Personal Trainer's Guide to Corrective Exercise Assessments

Corrective exercise allows Certified Fitness Trainers and physical therapists the opportunity to identify and address postural and movement dysfunctions and prevent injury in clients. A large majority of clients have movement dysfunctions or are recovering from injury of varying degrees. Corrective Exercise elements should be the foundation of every exercise program a fitness professional creates to ensure clients are moving efficiently. An effective training program uses risk assessment, prioritizes the observed or potential issues, and works to address them daily.

As people age, muscle mass decreases, negatively affecting strength and functional movement. Especially for a certified personal trainer who works with seniors, corrective exercise training is a necessity to keep them strong, active, and moving well as they age.

The elements of an effective corrective exercise program are:

1. Assessment

2. Self-myofascial release

3. Stretching/mobility

4. Strengthen

5. Train

6. Reassess

Complete the elements in the order listed and incorporate them into an everyday training protocol. Any deviation or dysfunction can be addressed when the correct assessments are used to determine a baseline.

Scope of Practice for a Personal Trainer

First, you need to understand the difference between a physical therapist and a personal trainer certified in corrective exercise. A physical therapist is a medical professional who will typically work with clients recovering from major injuries or surgery. They can diagnose and treat (physically and medically) medical conditions and administer a post-surgery rehab program. Physical therapy is more extensive and requires the guidance of the trained medical professional.

A corrective exercise specialist is not a medical professional, but they are qualified to assess and address musculoskeletal and soft tissue imbalances and deviations affecting someone's ability to move. Trainers develop a program to increase strength, prevent injury, and promote longevity. After all, the goal of corrective exercise is to improve the quality of a person's life or sport.

Still not convinced you should be certified in Corrective Exercise yet? Let's explore the elements of corrective exercise assessments to uncover how important this is for all fitness professionals.

Assessments for Corrective Exercise

To fully understand an assessment, the result, and how the information translates to a fitness program, you must identify the five kinetic checkpoints. Often referred to as a functional movement screen, assessments look for deviations at the head, shoulders, hips, knees, and ankles. Observing an assessment from as many angles as possible will complete a formative assessment, the fitness professional will take detailed notes, and a program can be written based on what is observed.

There are many assessments to choose from based on the abilities of the client. When deciding on which to use, understand that all movement assessments evaluate both concentric and eccentric phases as the muscles considered prime movers, synergists, and antagonists will change in each phase of the movement. The very first assessment for a personal trainer should be a posture assessment. The initial client health and readiness questionnaire (PAR-Q) will also offer valuable insight into any potential issues.

For example, people who sit all day will most likely have tightness and concerns in their hip flexors and issues with glute and calf strength. An individual who does a repetitive movement pattern like lifting or reaching overhead daily may have signs of dysfunction with a shoulder, their back, or a hip. An exercise specialist will know to look for dysfunction in these areas based on what they learn in early sessions and client interviews.

Here are some of the most commonly used functional movement screens:

Static Posture

Movement: none; client will remain stationary

Kinetic checkpoints: head, shoulder, hip, knee, ankle

Possible deviations: spinal imbalance (lordosis, sway, kyphosis), hip hike or drop, knee varus or valgus, a forward head, ankle pronation or supination

Gait

Movement: have client perform a normal paced walk

Kinetic checkpoints: head, shoulder, hip, knee, ankle

Possible deviations: spinal imbalance (lordosis, sway, kyphosis), hip hike or drop, knee varus or valgus, trunk stability, a forward head, ankle pronation or supination, dorsiflexion or plantar flexion at ankle, knee and hip flexion and extension, foot strike

Should be observed from the frontal and sagittal plane through the entire stride range of motion to determine if the issue is during flexion or extension.

Range of Motion: Upper Body

Movement: palm facing medially, shoulder down and packed, have client complete range of motion with straight arm from hip to overhead as far as they can reach

Can also be performed as shoulder extension, abduction, adduction, rotation, or circumduction.

