How To Assess A Client For Body Asymmetries (repost)

Asymmetric Musculature

I originally wrote this piece for AFE and am reposting it here.

Fitness pre-testing is a valuable tool for evaluating movement patterns and assessing a client’s strengths and weaknesses. The information gathered from such testing can then be utilized to develop a customized program which addresses and corrects functional abnormalities. The more thorough the pre-testing, the better equipped a trainer is to help the client reach optimal potential within the training program, while also guarding against injuries which the client might be predisposed to as a result of compensatory patterns.

Many people have developed compensatory patterns over time. Sometimes structural abnormalities exist from birth, or develop in childhood, and often throw surrounding soft tissues and joints out of alignment. In other cases, injuries from sports or other activities can cause a person to begin favoring one side of the body in an effort to reduce the stress load on the injured side. The problem with these compensatory patterns is that they allow the weak or restricted side to become even worse over time. Because of this, functional weight training should always address these patterns in an effort to correct them.

How To Determine Asymmetry

One of the most valuable early tests for determining structural asymmetry is the single leg stance, in which the client’s ability to stabilize the trunk over the supporting leg is determined. Misalignments of the hips, knees, or ankles/feet can be detected easily with this screening tool. For example, if one hip joint is restricted or otherwise unstable, the client will shift weight in an effort to maintain balance. A trainer can then utilize the information gathered from the single leg stance test to focus on compromised function in a joint or extremity.

Clients will frequently exhibit asymmetries in strength, range of motion, or muscle recruitment which can easily be overlooked if a trainer doesn’t have a practiced eye. Because of this, a thorough assessment of the client’s posture, range of motion, and form should be implemented before training begins so that the trainer can identify and properly address compensatory movement patterns.

Let’s say a client exhibits poor movement while performing a basic bodyweight squat, the source of the dysfunction must be determined so that the trainer can correct it. Is the limitation is coming from the foot, the knee, the hip joint, the pelvis, or the sacrum? Is the issue one of limited mobility, muscle weakness, joint instability, or of poor muscle activation? The origin and the nature of the dysfunction will determine which corrective exercises should be added to the client’s program.

Sports and Compensatory Patterns

Asymmetries are especially common in people who engage in sports such as baseball, golf, soccer, football, and tennis, which rely heavily on one side of the body. Because of this, it is important to ask clients if they currently play sports or have played them in the past. It is also important to ask clients about any past injuries which may be contributing to current compensatory patterns. Compensation results from a number of factors, including muscle weakness, impaired joint mobility, musculoskeletal asymmetry, leg length discrepancy, previous injury, and even joint stress from obesity. Joints can become lax and unstable, forcing contralateral muscles to take the brunt of the movement in order to stabilize the dysfunction. What often results is overuse in the compensating region, which in turn adversely affects the client’s training, and also reinforces the asymmetry.

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