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NASM CES Chapter 9: Movement Assessments 1

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    Chapter Goals:

    • Know the functions of movement assessments.
    • Be able to tell the differences in dynamic and transitional movement assessments.
    • Find the relationship that exists between the muscle imbalances and movement impairments.
    • Know the steps for doing the movement assessments.

    Introduction

    Static posture was the position of the musculoskeletal system while the person is standing still, and that was the first set of assessments we go through.

    The next set is going to be these dynamic posture assessments.

    Dynamic posture is the alignment of the body as it is in motion.

    Some of those static posture assessment imbalances that we found, may be shown throughout these movements also, but the same cannot be said for dynamic imbalances appearing in the static postures.

    When at rest, the client might have absolutely perfect alignment, but then have some imbalances that only show themselves when going through movements.

    Understanding the proper alignment and movement strategies allow us to identify abnormal ones and find these muscle imbalances. 

    The Scientific Rationale for Movement Assessments

    These are going to be the cornerstone for comprehensive and integrated assessments processes.

    Optimal movement of our bodies will require integrated functioning of the whole human movement system.

    The proper function of our muscles and the optimal recruitment of force-couples are needed for maintaining the precise levels of joint motion and decreasing stress that is placed on the body. 

    All of the previous info essentially means that efficient force transfer for acceleration, deceleration, and stabilization of the interconnected joints of the body will apply to the kinetic chain which we have discussed.

    Every joint has an impact onto another joint in the body, so one imbalance is actually multiplied. 

    Types of Movement Assessments

    We are going to group the different forms of movement assessments into the three categories of transitional, loaded, and dynamic assessments. 

    Transitional Movement Assessments

    These are the foundation of the movement assessment process and they will involve movement without changing your actual base of support.

    These movements allow the assessment of someone to be focused on their dynamic posture, their quality of control for the movements, and the alignment of their joints during these specific patterns of movement.

    Just like before, we observe to see the overactive and underactive muscles, with the only difference being the movements happening instead of static assessments. 

    These assessments only use the body weight of the client and these typical assessments are: 

    • The overhead squat
    • Modified overhead squat
    • Split squat
    • Single-leg squat 

    Loaded Movement Assessments

    These are going to look at the dynamic posture also with an addition of some source of resistance and they will relate directly with the normal patterns of movement that we use each and every day. They include the following:

    • Push
    • Pull
    • Overhead press
    • Trunk rotation
    • Squat
    • Hinge
    • Split stance
    • Single leg and stepping

    These are going to be considered as optional assessments for clients. And if included, these discrete loaded movement assessments will be:

    • Loaded squat
    • Standing push
    • Standing pull
    • Standing overhead press

    Dynamic Movement Assessments

    These assessments are going to involve movement that changes someone’s base of support.

    This is seen with things like walking, jumping, running. just like the loaded assessments, these will be optional and more advanced components in the CES assessment flow. 

    The typical assessments includes will be:

    • Gait (walking) 
    • Depth jump
    • The Davies test

    Kinetic Chain Checkpoints

    Just like with our static postural assessments, we will be looking ot specific body areas from various views.

    Each region of the body is looked at on its own, but the fitness professional should also look at the body while relating to the regional interdependence model.

    Again, this has the body viewed as an inter-related system where one joint or region will impact the others. 

    We are again going to look at the body from the anterior, lateral, and posterior views. 

    Common Movement Impairments

    • To prepare for the next sections, it is important to look over what is considered to be the more common impairments to help narrow down your results. Know these terms well.
    • Excessive pronation – you look to the arch of the foot and find that it collapses or flattens out, the heel are everted, or there is a poor alignment in the Achilles tendon. 
    • Feet turn out – you look to the toes and see they move laterally during some movements.
    • Heel raise – you look to the heel and see it comes off of the ground while moving.
    • Knee Valgus – you look to the knees and find that they collapse inward.
    • Knee Varus – you look to the knees and find that they collapse outward.
    • Knee dominance – you look for an upright trunk and the knees move toward the front of the toes, and for more knee anterior excursion comparing to the hip posterior excursion. 
    • Asymmetrical weight shift – you look to the hip and see a shift to one of the sides. The side of the body that is opposing the shift exhibits the hip dropping in the frontal plane. 
    • Excessive trunk movement – you look for instability of the trunk when they are in a position of the pushup. 
    • Excessive anterior pelvic tilt – you look to the pelvis and you see it roll forward and the lumbar spine extends forward and creates a prominent arch there.
    • Excessive posterior pelvic tilt – you look to the pelvis for backward rolling and the lumbar spine flexing, which may show in a flattening of the lower back. 
    • Excessive forward trunk lean – you look to the trunk of the body and see it lean forward and out of the proper alignment with the shins.
    • Trunk rotation – look to the trunk of the body and you will see internal or external rotation occur when doing single-leg moves.
    • Scapular elevation – you look for the shoulders to move toward the ears.
    • Scapular winging – this is when you look at the scapula and they will protrude excessively from the back, and it is seen the most in the push-up position.
    • Arms fall forward – you look for the arms to fall forward and not be aligned with the torso and the ears.
    • Excessive cervical extension (forward head) – you look for the had to migrate forward, and this shows the ears moving out of alignment with your shoulders. 

