ASSESSMENTS & CORRECTIVE EXERCISE · Dumbbell Front-Raise Barbell Front-Raise Weight Plate...

ASSESSMENTS & CORRECTIVE EXERCISE

TOPICS:

▪ BONES & MUSCLES

▪ JOINT ACTIONS

▪ FITNESS FORMS

▪ OBJECTIVE TESTS

▪ EXERCISE TESTS

▪ CORRECTIVE EXERCISE

▪ FOAM ROLLING

▪ STRETCHING

YELLOW SECTION

Sub-Topics:

▪ Shoulder muscles

▪ Rotator cuff muscles

▪ Other shoulder muscles

▪ Anterior upper arm muscles

▪ Posterior upper arm muscles

TOPIC: BONES AND MUSCLES


ARMS, WRIST & HANDS BONES

A. Humerus

B. Ulna

C. Radius

D. Carpals

E. Metacarpals

F. Phalanges

A

B

CD

EF

Anterior View

DELTOID MUSCLES

A. Deltoid [Anterior]

▪ Origin: Lateral 3rd of clavicle | Inserts: Superior Humerus

▪ Isolative Function: Concentrically accelerates shoulder flexion and internal rotation

▪ Integrated Function: Eccentrically decelerates shoulder extension and external rotation; Isometrically stabilizes

the shoulder girdle

B. Deltoid [Middle]

▪ Origin: Superior Scapula| Inserts: Superior Humerus

▪ Isolative Function: Concentrically accelerates shoulder abduction

▪ Integrated Function: Eccentrically decelerates shoulder flexion and internal rotation; Isometrically stabilizes the

shoulder girdle

C. Deltoid [Posterior]

▪ Origin: Superior Scapula| Inserts: Upper Humerus

▪ Isolative Function: Concentrically accelerates shoulder external rotation, abduction and extension

▪ Integrated Function: Eccentrically decelerates shoulder internal rotation, adduction and flexion; Isometrically

stabilizes shoulder girdle

B

A

C

ROTATOR CUFF MUSCLES

A. Supraspinatus

▪ Origin: Superior scapula | Inserts: Superior Humerus

▪ Isolative Function: Concentrically accelerates abduction of the arm

▪ Integrated Function: Eccentrically decelerates adduction of the arm; Isometrically stabilizes the shoulder girdle

B. Infraspinatus

▪ Origin: Medial Scapula | Inserts: Superior Humerus

▪ Isolative Function: Concentrically accelerates shoulder external rotation

▪ Integrated Function: Eccentrically decelerates shoulder internal rotation; Isometrically stabilizes the shoulder girdle

C. Subscapularis

▪ Origin: Medial underside of Scapula| Inserts: Anterior Superior Humerus

▪ Isolative Function: Concentrically accelerates shoulder internal rotation

▪ Integrated Function: Eccentrically decelerates shoulder external rotation; Isometrically stabilizes the shoulder girdle

D. Teres Minor

▪ Origin: Lateral border of the scapula| Inserts: Posterior Superior Humerus

▪ Isolative Function: Concentrically accelerates shoulder external rotation

▪ Integrated Function: Eccentrically decelerates shoulder internal rotation; Isometrically stabilizes the shoulder girdle

A

B

C

D

OTHER SHOULDER MUSCLES

A. Teres Major

▪ Origin: Inferior Scapula | Inserts: Anterior Superior Humerus

▪ Isolative Function: Concentrically accelerates shoulder internal rotation, adduction and

extension

▪ Integrated Function: Eccentrically decelerates shoulder external rotation, abduction and

flexion; Isometrically stabilizes the shoulder girdle

B. Latissimus Dorsi

▪ Origin: Spine T7-T12; Posterior pelvis; Thoracolumbar fascia; Ribs 9-12| Inserts: Inferior

Scapula; Proximal (to shoulder joint) Humerus

▪ Isolative Function: Concentrically accelerates shoulder extension, adduction and internal

rotation

▪ Integrated Function: Eccentrically decelerates shoulder flexion, abduction and external

rotation; Eccentrically decelerates spinal flexion; Isometrically stabilizes the LPHC and shoulder

A

B

UPPER ARM MUSCLESA. Tricep Brachii (long head)

▪ Origin: Scapula| Inserts: Ulna

▪ Isolated Function: Concentrically accelerates elbow extension and shoulder extension

▪ Integrated Function: Eccentrically decelerates elbow flexion and shoulder flexion; Isometrically

stabilizes the elbow and shoulder girdle

B. Tricep Brachii (short head)

▪ Origin: Posterior Humerus| Inserts: Ulna

▪ Isolated Function: Concentrically accelerates elbow extension

▪ Integrated Function: Eccentrically decelerates elbow flexion; Isometrically stabilizes the elbow

C. Tricep Brachii (medial head)

▪ Origin: Posterior Humerus| Inserts: Ulna

▪ Isolated Function: Concentrically accelerates elbow extension

▪ Integrated Function: Eccentrically decelerates elbow flexion; Isometrically stabilizes the elbow

AB

C

UPPER ARM MUSCLESA. Biceps Brachii (long & short head)

