PT on the Net Research

Reebok Movement Screens - Case Study 1


The purpose of this article is to give an example of how to use the Reebok Movement Screens to help you decide program priorities for a current or future client.

Getting Started

First, you should complete the traditional health and fitness assessments you and/or your facility prefer to use. From there, go to the “Training Tools” section in the main menu of PTontheNET.com, where you can use the Health & Lifestyle Questionnaire to get extensive information about your client. With this and other information you receive, you can "create a client profile" of which several are listed. For the purposes of this article, I will use the Reebok Movement Screens in order to get a well rounded insight into what the client needs in the program.

Reebok Movement Screens

There are five movement screens on the website: Deep Squat, Hurdle Step, In Line Lunge, Active Straight Leg Raise and Seated Rotation.

These screens are great tools for determining:

  1. Asymmetries between the left and the right sides.
  2. Gross instabilities in the kinetic chain and/or the core.
  3. The relationship between mobility and stability throughout the entire body.
Deep Squat
Hurdle Step
In Line Lunge
Active Straight Leg Raise
Seated Rotation

General Thoughts Concerning the Movement Screens

These Screens are NOT designed to diagnose any medical conditions. They are simple assessments to help personal trainers get a better perspective of your clients' movements. Traditional assessments look at quantity of movement, but not always quality of movement. These screens are wonderful for giving you an insight into where your client has developed imbalances in movements. All of these screens are based on fundamental patterns that we have learned very long ago. When you think of kids playing, or sports in general, these movements are foundational patterns. It is not necessary for your client to warm up before doing these screens, as they are designed to look at the ‘weakest link’. Also, during the screens, we don't ask the client to lift any additional weight besides their own body weight. In short, we want to see how your client moves when he/she doesn't know what we are looking for!

All of the movement screens and guidelines are explained and described in detail in Gray Cook’s Reebok Movement Screen Audio Clinic series.

Client Assessment

For the purpose of this article, I will describe a specific client case study. His name is Scott and I will show how, with what I see in the screens and learn from his health and fitness assessment, I can set up his program.

Responses from the Health History/Lifestyle Questionnaire

Movement Screen Assessment

Scott's Deep Squat

Following the directions for the Deep Squat, my observations include:

I scored a 1 for the Deep Squat, because his right foot did not stay in line with the rest of the chain as he squatted.

The first suggestion if the client's squat does not look really good is to elevate the heels, putting the ankle in a plantar flexed position before the movement starts. By doing this, the ankle no longer needs to dorsiflex as much as before, essentially making it easier for those clients who have difficulty in getting enough dorsiflexion for a proper squat. I ask Scott to do another set of squats with his heels up on a board, and it does look a lot better. His right foot no longer turns out/everts as he squats.

My thoughts as of now include:

The most important thing is to not jump to automatic conclusions at this point. The only thing I know now is what I observed during the squat. I will have a clearer picture of what is happening after I see the other 4 screens, as well as any other assessments I might ask him to do later.

Scott's Hurdle Step

Following the directions for the Hurdle Step, my observations include:

Based on these observations, I score the right side a 1, because he doesn't keep the leg in the same plane (it abducts and externally rotates). I score the left side a 2 because that looked okay although I make a note about the little instability on the right side while the left side moves. The entire screen gets a score of 1 though, because you always score the total screen with that of the weaker/lower side.

My thoughts as of now include:

Scott's In Line Lunge

Following the directions for the In Line Lunge, my observations include:

Based on these observations, I score the right side a 2 (the right leg is in front and the left leg is in back), because all the criteria are met. I score the left side a 1 (the left leg in front and the right leg in back) because it was a little difficult for him to maintain the inline position with that right leg. Therefore, the entire screen is scored a 1. When there are two separate scores for each screen, you can easily determine what to score, because if both sides don't look almost the same, you cannot score them the same.

My thoughts as of now include:

Scott's Active Straight Leg Raise

Following the directions for the Active Straight Leg Raise, my observations include:

I score the right side moving a 1 because he externally rotates before he gets to 80/90 degrees hip flexion. I score the left side moving a 2 because he does get to 80 degrees hip flexion. The score for the entire screen is a 1 because I score the lower side and I make a note of the difference.