Keep in mind, general flexibility is often overlooked in fitness and should be a focus for every client! Stretching is a component of a corrective program and the lack of flexibility are risk factors for future injury.

Kinetic checkpoints: head, shoulder, hip

Possible deviations: forward head, kyphosis of thoracic or cervical spine, shoulder elevation, limits to range of motion, scapular rotation. Should be observed from frontal (in front and behind) and sagittal plane

Squats: Stand from a Chair

Movement: From a seated position, arms folded across the chest, feet planted under knees at hip width, have client rise to a standing position

Kinetic checkpoints: shoulder, hip, knee, ankle

Possible deviations: excessive forward lean, reduced angle at the knee (knees too far over toes), knee valus or valgus, knee extension, ankle pronation or supination, lumbar extension, postural contro

Can be observed form frontal or sagittal plane and provides important indicators prior to progressing to a true squat assessment.

Goblet Squat

Movement: weight held in front of chest in the heels of the hands, have client perform a squat with the lowest position being elbows to the inside of the knees

Kinetic checkpoints: head, shoulders, hips, knees, ankles

Possible deviations: shoulder dip, excessive forward lean, knee strategy (knees or hips first), knee valus or valgus, extent of hip flexion and extension, ankle mobility (pronation, supination, dorsiflexion, and plantar flexion), angle at the knee, lateral weight shift

Overhead Squat

Movement: same as goblet squat, arms extended overhead with elbows back near ears

Kinetic checkpoints: head, shoulders, hips, knees, ankles

Possible deviations: excessive forward lean, arm drop, lumbar spine extension or flexion, heel elevation, knee valus or valgus, ankle mobility (pronation, supination, dorsiflexion, and plantar flexion), angle at the knee, lateral weight shift

Split Squat

Movement: wide stance, break at the back knee, have client complete a stationary split squat. Both legs should be observed to determine any imbalances and from all angles

Kinetic checkpoints: hip, knee, ankle

Possible deviations: reduced knee angle, forward lean, hip internal or external rotation, knee valus or valgus, ankle mobility (pronation, supination, dorsiflexion, and plantar flexion), lateral pelvic tilt, postural control and balance

Shoulder Press: One Arm

Movement: ideally standing, have client press a dumbbell from shoulder to full extension overhead

Kinetic checkpoints: head, shoulder, hip

Possible deviations: elbow flexion and extension, core postural control, trunk lateral flexion and extension, lumbar spine extension, scapular rotation, glenohumeral (GH) abduction and adduction, shoulder elevation, head tilt, shoulder dip (thoracic spine flexion)

Shoulder Press: Two Arms

Movement: same as the single-arm assessment, but with both arms extending overhead simultaneously

Kinetic checkpoints: head, shoulder, hip

Possible deviations: lumbar spine extension, ribcage elevation, shoulder elevation, elbow extension and flexion, scapular rotation, core posture control, head tilt, GH abduction and adduction

What's Next?

You can see all the information personal trainers can gain from observing these assessments from as many angles as possible. Detailed notes on any "events" or dysfunctions observed can be used to determine the next steps in the corrective exercise program.

Piles of Data

Now, we see the benefits and importance of corrective exercise assessment. Look at all the possible data derived from these assessments! There are many more options when you know what you are looking to find. A great trainer will go into a functional movement screen with an idea of what they are looking for and, with a critical eye, determine the overactive and under-active soft tissue that needs to be addressed. With that information, you can create a highly effective sports medicine or functional exercise program.

Pain is preventable in most cases. Who wouldn't want to make someone move better and have a better quality of pain-free life?

So, now you're convinced! If you are not already a corrective exercise specialist, the time is now! Make yourself valuable and invaluable in the field regardless of where you train your clients. The certification text is full of tools and resources for corrective exercise assessment for every personal trainer. Become an ISSA Corrective Exercise Specialist!