▪ (long head) Origin: Superior Humerus| Inserts: Proximal Radius

▪ (short Head) Origin: Underside of Superior Scapula| Inserts: Proximal Radius

▪ Isolated Function: Concentrically accelerates elbow flexion & supination of

forearm

▪ Integrated Function: Eccentrically decelerates elbow extension, shoulder

extension & pronation of forearm; Isometrically stabilizes the elbow and

shoulder girdle

B. Brachialis

▪ Origin: Lower Half of Anterior Humerus| Inserts: Proximal Ulna

▪ Isolated Function: Concentrically accelerates elbow flexion

▪ Integrated Function: Eccentrically decelerates elbow extension; Isometrically

stabilizes the elbow

A

B

LOWER ARM MUSCLESA. Brachioradialis

▪ Origin: Lateral Humerus | Inserts: Distal Radius

▪ Isolated Function: Concentrically accelerates elbow flexion

▪ Integrated Function: Eccentrically decelerates elbow extension; Isometrically stabilizes

the elbow

B. Wrist Flexors

▪ Origin: Distal Forearm (close to elbow)| Inserts: Wrist and Hand

▪ Isolated Function: Concentrically accelerates wrist flexion

▪ Integrated Function: Eccentrically decelerates wrist extension; Isometrically stabilizes the

wrist

C. Wrist Extensors

▪ Origin: Distal Posterior Forearm| Inserts: Back of Wrist and Hand

▪ Isolated Function: Concentrically accelerates wrist extension

▪ Integrated Function: Eccentrically decelerates wrist flexion; Isometrically stabilizes the

wrist

A

B

C

Sub-Topics:

▪ Shoulder flexion

▪ Shoulder extension

▪ Shoulder adduction

▪ Shoulder abduction

▪ Shoulder internal rotation

▪ Shoulder external rotation

▪ Shoulder transverse adduction

▪ Shouler transverse abduction

▪ Elbow Flexion

▪ Elbow Extension

▪ Wrist Flexion

▪ Wrist Extension

TOPIC: SHOULDER JOINT ACTIONS


SHOULDER FLEXION

▪ Joint Action▪ Shoulder Flexion

▪ Plane of Motion▪ Sagittal

▪ Agonist▪ Deltoid [Anterior]

▪ Synergist▪ Biceps Brachii▪ Pectoralis Major (Clavicular)

▪ Stabilizer▪ Shoulder Stabilizers

▪ Antagonist▪ Triceps Brachii

▪ Teres Major▪ Deltoid [Posterior]▪ Latissimus Dorsi

▪ Exercises▪ Dumbbell Front-Raise

▪ Barbell Front-Raise▪ Weight Plate Front-Raise

SHOULDER EXTENSION

▪ Joint Action▪ Shoulder Extension


▪ Agonist▪ Latissimus Dorsi

▪ Synergist▪ Teres Major▪ Triceps Brachii


▪ Antagonist▪ Deltoid [Anterior]▪ Biceps Brachii

▪ Exercises▪ Dumbbell Pull-Over▪ Bar Straight Arm Lat. Pull-Down▪ Rope Straight Arm Lat. Pull-Down

SHOULDER ADDUCTION

▪ Joint Action▪ Shoulder Adduction

▪ Plane of Motion▪ Frontal

▪ Agonist▪ Latissimus Dorsi

▪ Synergist▪ Rhomboids Major/Minor▪ Levator Scapulae▪ Teres Major


▪ Antagonist▪ Deltoid [Middle]▪ Supraspinatus

▪ Exercises▪ Wide Grip Lat Pull-Down▪ Wide Grip Pull-Up▪ Wide Neutral Grip Pull-Up

SHOULDER ABDUCTION

▪ Joint Actions▪ Shoulder Abduction

▪ Plane of Motion▪ Frontal

▪ Agonist▪ Deltoid [middle]

▪ Synergist▪ Supraspinatus


▪ Antagonist▪ Latissimus Dorsi

▪ Exercises▪ Dumbbell Lateral Raises▪ Cable Lateral Raises▪ Upright Row

SHOULDER INTERNAL ROTATION

▪ Joint Action▪ Shoulder Internal Rotation

▪ Plane of Motion▪ Transverse

▪ Agonist▪ Subscapularis

▪ Synergist▪ Teres Major▪ Deltoid [Anterior]


▪ Antagonist▪ Infraspinatus

▪ Exercise▪ Cable Internal Rotation▪ Dumbbell Internal Rotation▪ Band Internal Rotation

SHOULDER EXTERNAL ROTATION

▪ Joint Action▪ Shoulder External Rotation


▪ Primary Mover▪ Infraspinatus

▪ Synergist▪ Deltoid [Posterior]

▪ Stabilizers▪ Shoulder Stabilizers

▪ Antagonist▪ Subscapularis▪ Teres Minor▪ Pectoralis Major▪ Latissimus Dorsi

▪ Exercises▪ Cable External Rotation▪ Dumbbell External Rotation▪ Band External Rotation

SHOULDER TRANSVERSE ADDUCTON

▪ Joint Action▪ Shoulder Transverse (horizontal) Adduction


▪ Agonist▪ Pectoralis Major

▪ Synergist▪ Shoulder Internal Rotators


▪ Antagonist▪ Deltoid [Posterior]▪ Shoulder External Rotators

▪ Exercises▪ Pec. Fly Machine▪ Dumbbell Flys▪ Cable Flys

SHOULDER TRANSVERSE ABDUCTON

▪ Joint Action▪ Shoulder Transverse (horizontal) Abduction


▪ Agonist▪ Deltoid [Posterior]

