begin to adjust and manipulate programming variables to better suit their clients’ goals, needs, and abilities. To learn more about a systematic assessment process, training process, or advanced education please visit our website at www.NASM.org. We are committed to become your complete source for valid, practical information. Thank you for taking time to share with NASM.

References

  1. American College of Sports Medicine. ACSM’s guidelines for exercise testing and prescription. 5th edition. Philadelphia: Williams & Wilkins; 1995.
  2. Thomas S, Reading J, Shephard RJ. Revision of the Physical Activity Readiness Questionnaire (PAR-Q). Can J Sports Sci 1992; 17:338-345.
  3. Kendall FP, McCreary EK, Provance PG. Muscles testing and function. 4th edition. Baltimore, MA: Lippincott Williams & Wilkins; 1993.
  4. Norkin CC, Levangie PK. Joint structure and function. 2nd edition. Philidelphia, PA: F.A. Davis Company; 1992.
  5. Soderberg GL. Kinesiology. 2nd edition. Baltimore, MD: Williams & Wilkins; 1997.