Movement Screening & Reduction Of Injury Risk

By Lincoln Blandford and Mark Comerford

Keeping your clients injury free is paramount to both personal trainers’ bottom line and professional ethics. In this pursuit trainers often trial a variety of different approaches with varying degrees of success. Movement screening, a recent addition to this list, is best described as a collection of tests highlighting movement control deficits thought to influence injury risk. Contrasting principles underpin the current crop of movement screening tools. These distinctions appear to leave personal trainers with a stark choice. As all too frequently, clients can quickly become the patients and as those in the world of rehab know the wrong choice can have a negative impact on both turnover and reputation.

Traditionally, the injured client will return to you from the rehab environment once they are pain free and the following ‘biomechanical benchmarks’ have been achieved:

l ‘sufficient’ strength/force production l ‘adequate’ joint range.

The Biomechanical Model Biomechanical focussed movement screens

What You Don’t Know Can Hurt You (And Your Clients)

seek to quantify clients’ strength and range as deficits in either can increase injury risk. Such criteria feel intuitively correct to many trainers explaining the popularity of Gray Cook’s Functional Movement Screen, as they sit comfortably with their professional skill set. Arguably, every exercise trainer’s delivery is governed by these same parameters and therefore a movement screen of sorts.

For example, during a lunge (see Fig. 1), insufficient eccentric or isometric force production from the hip extensors may result in excessive hip flexion. Restrictions at the hip or ankle will often be accompanied by movement compensations above or below the stiffer region in an attempt to achieve full range. Rectifying these movement control faults appears to be well within trainers’ professional remit - make it stronger, for longer over a bigger range of motion (see Fig. 2).

However, when it comes to injury prevention, previous injury is still the most consistent and reliable predictor of re-injury as opposed to either force production or flexibility based factors . The implication is that there is something amiss amongst many current screening models including strength and range focussed protocols. Although biomechanical benchmarks are achieved, maintained and probably surpassed to improve performance and function, annoyingly injuries can still persist.

The Neuro- Physiological Model Contrasting biomechanical screening models, ‘motor control’

Fig.1. Reinforcing correct alignment

Fig. 2. Adding load and working through an increased range are familiar strategies

driven protocols, have slowly infiltrated the world of fitness. If biomechanical screens are equivalent to diagnostics for the body’s hardware, motor control screening is software specific. Although ‘motor control’ is inherent to all movement, contemporary usage of the term typically relates to challenges of skill and/or co-

20 The REPs Journal 2013;27(May):20-21