▪ Synergist▪ Shoulder External Rotators


▪ Antagonist▪ Pectoralis Major▪ Shoulder Internal Rotators

▪ Exercises▪ Reverse Machine Fly▪ Reverse Dumbbell Fly▪ Reverse Cable Fly

ELBOW FLEXION

▪ Joint Action▪ Elbow Flexion


▪ Agonist▪ Bicep Brachii

▪ Synergists▪ Brachialis▪ Brachioradialis

▪ Stabilizers▪ Elbow stabilizers

▪ Antagonist▪ Triceps Brachii

▪ Exercises▪ Dumbbell Curl▪ Barbell Curl▪ Hammer Curl

ELBOW EXTENSION

▪ Joint Action▪ Elbow Extension


▪ Agonist▪ Triceps Brachii

▪ Synergists▪ N/A

▪ Stabilizers▪ Elbow Stabilizers

▪ Antagonist▪ Biceps Brachii▪ Brachioradialis▪ Brachialis

▪ Exercises▪ Tricep Press Down▪ Body Weight Dips▪ Dumbbell Skull Crusher

WRIST FLEXION

▪ Joint Action▪ Wrist Flexion


▪ Agonist▪ Wrist Flexors


▪ Stabilizers▪ Wrist Stabilizers

▪ Antagonist▪ Wrist Extensors

▪ Exercises▪ Dumbbell Wrist Curls▪ Barbell Wrist Curls▪ Band Wrist Curls

WRIST EXTENSION

▪ Joint Actions▪ Wrist Extension


▪ Agonist▪ Wrist Extensors


▪ Stabilizers▪ Wrist Stabilizers

▪ Antagonist▪ Wrist Flexors

▪ Exercises▪ Barbell Reverse Wrist Curls▪ Dumbbell Reverse Wrist Curls▪ Band Reverse Wrist Curls

Sub-Topics:

▪ Purpose

▪ Informed Consent

▪ Par-Q

▪ Medical History

▪ Lifestyle questionnaire

TOPIC: FITNESS FORMS


PURPOSE

▪ The primary purpose of any personal training form is to gather data

that can minimize personal liability or company liability

▪ Informed consent form and/or a liability waiver being the most important for

this purpose

▪ The important secondary purpose is to gather information that will give

frame work to your exercise program and nutrition program

▪ Par Q, Medical History and Lifestyle Questionnaire to name a few are very

useful to understand client limitations and help construct fitness program

INFORMED CONSENT FORM

▪ Informed consent requests permission or consent for health screenings, fitness evaluations, and/or exercise participation

▪ This form and or the liability waiver are the first form a client will fill out when entering a training program or a training facility

▪ Components of an informed consent document may include:

▪ Background and purpose

▪ Assumed risks of participation

▪ Reasonable expected benefits

▪ Reasonable explanation of procedures

▪ Normal physiological expectations

▪ Opportunity for inquiry

▪ Right of refusal

▪ Right of confidentiality

▪ A liability waiver is very similar, but additionally releases the trainer, facility or company from legal recourse the event someone was to be injured or died

PAR-Q

▪ The Par-Q includes seven (7) questions which serve as red flag

indicators designed to identify individuals who require medical

clearance before participating in any physical testing or starting an

exercise program

▪ Provides little benefit to trainer other than identifying those clients that might

need medical clearance from their doctor

▪ If client answers “yes” to any of these questions a medical clearance form

should be sent with client to their doctor so, he or she can identify safe heart

rate range and any specific limitations

MEDICAL HISTORY

▪ Gathering medical history is always extremely important and will help

you not only create a safe fitness program, but also help you identify

the correct course of action if a situation was to occur

▪ Some information collected includes

▪ Contact information for client and emergency contact

▪ Past medical history

▪ Medications

▪ Past injuries

▪ Areas of discomfort

▪ Family history

LIFESTYLE QUESTIONNAIRE

▪ A lifestyle or behavioral questionnaire identifies how a client currently

undertakes fitness and nutrition

▪ Without first knowing what the client is doing currently, we cannot hope to

intelligently give them advices or recommendations

▪ Certain areas of this form should correlate directly with findings during

our objective health tests and exercise tests

▪ Example:

▪ Client Disclosures: Sedentary most of the day and consume high sodium foods

▪ Objective Tests: Has high blood pressure, high resting heart rate, elevated body fat levels

▪ Exercise Tests: Performs poorly on cardiovascular tests and muscular endurance tests

Sub-Topics:

