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Biomechanical screening for better results and more motivated clients

Biomechanical screening can improve your exercise prescription and injury prevention knowledge, which will not only improve your client’s motivation but also your commercial results”.

Blog -The -secret -to -motivating -your -clientsMany clients come to health clubs with injuries, the challenge for Personal Trainers (PT’s) is how to manage them within their personal training sessions and reduce the risk of recurrence. Functional training is fine, but unless you are correcting their biomechanical problems first, your clients are only learning faulty movement patterns to compensate for their biomechanical issues, which will inevitably lead to further problems.

Speaking to PT’s on a regular basis, this has been one of the most consistent yet mostly over-looked causes of clients not complying with their training programmes and leaving their personal trainers. Moreover, if the clients are not achieving their goals they will be less motivated and more likely to leave your care. This affects your commercial opportunity but also negatively knocks on to your PR efforts.

Performing a biomechanical screen, comprising of a series of tests, prior to embarking upon an exercise programme will achieve several things:

1. Drive personal training sales
2. Reduce the risk of injury and injury recurrence
3. Provide further evidence of your professional service

Background

According to Stu McGill PhD, biomechanics can be classified into two simple groups: Extrinsic and Intrinsic (or external and internal).

1. Extrinsic biomechanics is where we consider projected force vectors from the floor through various joints, distances from external loads to various joints and is fundamentally the study and measurement of movement patterns of a particular task.

2. Intrinsic biomechanics relates to muscle and joint architecture and body segment variables which can be inherited or can be compensatory through extrinsic factors like sitting at a desk all day, driving, doing the wrong gym exercises or running in the wrong shoes for example. These intrinsic biomechanical factors can be things like leg length discrepancies, rotated pelvis’, tight nerve and so on. Intrinsic biomechanical efficiency will affect extrinsic biomechanical performance.

A-Career -In -Fitness -Polaroid -14“It is impossible to deliver safe and effective exercise prescription without first identifying the needs of the individual”. That is the mantra that has been used in the fitness industry for years, yet the only way this is being performed at present is in the cardiovascular field. There are some loose ideas on exercise prescription based upon a variety of postural analyses and from assessing the performance of particular ‘functional’ movement patterns.

However, if somebody's intrinsic biomechanics are incorrect, then their posture and movement patterns will be compromised anyway. There is little point, therefore, in testing these areas then until we have a more profound understanding of their intrinsic biomechanics. An individual’s biomechanical make-up is critical to understand if you are going to prescribe safe and effective exercises for your clients.

The Performance Continuum

We need to identify where clients are on what we call the Performance Continuum, which is a scale from illness to wellness and on to elite performance over time. Your clients will be somewhere on the scale and you need to find out where they are before you can prescribe their conditioning exercises.

Most exercises are suitable to most people; the problem arises when they are prescribed at the wrong time for the wrong person. For example, core stability training can help some people and hurt others (McGill 2006). Likewise, lunges can help some people and hurt others. For example, if someone has a rotated pelvis and a leg length discrepancy with associated muscle spasm in their hips, then lunges will most likely hurt them. If, however, they are functioning correctly around the pelvis, then lunges are far less likely to hurt them. That is one simple example demonstrating why some of your clients can do some of the exercises you prescribe, but others can’t. But you won’t be able to predict that until you’ve assessed their biomechanics.

To be able to identify where your clients are on the Performance Continuum, you need to perform a biomechanical assessment. These can be simple to perform and take 10 minutes. Once you know where they are on the Performance Continuum, you can safely progress them through a sequence of exercise progressions in the knowledge that you’ve ‘pitched’ the exercises at the right level for that individual, at that moment in their life.

The Biomechanical Model

In a biomechanical model, these progressions start by making the client biomechanically sound by ensuring their fundamental pelvic and spinal mechanics are ‘normalised’ and so provide the building blocks for normal movement.

In this first phase the biomechanical screen should be looking for any muscle imbalances, nerve immobility and sub-clinical muscle spasm. This 'Normalisation' phase we also refer to as 'Before the Core', because typically people will start their early exercise programmes with core stability-type exercises and they are often not ready. That is why Pilates-type training helps some people and hurts others (McGill 2006). Core Stability training improves your clients motor programming strategy, so why would we want to stabilise someone in a biomechanically incorrect position? Let’s 'Normalise' them first, then Stabilise them. If we perform core stability training when they are not prepared, all we are doing is teaching clients to compensate for their biomechanical problems rather than training correct movement patterns.

So, once the Normalise Phase has been completed the client should then be progressed to the next stage which gives them the ability to consolidate and learn new motor programming strategies in the ‘Stabilisation’ Phase. Here they should be biomechanically screened to establish their ability to engage the ‘core’ and also their ability to functionally integrate the core with their other trunk muscles. Their exercise programme is progressed through a series of specific stability exercises and then work towards more functional stability patterns. It is important to understand that no one or two muscles are more important than any other when it comes to core stability training. In fact recent work suggests that if we focus on the often quoted Transverse Abdominus and Multifidus, then we can actually be de-stabilising the spine. The model used by Bermark in 1987 is the biomechanical model of choice for current researchers and it explains that only one muscle in the trunk has to be deficient to cause spinal instability.

The final Functionalise phase is where clients learn to use their new motor programming strategies in a more functional manner and the biomechanical screen should establish the efficiency of the body to work functionally and then how well it can perform tasks at functional velocities. As they progress through this phase, they work towards the functional patterns and velocities that are relevant their ‘purpose’.

Philosophy

We should always be challenging what we do and how we do it. Just because something new, like functional training and perhaps Pilates comes along to the industry, does that mean all the work you have been doing doesn’t work anymore? Of course not, it just means we have something else to integrate into what we are already doing, not necessarily to be used instead of it.

The industry is often seduced by the 'next big thing', but invariably this is simply another way of achieving certain targets for your clients, not necessarily the only way, and it certainly doesn’t mean you should be forgetting what you were doing - unless it’s been directly discredited. Nothing should ever be done in isolation, no one thing is the panacea for all ills. As the exercise model suggests, a series of progressions through logical phases is the most effective way to progress exercise (Siff 2004).

We should focus our attention to real issues, and using all the proven methodologies available to us answer questions like:

  • How do I know which exercise to give to my clients – how do I know which will help them and which will hurt them?
  • Apart from increasing the number of reps and sets, how should I be progressing my client’s exercise programmes
  • Why chose one particular exercise over another that seemingly does the same thing?
  • Should I be using gym balls in their training and if so, when?
  • Should I be using machines anymore? Are they ‘functional’? Does that matter?

It is often difficult to answer these questions for all our clients with any degree of honesty and accuracy with the assessments that are in place at the moment. Until the industry’s understanding of biomechanics and its implications to exercise prescription is better understood our exercise prescription will not be as good or as safe as it should be.

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