Updated: May 15, 2020
As with almost anything in strength and performance training, there isn’t a right or wrong way to go about evaluating your athletes (within obvious reason). Everyone has their own approach, and there can be a valid advocation for a litany of these approaches. Formalized assessments have been around for decades, but have been subject to criticism more recently, and for somewhat justifiable reason in my opinion. It was particularly rampant following the explosion of the Functional Movement Systems (FMS) developed roughly a decade ago by renowned physical therapists Gray Cook and Lee Burton. The FMS essentially popularized assessing athletes/clients by introducing a comprehensive, uniformed system that produced tangible ‘grades’ and classifications. This system was excellent in theory but had its shortcomings practically. We’ll discuss more on this in a bit though.
Where the FMS is developed around an athlete’s ability to demonstrate proficiency in global ‘functional-based’ movements such as the overhead squat and inline split squat there are other approaches to assessing athletes such as the Neurokinetic Therapy (NKT) method. NKT, developed by David Weinstock, describes itself as a “connective movement system that addresses the cause of pain”. The NKT method, which is objectively somewhat more complex than something like the FMS, is based on muscular activations and their relationships to other muscles; namely the functional opposites or antagonist muscles. In theory, every muscle has an optimal firing ability (or contractility) and optimal recruitment in regard to firing sequence. Meaning, we can independently test muscular activation, then subsequently test other muscles to see if each is firing and if it’s firing correctly. It should go without saying, there is a long line of critics for these types of assessments or even just beliefs in general. But that’s not the focus of this article.
Point being, these are just two of hundreds of formalized assessment certifications. They also happen to be the two that I hold as well. Personally, I think both FMS and NKT have merit, obviously considering I invested in them. But I don’t disagree with some of the knocks and opposing viewpoints. As with damn near everything, I feel like there is good logic behind FMS and NKT and others, but it’s incumbent on the coach to integrate them into their practice with autonomy and good judgement. I use the NKT principles in my assessment, but it isn’t the start and stop point. I use the active straight leg raise (FMS item) in my assessment, but I don’t understand a point in giving the athlete a “score” for something that’s going to improve because we’re gonna work on it. The most important things above anything else are A.) you have an actual dedicated assessment, B.) your assessment makes sense to YOU and C.) you actually address the things you point out in your eval and reference the notes you took on them. If those items are met, the world is yours and we’re just living in it.
I.) Know what you’re looking for
It’s always at the forefront of our conversations but can’t be emphasized enough- you MUST know your anatomy. Wouldn’t make much sense to have a mechanic look at your car if they don’t know what a transmission looks like, right? But in all seriousness, this is where knowing your specific muscle actions comes into play. Let’s take the rotator cuff muscles as an example. Lets say you detect dysfunctions in overhead flexion, instead of just jotting down “OH flexion is off” and/or simply avoiding overhead movements altogether, you now have the ability to make programs/training sessions highly specific and effective. In this hypothetical, let’s say you identified the athlete wasn't able to fully externally rotate their hand as they went overhead. This allows you to assume their restriction is likely due to a weak infraspinatus (external rotator) or tight subscapularis (internal rotator) because they weren’t able to externally rotate the arm very well when going into flexion. Now, you can program more specific and effective exercises down the road, as opposed to just avoiding the area or misapplying exercises.
That feeds right into the next point, which is never test “just to test”. It does you no good to waste time on something you either don’t understand or aren’t going to address. I know there’s always pressure to demonstrate to the athlete that you know what you’re doing, but it’s just as important to remember scope of practice and knowledge boundary during assessments as it is during training. I’ve always treated assessing my athletes as if I were in an anatomy lab, it’s a critical opportunity to learn your athlete, but it’s equally a tremendous opportunity to challenge your level of thinking/ability and learn. Anytime something looks off, or the athlete comes in with something you’ve yet to work with, it should spark an excitement to do your homework and dig deeper on things you’re not yet familiar with. Don’t be intimidated by things you see or come across; embrace the challenge of learning something new and ultimately expand your toolbox for athletes to come down the road.
