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| A navigator with sextant I am exactly like this, except with iron not brass and also not a woman |
You the trainer have now got yourself the right education, you've got employment and recruited a few clients. How do you begin? Remember that the personal trainer is a navigator. A navigator finds out where you are, where you want to be, and plots out the safest and quickest route between the two places – it's up to you to actually make the journey. Where is the client now? That's their capabilities. Where do they want to go? That's their goals. So in the initial appointment the PT should assess the client's capabilities and goals.
A health screen is not an assessment
Most responsible gyms and competent PTs will have some sort of health screening system, commonly called a PAR-Q (physical activity readiness questionairre). A health screen is not an assessment, it's a tool to discover any major health issues which might mean the person is likely to hurt or kill themselves in the gym. Things like diabetes, heart disease, stroke, recently dislocated limbs, high blood pressure and so on. If the person has these issues you may want to refer them for medical advice before letting them do anything at all, and considering your own level of knowledge about these issues, you may actually refuse to train them and refer them to someone who can train them safely and effectively.
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| Yes but what's his VO2 max? |
In that casual conversation I was adopting an informal health screen. Of course we need a formal health screen as well, a series of questions written down covering common and dangerous health issues. But this is a screen, not an assessment. It's like when recruiters look at resumes and toss out anyone who doesn't have the relevant degree or experience – that's a screen. The assessment when they look at the resumes left over and start interviews and later reference checks. We use a screen to filter people into “no way!” and “let's look further.”
The screen though not an assessment will give us things to look for during our actual assessment. For example, the other day I began training Yvonne, who reported a previous knee injury. So when assessing her squat, I looked for any instability in that knee, and compensations at ankle and hip and in the other leg.
Assessment
Assess movement. Measure what's important. PTs can and commonly do assess many irrelevant things. If my goal is to rehabilitate my injured shoulder, you don't need to take my waist measurement. If I am 180kg and my goal is to lose weight, you don't need to measure my bodyfat percentage – I'm 180kg, unless I'm 3 metres tall my bodyfat can be measured as “too bloody much.” Contrary to popular belief, measuring many things to several decimal places doesn't make us look smart – people can smell bullshit. Measure what's important to the client, what's relevant to their goals. And nothing else.
When I was overfat I had a 97cm waist and only a 103cm chest. I signed up for the local gym and the PT got out the bodyfat calipers. That's exactly what a chubby 36 year old guy wants, to take off his shirt in front of a pretty and fit young woman in her twenties and let her pinch his blubber. I said, “My waist is almost as big as my chest, that's all I need to know. I don't need to know my exact bodyfat percentage, it means nothing to me. When my waist gets smaller and my chest gets bigger I'll be happy.” What she needed to do was set aside the calipers and get out a tape measure which could be used without any shirt-stripping or fat pinching. But she insisted. I put up with it then but didn't go back to the gym. She did not measure what's important.
What is important to everyone is movement. Physical training can change how you look, feel and perform. How you move affects your looks (eg posture), how you move affects how you feel (are you stiff and sore, do you lose your breath easily?), how you move affects how you perform (in sports and everyday life). And an exercise is just a movement. This is why as personal trainers, our job is to teach correct movement. So we begin by assessing movement.
But on what basis will we assess movement? There are many ways to do it. The functional movement screen is a famous one, but I don't find it very useful, since most people will score so badly on it. For example, only at most one in ten typical gym-goers will be able to do anything resembling a competent overhead squat. We may as well measure how well they do the splits. The FMS will be useful with athletes, but much less useful with general population clients. PTs rarely work with athletes, so we need something different.
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| The Van Damme Movement Screen If you cannot do this, you FAIL and the Belgians win, which is never right |
I have previously laid out the basic human movements when I spoke of training movements not muscles: squat, lunge, push, pull, bend, twist and gait. Since then I've changed my thinking a little. If a person can do a good squat they will be able to do a good lunge and vice versa, and if one is bad the other will be too. If they get strong in the squat their gait will become stronger and faster, and further improvements in gait are usually the domain of running coaches or physiotherapists, depending on the issues. And so on.
Movement assessment
None of those things are a bad idea left as they are, but I'm now more inclined to Dan John's scheme laid out in Intervention: push, pull, squat, hip hinge and loaded carry. I'll talk about this further in the next article.
