NASM CES Chapter 10: Mobility Assessments

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Chapter Goals:

• Know the importance of achieving optimal levels of flexibility and range of motion in movements. 
• Know the integrated function of the muscular, skeletal, and nervous systems and how they influence the flexibility and the ability for you to move through the full intended range of motion.
• Find the common flexibility and joint range of motion assessments. 
• Be able to talk about the performance of flexibility and range of motion assessments discussed in this chapter. 

Introduction

Being able to move optimally will require us to have good mobility, and this will depend on a combination of different soft tissue flexibility and joint range of motion.

Flexibility is defined as the normal extensibility of the soft tissues that allow full range of motion.

Mobility on the other hand is the entire range of motion that is available to the joints, as well as the control of the neuromuscular system during motion in these joints.

The targeted mobility assessments should focus on and confirm the observations found through the static and movement assessments that preceded this chapter. 

The factors that will affect someone’s mobility will be posture, pattern overload, joint structures, age, pain, injuries, gender, and psychosocial influences. 

The Mobility Assessment

These mobility assessments give the fitness professional some added insight into the client’s quality of movement and the availability of movement for their joints.

A lot of the time we see these restrictions of movement stemming from the overactive and shortened muscles or shortening of the soft tissues.

These assessments will be used for confirmation of impairments and if they are due to the muscles that were previously identified as overactive and help to find the ones that will be underactive. 

The professional must always have in their mind, the idea that the body is one interdependent system.

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When looking at the mobility of the kinetic chain, the regional interdependence model needs to be thought about.

Mobility testing will look at the specific joint motions to determine dysfunctions. 

The Scientific Rationale for Mobility Testing

The presence of flexibility deficits can be caused by the shortened soft tissues and contractile tissues.

This is very common in the active population and affects the mobility greatly. 

Upper Body Mobility Testing

In the cervical and the thoracic regions, if the static assessment shows a distortion of posture and the movement assessment find the impairments in movement, then a mobility assessment needs to be done for the shoulders, head and neck, and the cervicothoracic spine.

The flexion, extension, rotation, and side bending can be looked at by having the client actively move through motions that are reliable when looked at by a fitness professional. 

Lower Body Mobility Testing

Shortened soft tissue or muscles in the LPHC, knee joint, and ankle will commonly be the causes for impairments found in the overhead squat. 

Mobility assessment Procedures

While the static and movement assessments help us to find the muscles that are over or underactive, the mobility assessments will be more used for confirming and narrowing down those previous results.

Mobility restrictions are the inability for moving a joint through what should be the full range of motion.

When a client has restrictions in their mobility, it means they have overactive muscles and soft tissues on the opposite side of the observed restriction.

This is what reduces the joint’s ability to move. 

An example for this could be seen in a client that has some form of knee valgus in a movement assessment.

The hip adductors are found to be possibly overactive and shortened, and the opposite is true for the abductors.

The mobility assessment will then show restrictions in the pelvo-femoral abduction and confirm the overactivity of the adductors. 

Ankle Screening

Clients that show their feet turning out, excessive levels of pronation, or excessive leaning forward in the overhead squat assessment will likely have some mobility restrictions shown in the foot and ankle complex.

Some additional testing in the ankle will find specific limitations that allow the fitness professional to create a more individualized program for lower body corrective exercise.

Make sure to look through the photos and the descriptions for the various movements and tests for mobility shown for this section in the chapter. 

Knee Screening

When some static malalignments and impairments of movement have been seen in the ankles, knees, and the LPHC, some knee mobility testing needs to be done.  

Clients that have shown an anterior pelvic tilt, excessive leaning forward, or knee dominance when doing the overhead squat, some limitations of flexibility or range of motion for joints will be found.

Make sure to look through the photos and the descriptions for the various movements and tests for mobility shown for this section in the chapter. 

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Lumbo-Pelvic-Hip Complex Screening

If we have found that there are static malalignments or some impairments of movement in the LPHC or the knee, then we should do mobility testing of the trunk.

Clients that show excessive anterior or posterior pelvic tilt, asymmetrical weight shifting, knee valgus, or excessive leaning forward in the overhead squat assessment will possibly have these restrictions of the LPHC.  

Mobility testing in the lumbar spine helps to further narrow down limitations in the LPHC.

This allows the professionals to create a program that is more individualized.

Make sure to look through the photos and the descriptions for the various movements and tests for mobility shown for this section in the chapter. 

Shoulder-Elbow Screening

Movement impairments of the shoulder will often be due to some restriction of mobility in the arm.

Shoulder-elbow mobility assessments should be done with the clients that show movement compensations in the shoulders and the head and neck kinetic checkpoints.

Clients may have restrictions of mobility in the upper body if they show the arms falling forward when doing the overhead squat assessment.

Specific limitations may also be found when looking into the shoulder girdle, glenohumeral joint, elbow, and also the wrist.

Make sure to look through the photos and the descriptions for the various movements and tests for mobility shown for this section in the chapter. 

Cervico-Thoracic Mobility

If the static malalignments are found in the hip, or movement compensations are seen in the shoulders or the head and neck, these assessments should be done next.

Clients that have shown forward head postures, rounding of the shoulders, or the arms falling forward when doing the overhead squat, may all have these mobility restrictions revealed.

Make sure to look through the photos and the descriptions for the various movements and tests for mobility shown for this section in the chapter.