▪ Purpose

▪ Heart rate

▪ Blood pressure

▪ Use technology

▪ Body composition

▪ Circumference measurements

▪ Outdated tests

TOPIC: OBJECTIVE TESTS


PURPOSE

▪ Objective health tests have multiple purposes including

▪ Create correlations with medical and lifestyle questionnaire

▪ Identify if medical referral is needed based on findings

▪ Create a starting point for comparison during re-assessment

▪ The more objective test that are done, the more positive change that

can be shown

▪ This creates motivation and increases adherence to the fitness program

▪ Makes the chance of a training contract re-sign more likely

WEIGHT

▪ Weight is a very basic measurement, but make sure the

procedure used is replicated every time

▪ Preferable to have client weigh in the morning before significant food

or water intake

▪ Document if clothes and shoes are off or on during measurement

▪ Document weight to at least one decimal point, especially if client is

not visibly obese

▪ Client may only be losing fractions of pound between weigh-ins

HEART RATE

▪ Heart rate is typically taken for the radial artery, located on the

lateral side of the lower wrist, just under the thumb

▪ Two fingers (pointer and index) are placed over radial

▪ Palpate to find pulse, then count beats for (1) minute

▪ Average resting heart rate should be between 70-80 bpm

▪ If resting heart rate exceeds 100 bpm a medical referral will be

required

BLOOD PRESSURE

▪ Blood pressure is the measure of pressure of circulating blood against the walls of the blood

vessels after blood is ejected from the heart

▪ Blood pressure measures are broken up into (2) parts Systolic and Diastolic pressures

▪ Systolic Pressure: The top number when documenting blood pressure, representing pressure within the

artery’s when the heart contracts

▪ Diastolic Pressure: The bottom number when documenting blood pressure, representing pressure within

the artery’s while the heart is at rest and not contracting

▪ A standard for good health is a result of 120/80

▪ High blood pressure is 140/90 or greater

▪ Medical clearance is required if

▪ Systolic blood pressure >160mmHg

▪ Diastolic blood pressure >100mmHg

USE TECHNOLOGY

▪ There are many technologies to

accurately gather data on heart rate and

blood pressure that are relatively

inexpensive these days

▪ We recommend investing (about $30) in

a electronic blood pressure cuff that can

also take pulse

▪ When doing manual assessments of blood

pressure and pulse there are so many

chances for error to occur, especially if you

do not perform these assessments on an

everyday basis

BODY COMPOSITION

▪ Body composition assessments help us compare and

individual’s fat mass (FM) to their fat free mass (FFM)

▪ Body composition can be taken many ways, but the (2)

methods used in most training settings are the skinfold calipers

or a bioelectrical impedance analyzer (BIA) unit

▪ Skinfold caliper measures in millimeters the subcutaneous layer of

fat beneath the skin

▪ The BIA sends out an electrical pulse and estimates an individual’s

fat mass by the time it takes for the electrical pulse to complete its

travel through the body

▪ Fat mass contains less water, so signal travels slower

▪ Muscle mass contains more water, so signal travels faster

CIRCUMFERENCE MEASUREMENTS

▪ Most common circumference

measurements sites

▪ Neck

▪ Shoulders

▪ Upper Chest (males only)

▪ Upper Arm (flexed/unflexed)

▪ Waist (at bellybutton)

▪ Hips (widest part of hips)

▪ Upper Thigh

▪ Calves

BODY MASS INDEX (BMI)

▪ Body Mass Index (BMI) is a comparison of one’s weight to their height

▪ A high BMI in conjunction with a large waist circumference is associated

with increased risk for many diseases and conditions

▪ BMI is not a very accurate measure of health for individual with elevated

amounts of muscle mass, because it does not discriminate between the fat

mass and lean mass makes up your total weight

▪ Equations

▪ BMI = Weight (kg) ÷ Height (m^2)

▪ BMI = [Weight (lbs.) ÷ Height (in^2)] x 703

CONSIDERATIONS

▪ Weight

▪ Make sure scale is appropriate for client’s weight

▪ Clients that weight more than (300) lbs. may need to use a higher capacity scale than a regular bathroom scale

▪ Body Composition

▪ The method you should used to assess body fat may depend on a few factors

▪ Trainers level of skill with each device

▪ The larger the pinch with the skinfold calipers, the more inaccurate the outcome becomes

▪ If client is not comfortable with touch, then use the BIA

▪ Circumference Measurements

▪ If there is any question of the tape being long enough to reach fully around the individual make

sure to take measurement to the side or back as to not embarrass the individual if the ends of the

tape do not meet

Sub-Topics:

▪ Purpose

▪ Static posture

▪ Static posture assessment

▪ Pronation distortion syndrome

▪ Lower cross syndrome

▪ Upper cross syndrome

▪ Overhead squat

▪ Overhead squat assessment

▪ Overhead squat [Lateral, Posterior, Anterior] findings

▪ Single leg squat

▪ Pulling

▪ Pushing

▪ Performance

▪ One rep max

▪ Cardiorespiratory

▪ Assessment modifications

TOPIC: EXERCISE TESTS


PURPOSE

▪ The purpose of fitness tests (assessments) is to identify

▪ Propensity of the body

▪ Identifying areas of poor or advanced performance

▪ Starting point for identifying one rep max

▪ Like objective test, the more test done initially, the more positive change that can be show during re-assessment