My thoughts as of now include:

Scott's Seated Rotation

Following the directions for the Seated Rotation, my observations include:

My thoughts as of now include:

Scott's Screen Scores
The Deep Squat 1
The Hurdle Step 1 (1 on the right side, 2 on the left side)
The In Line Lunge 1 (2 on the right side, 1 on the left side)
The Active Straight Leg Raise 1 (1 on the right side, 2 on the left side)
Seated Rotation 1 (1 on both sides)
Total Score 5

My thoughts as of now include:

Additional Assessments

Scott's Basic Needs

Exercises and stretches I will include in the program:

Scott's Basic Program

After talking with Scott, we determine that he will do his cardiovascular workouts on his own for now, as that is going well for him. Here is a sample program for the first 4 weeks. I am listing some progressions or variations that you can use to either slightly change the exercises each workout, or you and your client may want to change them once each week or two.

Scott will warm up and do the self myofascial release before we start the training program.

The rest of these exercises will be done in a Circuit: one set of each, and then go to the next exercise. The entire circuit will be done 2-3 times.

Lunges while standing on the Reebok slide board

Single leg squats

Single leg squats with touchdown

Squats while holding dumbbells/barbell

Single arm rows with opposite arm on stability ball

Dumbbell chest presses with upper body on the stability ball

Standing overhead presses

Reverse flies with dumbbells

At the end of the session, we will do some contract-relax stretching on the calves, hamstrings, piriformis. We will do five to eight more reps on the right and three to four on the left.

The following is what Scott’s Basic Program looks like in Create a Program:

Reebok Movement Screens Case Study 1 - Assymetry
Introduction : This case study no. 1 is based on the following observations: External rotation and compensations on the right side of the entire chain:
  • Right foot/ankle compensates during squat screen.
  • Right side abducts/externally rotates during hurdle step screen.
  • Right side abducts/externally rotates during the in line lunge screen when the left side is in front.
  • Right side externally rotates during active straight leg raise screen. Client reports feeling of tight hamstrings and calves.
Warm up : Client will warm up on his/her own using some of the following choices:
  • Elliptical machine - 10 minutes.
  • Full body movements using 2kg. medicine ball.
CARDIO PROGRAM
Activity
Intensity
Duration
Comments
Road Bike Client to do cardio at a different time
SUMMARY OF PROGRAM
Exercise/Stretch Reps Dur'n Tempo Sets Intensity Rest
Gastroc/Soleus - SMR 20-30 sec.
N/A
N/A
N/A
N/A
Hamstring - SMR 20-30 sec.
N/A
N/A
N/A
N/A
Piriformis - SMR 20-30 sec.
N/A
N/A
N/A
N/A
Dorsiflexion - Closed Chain 15 R, 5 L contin motion
N/A
N/A
N/A
N/A
Abdominal - 4-Point Drawing-In Maneuver 8
N/A
3-2-1 1 BW as reqd
Iso-Abs - Prone 3
N/A
hold 8 secs 1 BW as reqd
Lunge - On Reebok Slide Board 15 R, 8-10 L
N/A
contin m/ment Circuit see notes BW see notes
Squat - 1 Leg 8 R, 5 L
N/A
3-1-2 Circuit see notes BW see notes
Squat Touchdown - 1 Leg 8 R, 5 H
N/A
3-1-2 Circuit see notes BW see notes
Squat - Back w/ Barbell 12-15
N/A
3-1-2 Circuit see notes 60-75% see notes
Row - On SB 1 Arm DB 12-15
N/A
3-1-2 Circuit see notes 60-75% see notes
Chest Press - Alt Arm on SB 12-15
N/A
3-1-2 Circuit see notes 60-75% see notes
Shoulder Press - 1 Leg 12-15
N/A
3-1-2 Circuit see notes 60-75% see notes
Rear Delt Fly 12-15
N/A
3-1-2 Circuit see notes 60-75% see notes
Calf - Bent Knee Contract Relax Prone (Assisted) 3-5 R, 3 L 20-30 sec.
N/A
N/A
N/A
N/A
Hamstring - Straight Leg Contract Relax Supine (Assisted) 3-5 R, 3 L 20-30 sec.
N/A
N/A
N/A
N/A
Piriformis - Supine Contract Relax (Assisted) 3-5 R, 3 L 20-30 sec.
N/A
N/A
N/A
N/A
Cool Down : Cool down is included as the final 3 flexibility exercises in the program.
Gastroc/Soleus - SMR
Duration : 20-30 sec. Tempo : 0 Sets : 0
Intensity : 0 Rest : 0
Preparation :
  • Place foam roll under mid belly of lower leg.
  • Cross left leg over right leg to increase pressure (optional).
Movement :
  • Slowly roll calve area to find the most tender area.
  • If a “tender point” is located, stop rolling, and rest on the tender point until pain decreases by 75%.
Hamstring - SMR
Duration : 20-30 sec. Tempo : 0 Sets : 0
Intensity : 0 Rest : 0
Preparation :
  • Place hamstrings on the roll with hips unsupported.
Movement :
  • Feet are crossed to increase leverage.
  • Roll from knee toward posterior hip.
  • If a “tender point” is located, stop rolling, and rest on the tender point until pain decreases by 75%.
Piriformis - SMR
Duration : 20-30 sec. Tempo : 0 Sets : 0
Intensity : 0 Rest : 0
Preparation :
  • Begin positioned as shown with foot crossed to opposite knee.
Movement :
  • Roll on the posterior hip area.
  • Increase the stretch by pulling the knee toward the opposite shoulder.
  • If a “tender point” is located, stop rolling, and rest on the tender point until pain decreases by 75%.
Dorsiflexion - Closed Chain
Reps : 15 R, 5 L Duration : contin motion Tempo : 0
Sets : 0 Intensity : 0 Rest : 0
Preparation :
  • Position the client as pictured - a "tall" posture with shoulders and hips square.
Movement :
  • Instruct the client to slightly lunge forward while performing active dorsiflexion (keep the forfoot on the ground).
  • Maintain optimal allignment betweent the knee and 2-3rd toe.
  • TAKE THE BODY/JOINT THROUGH A FULL AVAILABLE ROM USING CONTROLLED MOMENTUM/MOVEMENT FOR 1 set of 5-10 reps.
Abdominal - 4-Point Drawing-In Maneuver
Reps : 8 Duration : 0 Tempo : 3-2-1
Sets : 1 Intensity : BW Rest : as reqd
Preparation :
  • Assume a 4-point stance on hands and knees in a neutral spine from head to sacrum.
Movement :
  • Draw the lower abdomen up and in while breathing naturally.
  • When performed correctly, the lower abdomen to elevate before upper.
  • The client must maintain neutral spinal posture. There should be no movement from the spine while drawing inward.
  • Maintain engagement for designated time, repeat.
Iso-Abs - Prone
Reps : 3 Duration : 0 Tempo : hold 8 secs
Sets : 1 Intensity : BW Rest : as reqd
Preparation :
  • Assume a prone position with elbows bent and closed fists positioned under your shoulders.
Movement :
  • Draw your lower abdomen inward toward your spine.
  • In optimal postural alignment tighten buttocks and lift body up onto forearms.
