All gyms have their new members fill in ParQ’s or at least they should. These are usually generic and have questions about general health and injuries. They are filled in by the athlete and then just filed away and never looked at. The part I want to focus on is the injury or previous injury part. There will be people who fill in these forms and will put that they have suffered back pain, bad knees etc, the most common response from the gym is, “is it ok now?” and the most common answer is usually “yes it fine” or “it comes and goes”
The gym/coach should be taking note at this point, as it has been shown that previous injuries can be a risk factor for another injury. (Hagglund, 2006). The injury is also likely to be either the same injury or something to do with the previous injury.
If the coach was to screen this athlete using some form of movement screen, then maybe it would show up any movement deficiencies or asymmetries, and this would give the coach a good starting point to program corrective exercise.
One of the most common screens used is the Functional movement screen (FMS), and this is made up of 7 tests that will show a side to side asymmetries, shoulder mobility, core strength, and movement dysfunction. It is scored out of a top score of 21 and it is said that if the person being tested scores <14 they are at risk of injury, up to 2.74 times more likely according to one study. (Chalmers et al., 2017)
Now there are also studies that will show little or no correlation between FMS scores and injury risk although this can be offset by adding a few more dynamic tests such as testing under load or tests that put the athlete under more stress, such as jumping and landing. (UKSCA, 2019)
Now let’s look at the normal response about screening from coaches.
Most coaches think they already screen while teaching their athletes how to do movements. Common ways this happens are;
“Well if their knees cave in, I’ll tell them to push them out and that will fix it”, “If their feet are turned out to much I’ll ask them to straighten them” or “ if the bar is out in front, I’ll tell them to pull it back while keeping their midline tight”.
All good responses and shows that the coach can see the faults, BUT, what if you are making the issue worse or not actually understanding the problem, so no matter how many cues you give, it will never get better.
Let’s take the knees caving in for an example, as it’s a big well know fault. You as a coach have to know why the knees are caving in, is it weak glutes?, How do you know?, is it bad ankle mobility?, How do you know? Unless you have assessed the athlete, a simple knees out may not fix the problem.
What if the athlete over pronates? this will then result in the lower leg rotating inwards and this then will cause the athlete to turn their feet out as the body will want the knee to face forwards in its natural position. Now if you tell this athlete to straighten their feet to “produce more torque” then this will cause then as overpronators to cave in and have the knees in a vulnerable position, on the flip side if you let them squat with feet out, they will probably still pronate and have a collapsed knee but they will also put a lot more stress on the hips and lower back.
Now let’s say their feet are ok yet the knees still cave in, where would you look then? Maybe their hips shift to the side, this will cause the knee on the same side to cave in and this could result in lower back pain and possible injury. Do you know what’s causing this? Can you fix it? Is it really just as simple as working the glute Medius and stretching the adductors?
So back to should we screen our athletes? If we did then these movement faults would be picked up before the athlete even started training, this would allow you to give them a corrective program before they lifted weights in your class and this, in turn, would reduce the likelihood of them getting injured and either missing training or leaving due constantly getting injured, because as already stated, a previous injury is a predictor for getting reinjured.
Remember movement efficiency will make you faster and stronger so any inefficiencies will have a negative effect on your performance and may cause injury.
If you want to find out more about screening either as an athlete or as a coach then feel free to get in contact.
Bonazza, N., Smuin, D., Onks, C., Silvis, M. and Dhawan, A. (2016). Reliability, Validity, and Injury Predictive Value of the Functional Movement Screen: A Systematic Review and Meta-analysis. The American Journal of Sports Medicine, 45(3), pp.725-732.
Chalmers, S., Fuller, J., Debenedictis, T., Townsley, S., Lynagh, M., Gleeson, C., Zacharia, A., Thomson, S. and Magarey, M. (2017). Asymmetry during preseason Functional Movement Screen testing is associated with injury during a junior Australian football season. Journal of Science and Medicine in Sport, 20(7), pp.653-657.
Hagglund, M. (2006). Previous injury as a risk factor for injury in elite football: a prospective study over two consecutive seasons. British Journal of Sports Medicine, 40(9), pp.767-772.
UKSCA. (2019). Is screening still a useful tool? It depends! A case example of male youth soccer players. [online] Available at: https://www.uksca.org.uk/uksca-iq-article/screening/1883/is-screening-still-a-useful-tool-it-depends-a-case-example-of-male-youth-soccer-players [Accessed 10 Oct. 2019].