I often talk about the importance of the test/retest concept when it comes to assessment.
It’s nothing fancy or complicated.
You try something – whether it’s range of motion or maybe a strength deviation – you apply a “corrective” method if something’s gone wrong, and then you rest that shit again to see if it worked.
If it did… you are Gandalf.
If not…#awwwwwkward.
The test/retest approach helps set the tone for any future “corrective” strategies or planning considerations you make as a coach or trainer.
Furthermore, and something I would argue is equally important, it also provides an added level of value to the assessment.
If you’re able to show someone a significant change or improvement in ROM or reduction in pain/discomfort by doing one or two exercises and it’s something they struggle with despite countless interactions with other fitness professionals, what’s the chance they’ll put down their checkbook or Bitcoin wallets (<—depending on their level?
I suspect very likely.
It shows a perceived level of “mastery” and knowledge base to the evaluator (you) and, in a circular, reverse psychology, digs into the “pain center” of the evaluator (athlete/client).
In this example it can be referred to literally pain such as a battered shoulder, knee or lower back. But it can also speak of pain in the metaphorical sense. Someone who is frustrated and “had it this far!” that they can’t lose weight, or maybe an athlete cut from their high school team would have a degree of “pain” that would prompt them to take action.
Show someone success or a clear course of action, no matter how small, and they’re putty on your hands.
Of course that’s assuming you’re not some shady jerk trying to sell the benefits of some super-secret, 47-week Eastern Bloc concurrent training program you copied from Muscles & Fitness or, I don’t know, organic raspberry ketones with mermaid placenta lace.
People who promote and use smoke and mirror tactics are the worst.
But let’s get back to the topic.
Test/Retest
One of the main monitors I use with my athletes and clients is their ability to raise or lift their arms above their heads.
Shoulder flexion is important for everyonenot just athletes and CrossFitters.
If someone doesn’t have shoulder flexion and is an athlete, it will affect their performance. A baseball pitcher can get “stuck” in too much shoulder depression, which in turn will affect scapular placement and kinematics, which in turn will result in faulty mechanics and compensatory issues up and down the kinetic chain.
Instead, regular ol’ Hank from accounting, who likes to hit the gym hard after work, if he lacking shoulder flexion, he could also have a host of problems ranging from shoulder and elbow pain to lower back ailments.
Shoulder flexion – and the ability to do so – is a big deal in my opinion. And it’s a screen that should be a high priority in any fitness professional’s evaluation protocol.
So let’s say I’m working with someone who doesn’t have shoulder flexion. I test it both actively (standing, image above) and passively (on a training table).
I guess it’s limited and it is May feeds why a particular person’s shoulder bothers him/her.
I can use the test/review approach to see if I can push an improvement.
Now, as I learned from many people much smarter than me – Mike Reinold, Sue Falsone, Dr. Evan Osar, Dr. Stuart McGill, Papa Smurf, etc. – you should not rely on anyone A monitor/corrective.
Everyone is different, and what works for one person may not even scratch the surface for another.
When it comes to dealing with (lack of) shoulder flexion, there are a few “go to” strategies that I like to use.
And then it’s just a matter of seeing which one sticks.
1) Encouragement for a better position
To raise the humerus (arm) above your head, the scapula (shoulder blade) must do three things:
- Spin up
- Back tilt
- Extend
The ability to do this is highly correlated with the chest. Those who are super kyphotic (very rounded upper back) will have difficulty raising their arms overhead. Often the simple “fix” here is to foam wrap the upper back and work on more spinal extension and you will almost always see an improvement.
T-Spine bench extension
Lateral windmill
But what about the opposite? Those stuck in more “gross” extension and downward rotation?
That is, most athletes and meatheads.
Here the shoulder blades can seemingly “stick” down.
In this case, some positional breathing exercises to “unstick” the shoulder blades (and to encourage more three-dimensional or 360-degree chest/chest expansion) would be extremely beneficial.
All 4s Belly-Breathing
It’s amazing what a few minutes of this drill can do for improving shoulder flexion ROM, without having to pull or pull or “break” anything.
2) Let the shoulder blades move
Some people just don’t know how to let their shoulder blades move. A case in point is last weekend.
One attendee who is a personal trainer – but also competes in figure – mentioned how her shoulders (especially her left) had been bothering her for ages and she couldn’t figure out why.
We had her do this drill.
1-Arm Quadruped Extension
in fact, both extension and revocation happen, but many people have a hard time with the former.
The idea here is to learn to gain movement from the scapula itself rather than through the t-spine.
Here’s another angle (why, triceps):
https://www.youtube.com/watch?v=eyNFNxqFlSc
After a few “passes” with this drill, she saw an immediate improvement in her ROM. Plus, the day after she showed up for Day #2, the first thing out of her mouth was “My shoulder feels amazing today.”
This is a win.
3) Pin and Go
Another route to take is to have the person foam roll their fins. Not many people do this, and there’s a reason: It’s not pleasant.
I will have the person spend about 30 seconds on each side and then have them stand up and perform a simple SMR drill using a lacrosse ball against the wall.
They will “pin” the teres minor (basically, find the tender spot behind their shoulder and hold it there) and then work in upward rotation.
https://www.youtube.com/watch?v=9OiGt_O1FvY
Another five or so go by here, and I’ll try again.
Many times I will see a noticeable improvement in their shoulder flexion.
Interruption
NONE of this is to imply that anything listed above will work for everyone. The idea is to understand that it is important to “try” a number of modes and then try again to see if you find improvement.
If you do, you’re likely barking up the right tree, which will make your corrective approach and subsequent strength training more successful.
If you don’t, my bad…..;o)