  • While maintaining the abdominal draw-in contraction, hold optimal alignment for 15 SECONDS and repeat 10 times.
  • Your spine should be in a neutral position from cervical to lumbar and your glutes should remain tight without compensatory motion.
  • Keep chin tucked in.
  • Reduce time if necessary. Form is more important than how long or how much!
Lunge - On Reebok Slide Board
Reps : 15 R, 8-10 L Duration : 0 Tempo : contin m/ment
Sets : Circuit see notes Intensity : BW Rest : see notes
Notes : sets: Circuit - 1 set, 2-3 circuits rest: up to 60 sec between circuits
Preparation :
  • Stand on the slide, facing the narrower end.
  • Start with both feet on the rubber end – thus adding stability.
Movement :
  • Once positioned, slide backwards with one foot into a reverse lunge.
  • Bring that foot back to the starting position.
  • The more you “push” the foot down into the slide during both movements, the more difficult the exercise becomes.
  • It is easy to spot, and address imbalances. If, for example you tend to abduct the right leg when bringing it back, stand on the very end of the slide, essentially not allowing abduction during the movement. This is an example of “reactive” training, i.e. putting the body into a position where it automatically corrects itself to perform the movement.
  • Increase the difficulty by starting the exercise with both feet on the slide, as opposed to against the rubber edging.
  • Stand in the center of the slide, and move one foot forward, and simultaneously move the other foot backwards, increasing the demand for coordinated movement.
  • Add resistance by using dumbbels.
Squat - 1 Leg
Reps : 8 R, 5 L Duration : 0 Tempo : 3-1-2
Sets : Circuit see notes Intensity : BW Rest : see notes
Notes : sets: Circuit - 1 set, 2-3 circuits rest: up to 60 sec between circuits
Preparation :
  • Perform drawing in and pelvis floor contractions.
  • Lift one leg off the floor and dorsiflex elevated ankle. Keep feet parallel in frontal plane.
  • Maintain level hips.
Movement :
  • Grip toes in your shoes or on the floor (IF NO SHOES)
  • Initiate the squat by bending the knee, keep the shoulder blades down and together.
  • As your knees bend, flex forward slightly in the spine but keep chest up.
  • Squat down as deep as you can with good control, maintaining heal contact with floor and watching hip and knee alignment (no pronation).
  • Return back to starting position and repeat.
  • Progressions: Inertia progressions - No weight to dumbbells to cables to tubing; Movement progression -S quat with touchdown to squat touchdown to overhead press.
Squat Touchdown - 1 Leg
Reps : 8 R, 5 H Duration : 0 Tempo : 3-1-2
Sets : Circuit see notes Intensity : BW Rest : see notes
Notes : set: Circuit - 1 set, 2-3 circuits rest: up to 60 sec between circuits
Preparation :
  • Begin balanced on one leg (opposite leg remains parallel to stance leg) while positioning entire body in optimal posture.
Movement :
  • Draw your belly button inward toward your spine.
  • Controllably, squat down bending the ankle, knee, and hip whilereaching toward, OR, touching your toe with the opposite hand.
  • While maintaining drawn-in maneuver, activate glutes & return to starting position.
Squat - Back w/ Barbell
Reps : 12-15 Duration : 0 Tempo : 3-1-2
Sets : Circuit see notes Intensity : 60-75% Rest : see notes
Notes : set: Circuit - 1 set, 2-3 circuits rest: up to 60 sec between circuits
Preparation :
  • Feet may be placed around shoulder width or SLIGHTLY wider, with minimal external rotation. (NOTE: The wider the stance [abduction], the more external rotation of the feet is required to maintain alignment at the knees).
  • Place bar comfortably on the upper back.
  • DON'T BE AFRAID TO USE A BAR PAD!
Movement :
  • From the start position, draw your belly button inward toward your spine.
  • Maintaining tone in the deep abdominal musculature, descend slowly by bending at the knees and hips.
  • During the descent, maintain weight distribution between the mid-foot and heels. Do not allow the feet to cave inward or shift outward .
  • While maintaining tone in the lower abdomen and optimal kinetic chain alignment, “drive” through the feet extending the ankle, knee, and hip joints while your weight is evenly distributed between heels and mid-foot. Do not allow body weight to shift toward the toes.
  • The knees should track over the second and third toe.
  • Perform downward reps slowly and concentrate on the eccentric (descent) and the isometric (squat position) alignment of your body.
  • Descend as far as you can control. Partial squats should progress to full squats as neuromuscular efficiency improves.
Row - On SB 1 Arm DB
Reps : 12-15 Duration : 0 Tempo : 3-1-2
Sets : Circuit see notes Intensity : 60-75% Rest : see notes