Another thing I like to be cognizant of is knowing your specific population as thoroughly as you can. It will give you a better starting ground for assessing them biomechanically, and a narrower window for where you should invest your time/attention. For instance, I now work exclusively with a military population. There is an extremely high degree of overlap between my athletes. Not only do they all have the same background in terms of work/duties, but the majority have very similar body types, postures and even injury histories. Taking the time to understand what their day-to-day looks like and how their duties are performed can significantly improve your ability to assess them. Frankly I didn’t know shit about the ins and outs of the military world and what they were subjected to when I first started working with this population. But I did everything I could to learn more about them as quickly as I could. A few things I did early on were going and doing some of the things they’re frequently tasked with, such as going and doing an O-course myself, understanding their equipment, and asking direct questions about training, deployments, etc. I also started watching a ton of YouTube videos on skydiving, fast roping, and combat action. Needless to say, it’s given me a much better perspective of where these men and women are coming from which has vastly improved my ability to assess and work with them.
Everything in the assessment starts with a static, total 360° view of the athlete. I do feel it’s important to have them out of their shoes and remove their shirt (if context/situationally appropriate). Clothes can mask a lot of important postural observations; thus, I feel it’s necessary to see as much directly as possible. When I’m doing a global observation, I first want to look for a general “feel” of their resting posture. Do they look tense or guarded? Are they favoring one side or the other? Do they feel uncomfortable being analyzed or having their shirt off? Does it look like they’re masking something? In addition, these are the more biomechanical items I’m looking for:
Once we’ve observed our athlete statically, it’s time to put them in motion. It’s important to treat static and dynamic assessments somewhat differently. In a static situation, the athlete has the advantage to put themselves in certain positions and in essence coverup potential dysfunctional areas or areas of weakness. Furthermore, not only are you putting them in specific positions during a static assessment, but you can also hold them there for as long as needed. This is why I feel it’s important to film your dynamic evaluations. There’s always a lot going on, and you only have so much time to put someone through tests and assessments. So I normally record every athlete I work with, and make sure I watch the film that night at home to collect more detailed notes. The easy analogy here is thinking about the car with loose lug nuts. If we take that car slowly around the block at 20 mph, we may not think there’s anything wrong. We take that car out on the interstate at 60 mph and shit’s gonna start to expose itself. Here’s an overview of some of my main criteria for a global-dynamic assessment:
Single Leg Balance:
Very informative video via Yoga Anatomy Here: Gait Analysis
IV.) Manual Muscle Testing
I suppose I have to start this section out by reiterating scope of practice. In our field, everything changes in a major way when we put people on tables and start putting our hands on people. I’ve been very fortunate throughout my career thus far to not have any incidents with regard to scope of practice or injuring someone. But man, I’ve heard some really wild and unfortunate stories from people, so it’s always something that needs to be at the forefront of your mind. I’m very lucky that my place of work has a high-quality camera system throughout the gym. I rely heavily on this. Especially when I’m doing my assessments or making direct physical contact with my athletes at all, I am always sure to be directly under a camera- just in case. In any event, use good discretion, and don’t ever violate your scope.
Manual muscle testing is a way that we can isolate a particular muscle to check and see if it’s firing properly. Additionally, we can then check individual muscles and see how they relate to other muscles or compare bilaterally to the same muscle. As far as I’m concerned, manual muscle testing is really just giving me a better idea of muscular relationships:
-How does the psoas relate to the ipsilateral glute and contralateral psoas?
-How does the hamstring relate to the ipsilateral glute and contralateral QL?
-How does the lat relate to the ipsilateral serratus and contralateral trap?
The caveat to this is that they could mean everything, or they could mean nothing at all. Again, I can’t stress this enough, we’re not looking to see what’s “broken” or deliberately trying to find every little muscle that can be deemed “dysfunctional”. All we are looking for is how this individuals’ muscles fire, how they compare bilaterally, and then how they relate to other muscles thereafter. It’s also important to recognize that we are NEVER looking to diagnose anything. Not only is that far from the responsibility of a strength coach, but without a comprehensive protocol (including imaging) we literally can’t diagnose anything. Once again, this is just us mapping out what we’re working with and using what we find in our assessments to strategize and plan our approach.