    Transitional Movement Assessments

    After the static postural assessment, these assessments will be the first of the movement assessments that you do.

    These are the ones that do not have a change in the client’s base of support, and they are not loaded with any resistance.

    The posture and alignment is viewed throughout the ascent and descent of the movements.

    They will be viewed from the side, front, and the rear. 

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    Overhead Squat Assessment

    This is designed for assessing someone’s dynamic posture, mobility, core stability, and their neuromuscular controlling the body while performing a squat with arms above the head.

    This has been found to very reliable and valid for repeated attempts in showing the movement impairments for the professionals that administer it.

    This is true even if one trainer does it and they aren’t the ones that make the program.

    It is a very useful assessment.

    Make sure to go through the pictures and the procedures for the movement to know the basis of it, and how it should look when you are viewing from the various angles. 

    Single-Leg Squat Assessment

    This is seen as a progression for the overhead squat.

    The assessment is used to look at the dynamic posture, strength, balance, and the neuromuscular control all in a single-limb stance.

    Like with the overhead squat, the single leg squat is a valid time to find the movement impairments, especially so with knee valgus. 

    This is the challenging of the lower body assessments due to the strength of single limb being tested and the need for balance.

    This test should only ever be done with those that perform the overhead squat assessment perfectly.

    Clients who wish to test their balance and have that as a goal will be able to see the differences in that based on the side.

    So, this can be a helpful piece of information for training also.

    Make sure to go through the pictures and the procedures for the movement to know the basis of it, and how it should look when you are viewing from the various angles. 

    Split Squat Assessment

    This is again used for the dynamic posture, stability, and assessing neuromuscular control but now in a narrow stance.

    This movement will mimic the stance needed for walking and running, as well as the stances used in everyday life. 

    Many clients will be unable to do the single leg stance, so this split stance can be used as a regression to refine these observations of unilateral compensations that are seen in the overhead squat assessment.

    Make sure to go through the pictures and the procedures for the movement to know the basis of it, and how it should look when you are viewing from the various angles. 

    Loaded Movement Assessments

    These are optional assessments that are after the transitional assessments.

    This are going to look at how a client’s posture and control will be affected by the addition of some external resistance of some kind.

    They are used to see how a person will respond to the regular training sessions and the exercises in them.

    With that in mind, every training session is somewhat like a time to view the client’s dynamic posture due to the inclusion of these moves. 

    Loaded Squat Assessment

    This is designed to look at someone’s dynamic posture, their core stability, and their overall neuromuscular control during the squat with weight.

    The goal is to see how this addition of weight will affect the dynamic posture, and maybe even compare that to when they don’t have weight added.

    Make sure to go through the pictures and the procedures for the movement to know the basis of it, and how it should look when you are viewing from the various angles. 

    Loaded Push Assessment

    The standing push assessment will look at one’s performance in a horizontal pushing move while using both arms.

    This allows the professional to look at and for scapular and shoulder mechanics that come into play here.

    This is the first of the pure upper body assessments.

    It also looks at the patterns of activation in the upper body and the stability of your LPHC and cervical spine or head.

    These assessments will often measure the force produced by the body, the biomechanical loads the spine and joints take on, and the efficiency of movement for the human movement system. 

    This assessment form is intended for use when clients are doing push type exercises, but also for the advanced clients that want a more detailed assessment into their loaded dynamic posture.

    Make sure to go through the pictures and the procedures for the movement to know the basis of it, and how it should look when you are viewing from the various angles. 

    Loaded Pull Assessment

    This is used for measuring the horizontal pulling motion with the use of both arms.

    The assessment allows for the assessment of the scapular and shoulder mechanics, the patterns of upper extremity muscle activation, and the stability to be seen in the LPHC or cervical spine and head.

