A fitness assessment is a tool professionals use to help them determine where you should begin your fitness journey. While I perform some type of of assessment on every client I work with, a dangerous trend is beginning to emerge within the industry. Some trainers are choosing to not perform an assessment before putting their clients on a fitness program. I'm not sure if it's because they don't see the value of it, or maybe their clients are bullying them to skip it, or it could just be the trainer is flat out lazy. I don't know, but what I do know is this borders on the verge of negligence, and if your trainer has NOT done a fitness assessment I would highly recommend talking to them about it. If they still refuse to do one, then drop him/her like a bad habit and run for the hills.

Ok back on point.  

A variety of assessment protocols and procedures are available to trainers, and the YMCA fitness assessment seems to be the most popular version used in commercial fitness centers. This consists of:

• standard circumference measurements
• a skin-fold body composition analysis (3, 4 or 7 site) 
• cardiovascular endurance test (usually cycle ergometer submaximal test or three-minute step test).
• sit and reach test to determine flexibility
• muscular strength and endurance (the pushup test and sit-up test for time are the ones most commonly used)

Now let me premise this by saying some type of assessment is better than no assessment, but if this the only information being collected I would conclude quite a bit of valuable information is being left out.

For starters, I want to see how strong the "core" is in relation to overall strength and stability. For example, when using the plank exercise to determine core stability, I take a number of factors into consideration. Is the pelvis in a neutral position or is it tilting from side to side? Is one hip higher than the other? Are you able to avoid lumbar hyperextension by maintaining a straight line from the ankles to the shoulders? Are the shoulder blades depressed and retracted so there is no rounding or flexion or extension of the thoracic spine, and are you able to hold this position for up to 30 seconds?

New way to look at things?

Another area I want to evaluate the difference between stability vs. mobility is with the hips. When performing a Single Leg Hip Lift we evaluate thoracic mobility by your ability to keep the elbows behind the ears in prisoner position while having the t-spine extended. Hips should remain level while the knee of lifted leg is above hip level, and the hips should be balanced with no forward or lateral movement, and they should remain level with no forward or transverse rotation. Finally core stability is determined by how well you can keep your upper body upright with no movement thus achieving a neutral lumbar spine.

As you can see, you can go much deeper into the evaluation process than just the "accepted norm", and it provides a more thorough look at your physical capabilities. Btw, this is not a "pass/fail" component in starting a fitness program. This simply provides additional information thus allowing your fitness professional to make the best recommendation.

One other thing, Primum non nocere is a latin phrase that means "First, do no harm", and is one of the principal precepts all medical students are taught in medical school. It essentially reminds physicians and other health care providers to consider the harm intervention may do especially with if there is an obvious risk of harm but a less certain chance of benefit.

As for the fitness industry I prefer to take a slightly different approach. If I fail to detect a weakness or an instability simply because I just didn't want to take the time to do a through evaluation, or that I was just too lazy, and my client became injured as a result of this oversight, I would be directly in violation of primum non nocere.

Until next time,

Steve