▪ The proper order for test are as follows

1. Objective Tests (resting)

2. Fitness Test

1. Flexibility/Mobility

2. Power/Strength

3. Anaerobic Endurance

4. Aerobic High Intensity

5. Aerobic Endurance

STATIC POSTURE

▪ Posture is often view as being static, but posture is constantly changing to

meet the demands placed on the kinetic chain

▪ Everything from our hobbies to our enviroment can greatly affect posture

▪ Distortions in posture can not only distort the way you look, but also predispose

an individual to injury

▪ Possible injuries NASM 5th Edition pg.192 Table 9.4-6

▪ Common Postural Distortions

▪ Pronation Distortion Syndrome

▪ Lower Cross Syndrome

▪ Upper Cross Syndrome

STATIC POSTURE ASSESSMENT

▪ Performing Assessment

▪ Instruct client to remove shoes

▪ Have client stand naturally

▪ View client from a lateral, posterior and anterior prospective

▪ Deviations should be obvious, do not micro-analyze for small distortions

▪ Check for symmetry and analyze if it is not present

▪ Organize your observations

1. Foot/Ankle

2. Knees

3. Lumbo-Pelvic-Hip Complex (LPHC)

4. Shoulders

5. Head and Cervical spine

PRONATION DISTORTION SYNDROME

▪ Pronation Distortion Syndrome:

Characterized by foot pronation

(flat feet) and adducted and

internally rotated knees

(knocking knees)

Pronation Distortion Syndrome

Shortened Muscles Lengthened Muscles

GastrocnemiusSoleus

PeronealsAdductors

Tensor Fasciae Latae (TFL)Hip Flexor Complex

Biceps Femoris (short head)

Anterior TibialisPosterior TibialisGluteus MaximusGluteus Medius

LOWER CROSS SYNDROME

▪ Lower Cross Syndrome:

Characterized by an

anterior tilt to the

pelvis (arched lower

back)

Lower Cross Syndrome


GastrocnemiusSoleus

AdductorsHip Flexor Complex

Erector SpinaeLatissimus Dorsi

Anterior TibialisPosterior TibialisGluteus MaximusGluteus Medius

Transverse Abdominis

UPPER CROSS SYNDROME

▪ Upper Cross Syndrome:

Characterized by a

forward head and

rounded shoulders

Upper Cross Syndrome


Upper TrapeziusLevator Scapulae

SternocleidomastoidScalenes

Latissimus DorsiTeres Major

SubscapularisPectoralis Major/Minor

Deep Cervical FlexorsSerratus Anterior

RhomboidsMid-Trapezius

Lower TrapeziusTeres MinorInfraspinatus

OVERHEAD SQUAT

▪ The Overhead Squat assessment (OHSQA) is a

transitional movement assessment and evaluates

dynamic posture/flexibility, core strength, balance

and overall neuromuscular control

▪ This assessment utilizes every bit of musculature in

the body to some degree so it is a great closed

kinetic chain test of how well the bod functions as

one unit

OVERHEAD SQUAT ASSESSMENT

▪ Performing Assessment

▪ Instruct client to remove shoes

▪ Give a basic instruction as not to alter the way the client performs the assessment

▪ Keep arms fully extended over head and squat down as far as you feel comfortable or the

same height as if they were sitting in a chair

▪ A demonstration of an overhead squat is best

▪ About 10-15 squats should be sufficient

▪ Observe client from a lateral, posterior and anterior prospective

▪ Organize your observations

▪ Start at feet and work your way up to the arms in each view

▪ Keeping in mind that some deviations are much more evident in certain views

OVERHEAD SQUAT [LATERAL VIEW]

OVERHEAD SQUAT [POSTERIOR VIEW]

OVERHEAD SQUAT [ANTERIOR VIEW]

SINGLE LEG SQUAT

▪ The single leg squat test is also a transitional movement assessment, but slightly more advanced than the OHSQA

▪ Preforming assessment

▪ Client should remove shoes an focus straight ahead

▪ Feet should be pointing forward and hands placed on thighs

▪ Instruct client to slowly squat and rise back up at a slow pace (5) times per leg

▪ Observe client from all perspectives

Checkpoint Compensation Overactive Muscles Underactive Muscles

Knee Moving Inward Adductor ComplexBiceps Femoris (short head)TFLVastus Lateralis

Gluteus MaximusGluteus MediusVastus Medialis

PUSHING ASSESSMENT

▪ The pushing assessment is also a

transitional movement assessment,

but this assessment aims to identify

compensations from the waist, up


▪ Client should stand with abdomen draw

in and in a staggered stance

▪ Have client press cable or bands

forward at a (2/0/2) tempo

▪ Instruct client to perform (20)

repetitions



Lumbo-Pelvic-Hip Complex Low Back Arches Hip FlexorsErector Spinae

Intrinsic Core Stabilizers

Shoulder Complex Shoulder Elevation Upper TrapeziusSternocleidomastoidLevator Scapulae

Mid/Lower Trapezius

Head Head Migrates Forward Upper TrapeziusSternocleidomastoidLevator Scapulae

Deep Cervical Flexors

PULLING ASSESSMENT

▪ The pulling assessment is also a transitional movement assessment, but this assessment aims to identify compensations from the waist, up


▪ Client should stand with abdomen draw in and in a staggered stance

▪ Have client pull cable or bands forward at a (2/0/2) tempo

▪ Instruct client to perform (20) repetitions



Lumbo-Pelvic-Hip Complex Low Back Arches Hip FlexorsErector Spinae

Intrinsic Core Stabilizers

Shoulder Complex Shoulder Elevation Upper TrapeziusSternocleidomastoidLevator Scapulae

Mid/Lower Trapezius

Head Head Migrates Forward Upper TrapeziusSternocleidomastoidLevator Scapulae

Deep Cervical Flexors

PERFORMANCE TESTS

▪ Push-up Test (Anaerobic Endurance)

▪ Max repetitions in (1) Min.