    They are commonly used for measuring the muscle forces made by the body, the biomechanical loads that the spine and joints take on, and the movement efficiency of our kinetic chains. 

    Just like pushing, this is intended to be for the clients that will be performing these pulling type exercises often, but it may also be for the athletes that wish to look further into their dynamic posture to have it assessed for weaknesses.

    Make sure to go through the pictures and the procedures for the movement to know the basis of it, and how it should look when you are viewing from the various angles. 

    Standing Overhead Dumbbell Press Assessment

    This is a loaded assessment that informs the fitness professional of the ability and posture of the client when doing pushing movements of the vertical variety in their programming.

    Like the other loaded assessments, it can be done before a workout session as part of an advanced clients’ request for more work into their dynamic posture.

    Make sure to go through the pictures and the procedures for the movement to know the basis of it, and how it should look when you are viewing from the various angles. 

    Dynamic Movement Assessments

    These dynamic movement assessments are another step that is optional and only really for further confirmation of the observations found in the prior assessment forms.

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    They may also be for those advanced clients that are preparing for sports training and want to ensure that their dynamic posture and things will be the best possible. 

    Gait Assessment

    The gait assessment is a dynamic posture assessment done for clarification and validation of previous movement assessment results in the real world.

    It is not the same as the gait assessment commonly done by scientists in biomechanics and advanced performance coaching. 

    The specialist here will be interesting in looking at the movement compensations that are seen in normal ambulation.

    One example is for clients that are actually interested in running or athletes in a running sport.

    They would benefit best from knowing how their walking and running gaits is affecting their movement system.

    Unlike the other two tests of the depth jump and davies test, this is not actually considered to be a performance test. 

    Make sure to go through the pictures and the procedures for the movement to know the basis of it, and how it should look when you are viewing from the various angles. 

    Depth Jump Assessment

    This is a dynamic movement assessment in which we find the impairments that occur when jumping and landing during different tasks.

    It is very common to see this form of assessment when looking at clinical, rehab, and sports performance settings.

    These are times when the jumping and landing mechanics need to be emphasized more. 

    This test has been found to be a significant predictor of repeated ACL injuries occurring.

    When clients show a lot of knee valgus, knee dominance, and hip external rotation, these are indicators of this heightened risk.

    When someone is ready to undertake this assessment, research shows that well designed programs for corrective exercise will be effective at reducing the impairments in movement that are associated with landing and jumping tasks. 

    The assessment is considered to be a performance test and thus, a max effort vertical jump needs to be encouraged in the explanation for the move.

    Make sure to go through the pictures and the procedures for the movement to know the basis of it, and how it should look when you are viewing from the various angles. 

    Davies Test

    This is a dynamic movement assessment that is used to find movement impairments during repetitive, and plyometric activity done for the upper body.

    It requires the performer to have agility, strength, and stabilization in the trunk and the upper body.

    It should only ever be done for the clients that have done the standing push assessment with ease and ensuring that they can safely participate in plyometric activity.

    Some of those that should not perform the assessment are those that have a lack of stability in the shoulder, they have current pain showing up in the shoulder, or some lack of functional strength for doing a push up. 

    Make sure to go through the pictures and the procedures for the movement to know the basis of it, and how it should look when you are viewing from the various angles. 

    Assessment Implementation Options

    The movement assessments we have gone over are key components in finding the efficiency of movement and the possible risks for injuries.

    These assessments in addition to the static and mobility assessments to follow are essential for designing specific exercise programs for enhancing functionality and overall performance, and simply decreasing the risk for injury. 

    The main assessment that should be done for all of your clients is going to be the overhead squat assessment.

    It gives the most information and is relatively short and most people will be able to perform it.

    The rest of the assessments should be viewed as optional and only progressed to if you believe the client has the required strength and abilities. 

    Another idea is that the performance of many of these exercises may be used as the initial workout with your client in order to assess all of these things in one setting and get it out of the way.

    The client will believe they are getting a workout, but the professional will actually be using this for assessing their structural integrity and forming a new workout to fix the things that come up. 

    The third thing is that these assessments may be done as a way to build up you base of clients.

    You can offer 30 – 45 minute sessions that take the possible clients through the process of assessment and this can attract new members, sign new clients, and help to generate revenue in general. 

    NASM CES Chapter 9: Movement Assessments 2
    NASM CES Chapter 9: Movement Assessments 3
    NASM CES Chapter 9: Movement Assessments 4

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