This is the second in a series of articles on mobility and stability screens for personal trainers. These screens are based on philosophies and specific protocols from the Reebok Reactive Neuromuscular Training Program, or RNT.

Before starting an exercise program, it is always a great idea to ask our clients if they experience any pain and/or discomfort when moving through full ranges of motion, or holding certain postures and positions. It is also extremely helpful to observe what their movement looks like, and determine if the client needs mobility and/or stability in any of the areas of the body. That, in and of itself, would greatly enhance the integrity of our profession. The challenge is, we need to consistently practice mobility and stability screens in order to be more proficient at doing them, just like we had to practice skinfold testing in order to get somewhat reliable readings.

These screens are presented with the understanding that the client has already completed a health history questionnaire and any relevant medical clearance before starting. They have also articulated to you that they have no pain and/or discomfort during their everyday life and exercise program. If you do these movements with your client and they report a distinct and specific pain or discomfort, some questions you may want to ask are:

I thought you didn’t have any back problems?!

Do you experience this or any other discomfort during your everyday life?

Do you experience this or any other discomfort during your exercise program?

Are you limited from doing any kinds of movement because of this or any other discomfort?

Based on the answers to the above questions, you may want to ask your client for medical advice and/or clearance before beginning or continuing with the training program.

Mobility Screens

Loaded and Unloaded Flexion and Extension

Loaded and unloaded flexion and extension are good screens to start with. The main purpose for these screens is to make sure the client can move through full ranges of motion in flexion and extension without pain or discomfort. We can see a lot in this movement that can help us understand what the client brings to the table before we start the program. We can then also compare these observations with other screens and assessments to confirm our thoughts.

Loaded Flexion

Ask your client to stand comfortably and curl forward as if to touch the toes. The head should be relaxed. Ask them if there is any pain or discomfort during the movement, or by holding the position for a few seconds. If your client says this is not a movement they feel comfortable with, you may need to reconsider whether you should continue with the screens. Many times our clients forget (or want to forget!) that they have a previous or current issue with their spine with which we as personal trainers should not be working until we get some feedback from a medical professional.

Besides determining that our clients feel no pain or discomfort during this movement, we can also look at other things, such as are they flexing from the hip? Are they flexing from the spine? If you look at the picture above, you can see the client flexes approximately 80+ degrees at the hip, and looks a little “flat” at the lumbar to thoraco-lumbar area. The extensor muscles are eccentrically contracting, and it would lead one to think that perhaps her hamstrings are relatively flexible, as their length is apparently not inhibiting the range of motion at the hip. The client above reports no significant feeling of stretching in the hamstrings or erectors. We can confirm our thoughts about the hamstrings by asking the client to lie on the floor and do an active straight leg raise assessment.

Active Straight Leg Raise

Ask your client to lie supine, with the both legs straight. They should lift the left leg up as high as possible, without the knee bending, or the right leg moving or bending at the knee.

In the picture above, we see that the client can flex the hip to approximately 80+ degrees, which is the same that we saw during the loaded flexion. This is just one example of how we as trainers can use different screens and assessments to constantly gain information about our client before, and during our training program.

Back to the original screens! The next one is the loaded extension.

Loaded Extension

Ask your client to stand with their hands on top of their butt, and arch backwards.

The most important question again, is if the client feels pain or discomfort while doing the movement, or while holding the position. Some clients will bend at the knee if they are restricted in extension. In the picture above, we see the client looks as if she extends from the hip and looks a little stiff in the spine. This is common in clients who have at least average range of motion in the hips according to the norms, although they are “stiff” in the core. Many times these clients have relatively weaker cores than the muscles of the limbs. It looks like they need mobility, when in actuality they need stability of the deep core stabilizers (that’s another article!)

Now, one more way we can ask the client to do these same screens is in an unloaded manner. Unloaded movements take the muscle out of the movement, and give us a better idea of whether any aches or discomforts during the loaded movements were due to muscles stretching or being slack, or from issues related to the spine with which we should not be working.

Unloaded Flexion

Ask the client to get into a quadruped position, with hands under shoulders, and knees under hips. They then sit back with their butt to their heels, relaxing all the way down and putting their arms out in front of them.

The most important consideration is whether the client feels pain or discomfort in this position. The extensor muscles are not working as they were in the loaded position. Therefore, if there is any feeling of pain, there is a greater chance that it is due to something other than muscles, such as disk problems, or many other conditions with which we – as personal trainers - are not qualified to work.

In the above picture, we see the same “stiffness” or flatness in the lumbar area as we did in standing. This may lead us to continue with our thoughts that the observation while the client was standing was maybe not due to tight erectors, as it would look different now with the erectors no longer eccentrically contracting in this unloaded position. The client again reports no feelings of stretching in the erectors in this position.

Unloaded Extension

Ask your client to lie prone on the floor or stretching table. For many people with various issues of the spine, this is an uncomfortable or even painful position.

In the picture above, we see that the client can flex the hip to approximately 80+ degrees, which is the same that we saw during the loaded flexion. This is just one example of how we as trainers can use different screens and assessments to constantly gain information about our client before, and during our training program.

CORE STABILITY SCREENS

Prone Stability

Ask your client to lie prone on the floor or stretching table. Have them prop themselves up on their forearms and toes. Before doing anything, observe the posture of your client.

If your client sags into the shoulders, you may want to work on some shoulder girdle/shoulder joint stability.

They then should lift up their body, leaving their forearms and toes on the floor. Your observations should include:

- Can your client lift up without sagging in the low back?

If not, this shows you that they do not engage in the core first before lifting up. It is important NOT to cue your client to tighten their abs before they lift. This should naturally happen if they have core integrity and proper sequencing of stability and movement.

- Can your client hold this position for 20 seconds without visibly shaking?

If your client cannot do this movement, you can modify it by keeping the knees on the floor. If your client is advanced, you can ask them to keep the legs straight as described, and then to lift one leg up, lower it, and then lift up the other leg. You may see some imbalance with stability on one side as compared to the other.

If your client has difficulty doing this movement, you can use this assessment as an exercise, having them hold as long as they can maintain good form, several sets, 3-5 days per week.

Supine Stability

Now ask your client to lie face up, propped up on your forearms and heels. Before your client even lifts up, you can observe if they have the tendency to keep their head in front of their body, as in a classic “foreward head” position, or rounded shoulder posture. There are great articles on this website for ideas on addressing these issues.

You may also notice that they again sink into their shoulder blades, indicating a possible need for shoulder joint/shoulder girdle stability.

Some of your observations should include:

- Can your client hold this position for at least 20 seconds without visibly shaking?

- Can they do this while maintaining a neutral spine?

If your client has difficulty in this movement or position, you can modify it by asking them to bend the knees and keep the feet on the floor.

If your client is advanced, you can ask them to do this same movement and then lift up one leg and hold it, then lower it and lift up the other leg.

Either of these positions, modified, normal, or advanced, can be used as exercises if your client finds them difficult to do. Have them do this at least 3-5 times per week, with 3-5 repetitions each time, holding as long as they can in good form.

For a more complete understanding of these concepts it is recommended that you also take the Reebok 5 Point Mobility Screen program.

The next few articles will focus on further assessments for core stability and reactive training. We will also look at more “functional” assessments and exercises for core integrity and stability.

Until then, integrate your training, have fun and be safe.