▪ Davies Test (Agility and Stabilization)

▪ Shark Skill Test (Agility and Balance)

▪ Bench Press (Strength)

▪ Squat (Strength)

▪ Vertical Jump (Power)

▪ 40 Yard Dash (Acceleration and Speed)

▪ Pro-Shuttle (Acceleration, Speed and Agility)

▪ LEFT Test (Acceleration, Deceleration, Agility and Neuromuscular Control)

▪ Standing Broad Jump (Power)

ONE REP MAX (1RM)

▪ During performance testing where additional resistance will be the

primary indicator of progress, finding a client’s 1RM is necessary

▪ A (1) rep max is found by adding weight to an exercise till the client can only

perform (1) successful repetition

▪ With most clients, it is best to perform a sub-maximal test instead of a true 1RM

to decrease the likelihood of an injury (i.e. 5RM, 10RM)

▪ Sub-max to 1RM conversion chart (NASM 742)

▪ Once a 1RM is found we can appropriately assign relative resistance

amount along with the appropriate repetition range

CARDIORESPIRATORY TEST

▪ YMCA 3-Minute Step-Up Test Protocol

▪ Client will perform (24) steps per minute on a 12-inch step for a total of (3) Min.

▪ Keep client on pace by coaching them to step up and down at appropriate pace

▪ Within (5) seconds of completion, measure the client’s resting heart for a period of (1) Min. and record as the clients Recovery Pulse

▪ Locate the recovery pulse number 5th Edition NASM pg.311 Table 9.11

▪ This will be used to determine the appropriate programing for their cardiovascular training

▪ Score (Poor or Fair): Start client in [Zone 1 (65-75% HR max)

▪ Score (Average or Good): Start client in [Zone 2 (76-85% HR max)

▪ Score (Very Good): Start client in [Zone 3 (86-95% HR max)

▪ Determine client’s HR max using the [Heart Rate Regression Formula: 208 – (0.70 x age)]

▪ Use client’s HR max to determine appropriate zones for aerobic training

▪ Zone 1: (65-75% of HR max)

▪ Zone 2: (76-85% of HR max)

▪ Zone 3: (86-95% of HR max)

ASSESSMENT MODIFICATIONS

▪ Youth

▪ Avoid maximal strength testing

▪ May need to cables or tubing for pushing and pulling assessments as machines are not designed for very small individuals

▪ Some exercises may need to be regressed such as push-up assessment

▪ Pregnant

▪ During the 2nd trimester explosive movements will need be avoided due to the release of relaxin, a hormone that loosens and softens ligaments

▪ During the late 2nd and 3rd trimester as the fetus grows balance may be an issue and supine exercise need to be avoided

▪ Seniors

▪ This population is more likely to be on multiple medications that may affect blood pressure or heart rate, make sure all medications are disclosed

▪ Certain exercise assessments may need to be modified for lack of flexibility or strength (i.e. overhead squat > overhead sit in chair and stand-up)

▪ Obese

▪ Make sure tests chosen are appropriate for client’s size and limitations

▪ Injuries

▪ If a client discloses that they have an injury, avoid assessments that could exacerbate the injury

▪ Test results that utilized the injured area will be inaccurate and therefore making the data irrelevant

COMPLETE LAB ACTIVITIES

▪ Complete Lab Activity [Yellow 1]


WEEK ONE LECTURE

COMPLETE

Sub-Topics:

▪ What is corrective exercise

▪ Precedures & terms

▪ Foot,ankle & knee

▪ Lumbo-pelvic-hip Complex

▪ Shoulder complex & neck

▪ Prioritizing compensations

▪ Reassessment

TOPIC: CORRECTIVE EXERCISE


WHAT IS CORRECTIVE EXERCISE

▪ Very few clients list one of their goals as improving posture or movement patterns; most clients will ask for weight loss, more muscle tone, or improved performance

▪ During our static posture assessment or fitness test, if a deviation is found, it is our duty to concurrently work towards their goal and address their movement pattern dysfunctions

▪ Corrective exercise is a specialized form of training that aims at helping client’s correct biomechanics that may have been altered due to occupation, activity or environment

▪ This is done through assessments, deactivating overactive muscle groups and activating/strengthening underactive muscle groups

▪ Bones do not position themselves, muscles and their contractions dictate posture and efficiency of movement

▪ Think of the human body as a small tree that has been staked to keep it up right; if the pull is unproportionate on one side the tree over time will lean that way

CUMULATIVE INJURY CYCLE

▪ The cumulative injury cycle is the cycle our body goes through to heal an

injury

▪ Process

▪ Traumatized tissue (exercise or movement related)

▪ Inflammation occurs at trauma site

▪ Tissue increases tension in an effort to immobilize affected area and protect it from further

injury

▪ Fibrotic adhesions (knots) develop in soft tissue to further decrease any additional trauma to region

▪ Over time, these adhesions can decrease extensibility of muscle fibers, resulting in altered

neuromuscular control and muscle imbalances

▪ Altered Relative Flexibility can also occur at joint complexes

▪ The lack of flexibility in one joint cause it to move improper direction or force another joint to

move improperly

PROCEDURES & TERMS

▪ Deactivation: Refers to the process of lengthening a tissue or muscle group to make it less active during a movement