Notes : sets: Circuit - 1 set, 2-3 circuits rest: up to 60 sec between circuits
Preparation :
  • Ensure that the client is comfortable using and balancing on the stability ball.
  • Maintain proper alignment through the kinetic chain by positioning the foot on the ground straight, glutes tight, ‘neutral’ spine angles, shoulder blades retracted and depressed, and chin tucked for good cervical alignment.
  • Activate the core with a proper drawing in and pelvic floor contraction.
Movement :
  • Form a tripod with one knee and hand on the ball in line, and the other foot on the ground to the side of the stability ball.
  • The free hand is hanging straight down towards the ground.
  • Simultaneously, row the dumbbell up toward the stomach (keeping the elbow by the side of the body) and retract and depress the scapula.
  • AVOID twisting the body.
  • Slowly lower the weight and protract the scapula.
  • NEVER retract and depress the scapula before rowing as it will ‘lock’ the scapulo-thoracic joint from gliding properly.
Chest Press - Alt Arm on SB
Reps : 12-15 Duration : 0 Tempo : 3-1-2
Sets : Circuit see notes Intensity : 60-75% Rest : see notes
Notes : sets: Circuit - 1 set, 2-3 circuits rest: up to 60 sec between circuits
Preparation :
  • Sit on the Swiss ball with the weights resting on your thighs, activate the core by drawing the navel towards the spine and squeeze the glutes.
  • Gently roll down on the ball until you have your head and shoulders on the ball, allowing the weights to move onto your chest.
  • At this stage you should have your hips up at the same height as your shoulders and knees in a plank position.
  • Keep your head tilted back slightly on the ball and push the weights up directly above your chest.
Movement :
  • Keep one arm stationary with weight extended above your chest while you lower the opposite DB towards the chest.
  • When the weight reaches chest height stop and return to starting position. Repeat with opposite arm.
  • Progressions: Stable to unstable - i.e. place a med ball under one of your clients feet prior to performing movement; Two extremities to one - 1 leg raised.
Shoulder Press - 1 Leg
Reps : 12-15 Duration : 0 Tempo : 3-1-2
Sets : Circuit see notes Intensity : 60-75% Rest : see notes
Notes : sets: Circuit - 1 set, 2-3 circuits rest: up to 60 sec between circuits
Preparation :
  • Perform drawing in and pelvis floor contractions.
  • Lift one leg off the floor and dorsiflex elevated ankle.
  • Keep feet parallel in frontal plane.
  • Maintain level hips.
Movement :
  • Press dumbbells upward maintaining optimal alignment. Lower, and repeat.
  • Progressions:
    Inertia progressions- No weight to dumbbells to cables to tubing.
Rear Delt Fly
Reps : 12-15 Duration : 0 Tempo : 3-1-2
Sets : Circuit see notes Intensity : 60-75% Rest : see notes
Notes : sets: Circuit - 1 set, 2-3 circuits rest: up to 60 sec between circuits
Preparation :
  • Sit "tall" in neutral spine.
  • Align shoulders with the axis of rotation.
Movement :
  • Perform the motion with emphasis on generating motion from the rear shoulder musculature.
  • Return at desired rep temp.
Calf - Bent Knee Contract Relax Prone (Assisted)
Reps : 3-5 R, 3 L Duration : 20-30 sec. Tempo : 0
Sets : 0 Intensity : 0 Rest : 0
Preparation :
  • Ensure client know pain should not be felt during stretching.
  • Have client lie prone.
  • Bend leg to be stretched to 90 degrees.
Movement :
  • With leg client lying prone, bend knee to 90 degrees.
  • Push down on ball of foot until stretch is felt in calf.
  • HOLD AT FIRST RESISTANCE BARRIER FOR 20-30 SECONDS, THEN STATICALLY CONTRACT FOR 5-7 SECONDS, RELAX AND MOVE INTO NEWLY ACQUIRED ROM, REPEAT FOR 2-3 REPS.
Hamstring - Straight Leg Contract Relax Supine (Assisted)
Reps : 3-5 R, 3 L Duration : 20-30 sec. Tempo : 0
Sets : 0 Intensity : 0 Rest : 0
Preparation :
  • Lie supine.
Movement :
  • Place one hand behind the clients ankle and the other hand over their knee.
  • Keeping the leg straight raise it until a stretch is felt.
  • HOLD AT FIRST RESISTANCE BARRIER FOR 20-30 SECONDS, THEN STATICALLY CONTRACT FOR 5-7 SECONDS, RELAX AND MOVE INTO NEWLY ACQUIRED ROM, REPEAT FOR 2-3 REPS.
Piriformis - Supine Contract Relax (Assisted)
Reps : 3-5 R, 3 L Duration : 20-30 sec. Tempo : 0
Sets : 0 Intensity : 0 Rest : 0
Preparation :
  • Have client lie as pictured.
Movement :
  • Externally rotate and adduct the knee (not pictured), until first resistance barrier is noted.
  • Hold here for 20-30 seconds.
  • Then instruct client to push with "knee-not-ankle," hold here for 5-7 seconds.
  • HOLD AT FIRST RESISTANCE BARRIER FOR 20-30 SECONDS, THEN STATICALLY CONTRACT FOR 5-7 SECONDS, RELAX AND MOVE INTO NEWLY ACQUIRED ROM, REPEAT FOR 2-3 REPS.