Assessing the starting point: The importance of a proper assessment for determining client capacities for program development
By Ryan Darling, RMT, R.Kin, CSEP-CEP, B.Sc, M.Sc. Kinesiology (Owner/Operator, RD Athletics – Therapy & Training)
If you are a new trainer, developing a new client's program can be a bit of an overwhelming task. From trying to decide which exercises to put into the program, to what warm-up movements to use, to rep ranges, to rest intervals, etc etc. Needless to say, it can be a bit of a challenge with a lot of moving parts that can leave novice trainers feeling a bit lost.
The single most important step to developing a new personal training client's program is a proper physical assessment. The initial assessment is not only an opportunity to develop rapport with your client, but also to determine where they are currently at physically. Information such as bodyweight, body composition, aerobic capacity, strength capacity, flexibility, motor control and training history are all potential areas to be covered. A holistic assessment should have testing to gain information on all of the above components of an individual’s fitness, but, which ones you use can be up to you.
Many pre-developed tests exist for these different domains of fitness. For aerobic capacity, low equipment requirement tests like the 12-minute walk test exist. On the opposite end of the spectrum, VO2 max testing requires expensive equipment but yields very detailed results. For flexibility and motor control, systems like the Functional Movement Screen (FMS) can provide a quick and easy way to gain insight about where someone may move well, and where they may need more work.
The point is, we should be running a client through a battery of tests that allow us to gain valuable information on where this person’s fitness level currently sits. Understanding an individual's starting point is the only way to allow for a proper program to be created.
We have all, unfortunately, been witness to the butchering of the training process in gyms where trainers have clients doing inappropriate exercises and movements, or using loads that they have no business handling. I can almost guarantee these same individuals are the ones who are either not completing a physical assessment, or worse, do not actually use any of the information gained from the assessment itself.
Why does it matter?
Well, it's important to consider the risk to reward principal. This principal weighs the potential benefit or adaptation of various exercises we might select for a program versus their potential risk. For general population - and really any client base - we want to heavily weight the reward side while minimizing the risk side. In other words, if you ask your 55 year old, overweight male client who has never trained in a gym setting before in his life to perform barbell cleans in his first program, you are weighting the wrong side of the equation. Not only does this provide high risk, but is a technical movement likely to yield poor performance initially. This limits your ability to load the movement to create an adaptation and worse yet, causes your client to become very frustrated with their inability to do what you are asking of them.
The training process is exactly that, a process. Just like in school settings, we want challenge, but not unreasonably so in that we get low success rates. Think of yourself as the teacher trying to create a test that gives you a 70% average.
In his assessment, say your client had a hard time performing a bodyweight split squat. The intelligent thing to do in this case would be to regress the movement in a way that allows him to successfully complete it while keeping proper form. Maybe this means an assisted split squat to a range that he can maintain upright posture and proper joint positions in the lower body. This may not be as “sexy” as some of your other options, but, this is a movement he can do safely and that, with time, will provide increases in his strength and motor control to then move away from the assistance and eventually to a more dynamic version of the exercise like a walking lunge.
The point of all of this is really quite simple, we want to challenge our clients, but in a way that allows for them to safely create a training stimulus so that it will lead to adaptation. If your guy has never trained before in his life, maybe you only need 5 or 6 exercises for 2 sets of 10 – 15 repetitions each with plenty of rest in between. We are always better off to exercise caution with total volume early on. We can always do more in future sessions with a client, but if your very first training session leaves your client so sore they cannot accomplish day-to-day tasks the following week, it is very likely that client may not return.
The assessment, and the training process are an opportunity for you as a trainer to educate your client on why it is important to use movements they can perform safely, why initially high volume and feeling like their dead is likely detrimental toward their goal, and how to make changes to fitness the most important factor is long-term consistency. As Bill Hartman a brilliant physical therapist says, "it’s about good workouts. Not great work outs." His point being that we need to think of training as creating a stimulus that will lead to an adaptation, and not necessarily just an opportunity to constantly test ourselves and do as much as we possibly can. The latter often leads to levels of soreness that get in the way of our next session, which means we aren’t staying consistent. And we know that consistency is likely the single most important aspect of physical change.
We should all sit down to take time to develop an assessment protocol for new clients. It doesn’t need to be etched in stone, but at least having a guideline to make sure you obtain a solid baseline and starting point for each individual. If we don’t know where we are, how can we decide how to get where we want to go? This protocol should be something that is updated as you see fit from your experience and continuing education. It should aim to obtain as much possible information in as short of a time frame as possible. Most importantly, it should give you the information to develop a program that contains appropriate movements, total volume, and workload to assure the client who is entrusting you with their health obtains results in a safe and effective manner.