▪ Done by stretching and myofascial release (foam rolling)

▪ Activation: Refers to the process of strengthening a potentially elongated and/or weak muscle group in an effort to make it more active during a movement

▪ Done by isolating the muscle group through controlled movements emphasizing that muscle group

▪ Integration: Refers to the process of integrating open kinetic chain movements that targets the joint complex where the movement pattern dysfunction was identified

FOOT, ANKLE & KNEE

▪ Foot, Ankle and Knee

▪ Dysfunction in this area are commonly seen during overhead squat and single leg squat assessments

▪ Feet turning out

▪ Knees caving in or outward

▪ Commonly occurs due to lack of ankle range of motion, weakness of hip musculature or both

▪ If compensations are present in these areas tests such as the step test may need to be done with caution and test such as the shark skill test may be contraindicated due to risk of injury

▪ Correction Protocol Examples

▪ Foot Turning Outward: Deactivate lateral gastrocnemius; activate the medial gastrocnemius more by keeping for more forward/inward during calf raise; integrate lunges, step-up and squats keeping foot more forward

▪ Knees Caving Inward: Deactivate adductors of hip; activate hip abductors with banded side steps; integrate Squats with bands around knees

LUMBO-PELVIC-HIP COMPLEX

▪ Lumbo-Pelvic-Hip Complex

▪ Dysfunction in this area are commonly seen during overhead squat, pushing, pulling assessments and in extreme cases during static posture assessment

▪ Excessive forward lean

▪ Anterior Pelvic Tilt (low back arches)

▪ Posterior Pelvic Tilt (low back rounds)

▪ Commonly occurs due to poor control of transverse abdominis, gluteals and other hip and trunk stabilizers

▪ Dysfunctions of these kind would make it contraindicated to do maximal squat or deadlift testing


▪ Excessive Forward Lean: Deactivate tfl, hip flexors, abdominals, calves; activate anterior tibialis (band toe curls), gluteus maximus, erector spinae (GHD back extension); integrate overhead squats with dowel

▪ Anterior Pelvic Tilt: Deactivate hip flexors, erector spinae, lats.; activate gluteus maximus, hamstrings (hip bridges), trunk stabilizers (plank variations); integrate squats and kettlebell swings

▪ Posterior Pelvic Tilt: Deactivate hamstrings, rectus abdominis; activate trunk stabilizers (plank variations), gluteus maximus, erector spinae (GHD back extension); integrate front squats and overhead squat

SHOULDER COMPLEX & NECK

▪ Shoulder Complex and Neck

▪ Dysfunction in this area are commonly seen during overhead squat, pushing, pulling assessments, davies test and push-up test

▪ Arms Falling

▪ Elevated Shoulders (scapular winging)

▪ Forward Head

▪ Commonly occurs due to weakness of scapular stabilizers and tightness in anterior shoulder complex

▪ If compensations are present in these areas tests such as the Davies test, pushing, pulling assessments and push-up test may be affected


▪ Arms Falling: Deactivate latissimus dorsi, pectorals; activate lower trapezius (prone y’s), middle trapezius (rows) and posterior deltoid (reverse fly); integrate overhead squats with dowel

▪ Elevated Shoulders: Deactivate upper trapezius, sternocleidomastoid, levator scapulae; activate middle trapezius (rows), lower trapezius (prone y’s), serratus anterior (scapular push-ups and presses); integrate pushing and pulling exercises with shoulderslowered

▪ Forward Head: Deactivate upper trapezius, sternocleidomastoid, levator scapulae; activate deep cervical flexors through chin tucks; integrate pushing and pulling exercises with head in neutral position

PRIORITIZING COMPENSATIONS

▪ When performing movement assessments its sometimes challenging for

trainers to determine which compensations are most important to address

▪ Always prioritize the most obvious compensations and try not to micro-

analyze the client

▪ When you think, you observe multiple compensations try to assign a severity

score (i.e. 1-10 or 1-5 system)

▪ It;s common for lower body compensation to be the cause for upper body

compensations

▪ Working from the upper body down to the lower body may not be the most efficient way to

address compensations

▪ Working from lower body to the upper body in most cases is the most efficient way to address

compensations

REASSESSMENT

▪ Correcting a compensation or postural deviation not a (1) day, (1) week or (1) month process

▪ Deactivating or activating muscle tissue takes a good amount of time and is highly determinate on quality and frequency activity

▪ The compensation observed did not develop overnight, it developed over years of bad posture and biomechanics

▪ It is most appropriate to reassess a client every (4) weeks for progress in corrective exercise capacity

▪ Use mirrors and photos to show progress

▪ Make sure the client verbalizes how they feel doing the assessment and make note

Sub-Topics:

▪ Purpose

▪ Contraindications

▪ Execution

▪ Lower body sites

▪ Upper body sites

TOPIC: FOAM ROLLING


PURPOSE

▪ Self-myofascial release (SMR) or foam rolling is a proven method to

help increase flexibility without a concurrent decrease in force

production and has been found to increase ROM when done before

static stretching

▪ Myofascial release can be done in many ways, but the most common

form uses a foam roller

▪ Deactivates trigger points and helps realign damaged fascia

▪ Stimulates the Golgi tendon organ and creates autogenic inhibition,

decreasing muscle spindle excitation and the release of hypertonicity

(tension) of the underlying musculature

EXECUTION

▪ Foam rolling is one of the many areas of fitness where quality is a

large determinate of positive results than speed

▪ Proper foam rolling execution follows these guidelines

▪ (2) minutes per site

▪ Roll full length of muscle group

▪ (30-45) second hold on trigger points

▪ Follow proper foam rolling technique to maximize effectiveness

LOWER BODY SITES

▪ Calves

▪ Roll from ankle to back of knee

▪ Make sure rotate leg to roll lateral gastrocnemius if tight

▪ Quadriceps

▪ Roll from hip to top of knee

▪ IT Band/TFL

▪ Roll from side corner of hip to side of knee

▪ Piriformis

▪ Cross leg and roll from top to bottom of gluteal

▪ Adductors

▪ Roll medial thigh from hip to knee

UPPER BODY SITES

▪ Latissimus Dorsi

▪ Extend arm out and roll from Humerus down to last rib

▪ Superficial Back

▪ Roll from shoulders down to last thoracic vertebra

▪ Deep Back

▪ Fold one hand over body (moving scapula into protraction) and roll ball over rhomboids and deep upper back muscles

▪ Pectorals

▪ Roll ball from sternum to shoulder

CONTRAINDICATIONS

▪ Certain conditions may contraindicate all or some of the foam rolling sites

▪ Varicose Veins: Avoid putting excessive pressure where these veins are present

▪ High Blood Pressure (not controlled): Though massaging has been shown to lower blood pressure, some positions such as those that put the client in a isometric position (such as a plank) may cause the client to hold breath and spine blood pressure

▪ Diabetes: Poor circulation in lower extremities may hinder the body’s ability to break up soft tissue adhesions and knots

▪ Pregnancy: Miscarriages have been associated with massage during the first trimester and in the third trimester, pressure points in the calf and adductor can induce contractions if pressure is applied

▪ Anytime you are unsure of a condition and the contraindications that may apply to foam rolling, have the client consult with their doctor before performing SMR

Sub-Topics:

▪ Purpose

▪ Integrated flexibility continuum

▪ Stretching techniques

▪ Common stretches

TOPIC: STRETCHING


PURPOSE

▪ Stretching (flexibility training) is performed to correct muscle imbalances, increase joint range of motion, decrease muscle soreness, relieve joint stress, improve muscle extensibility, and maintain the functional length of all muscles

▪ Understanding mechanoreceptors is a large part of flexibility training

▪ When starting a stretch the lengthening of the muscle may cause muscle may experience autogenic inhibition caused by the spindles

▪ Causes the muscle to tighten and resist any additional stretching to prevent injury

▪ As the stretch is held longer, the Golgi Tendon Organ is activated which overrides the muscle; This second activation allows the muscle to relax and stretch further

▪ Stretches should be held between (20-60) seconds to experience this relaxation

▪ Done over time, this can cause increase in flexibility of the muscle and other soft tissues such as the fascia and tendon

INTEGRATED FLEXIBILITY CONTINUUM

▪ Integrated Flexibility Continuum: Identifies how a muscle’s physiology plays a roll in stretching technique

▪ Example: Deactivating mechanoreceptors that may inhibit optimal stretching (such as the muscle spindles); Stretching longer than (20) seconds and foam rolling are two ways to achieve this

▪ Corrective Flexibility: Flexibility training is applied with the goal or improving muscle imbalances and correcting altered joint mechanics

▪ Active Flexibility: Flexibility exercises in which agonists move a limb through a full range of motion, allowing the antagonist to stretch

▪ Functional Flexibility: Multiplanar extensibility with optimal neuromuscular control through a full range of motion

Integrated Flexibility Continuum

Corrective Flexibility

Self-Myofascial Release

Static Stretching

Active Flexibility


Active-Isolated Stretch

Functional Flexibility


Dynamic Stretching

STRETCHING TECHNIQUES

▪ Static Stretching

▪ Holding a constant stretch for (20-60) seconds while relaxing antagonist (target) muscle group and contracting the agonist muscle group at a joint complex

▪ Example: Performing a static lunge stretch for hip flexors and contracting the glute to aid stretch

▪ Dynamic Stretching

▪ Using multiple planes of motion through full range of motion to stretch a muscle in a fluid movement

▪ Example: Using long stride body weight walking lunges to stretch hip flexors

▪ Active-Isolated Stretching

▪ Using the agonist muscle at a joint complex move a limb through a full range of motion allowing for the antagonist to stretch

▪ Typically done utilizing a (2-5) second hold at full extension and done for multiple repetitions

▪ Example: Using hip bridge held for (2-5) seconds for 10 cycles to stretch the hip flexors

COMMON STRETCHES

• Gastrocnemius/Soleus Stretch (NASM pg.540)

• Hip Flexor Stretch (NASM pg.547)

• Hamstring Stretch (NASM pg.542,550)

• Quad Stretch

• Adductor Stretch (NASM pg. 541)

• Glute & Piriformis Stretch (NASM pg.548)

• Lat Stretch (NASM pg.551)

• Pectoral Stretch (pg.552)

• Neck and Upper Trapezius Stretch ( NASM pg.544-545)

• Dynamic Stretches (NASM pg.553-563)

COMPLETE LAB ACTIVITIES


END OF SECTION

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