How long should your client assessment take?

This post was prompted from the recent DVD (yes a DVD) series I watched called Assessing Movement with Dr Stuart McGill, Grey Cook and Craig Liebenson.  They are some big hitters in the movement/rehab world and individuals I would highly recommend to you look at. 

The FMS

They were discussing the role of FMS in the context of performance, general public and if there is a place for it before participating in activity/weightlifting.  The overall conclusion was, absolutely there is a need for it……but sometimes further investigation is needed when people are scoring ones and zeros. 

This is a roundabout way to getting my point, but bare with me.

One of the tasks was to take a volunteer from the audience and put them through an FMS.  The guy came up, looked athletic and had a decent score of a 15 without any 1s or 0s.  Clear for exercise. Great.

Then Dr. Stuart McGill got him to do a simple task of a rope pull. After a few minutes, Dr Stuart McGill wasn’t getting anywhere with his technique, so he ran his hand down the guy's back which revealed a back problem (antalgic disk) and Dr. McGill wouldn’t clear him for exercise. Well that exercise specifically.  So, he was clear from the FMS but not from Dr. McGill.

What am I trying to say here? Well, the FMS doesn’t always show the whole story. Another example of this is when another volunteer was asked to come up who was already a weightlifter and squatted regularly. 

After watching just one squat, immediately Dr. Stuart McGill said that he wouldn’t allow her to squat heavy because her movement was poor.  She had probably been squatting blissfully unaware of this break in form.  Does this mean that they can’t squat at all? No. The art then becomes exercise modification to suit the individual in front of you.

So, the FMS does clear you for exercise, but it won’t show any glaring issues without further investigation. Does this mean we should be putting in rope pulls as a screen? No, I don’t think so.  But taking this example and modifying it is where I think we can get some benefits.  Effectively it was watching someone do a "functional" movement in real life. 

When I see a new client, I conduct the FMS and if no problems are present, they then progress to a further 45-minute assessment. However, to the untrained eye, this will look like a regular training session.  But I treat the next 45 minutes as an extended assessment to test capacity and ability. All this while letting the client feel like they are getting a workout in (which is what they’re paying for).  

This further assessment is where I really start to find out what their general fitness level is.  I keep it simple as I want the client to be successful.  I add further assessments in the warm up but that’s for a later blog post, and yes, they do work through different planes of motion in that. At the moment I am developing this, but have found the following to work well. 

Functional Movement Assessment

You see, I finish with a small circuit and their fitness level will determine how many rounds we do.  One thing to note is that before the start the circuit, I tell them to go at about 80% because I don’t want them throwing up the first time they do it. I’ve learned this from experience! Also, the setup in my gym allows for easy transitions between exercises which you need to keep in mind.  You can chose your own circuit, but I suggest a safe “cardio” exercise at the beginning and end to test capability. 

The above "training session" gives me a huge amount of information to an individual's basic patterns under light load in a controlled environment.  Effectively, I have checked their motor pattern, mobility and strength under moderate fatigue in one session.    Most of the above movements have many varieties, but if these foundational movements lose form it will guide my programming.  

Throughout the session I am taking mental notes of movement, corrections to work on and I will add it to their client profile at the end of the session.