The Allegiate Screen
not cleared? here’s why and what to do.
The most important job we have as coaches is to prevent injuries in training. We want to help you on your journey to getting stronger, getting in better shape, and ultimately feeling and looking the way you want to. If we are smart and have a locked-in screening process, we can accomplish both and not have to compromise with either.
A common misconception is that an exercise (like a barbell back squat) or specific protocol (like 6/12/24) is meant to reach an outcome. This is misguided and oftentimes leads to pain and injury. When we prioritize the what over the how or why we end up with results that are not in line with our goals.
Any goal is directly tied into the underlying physiology and biomechanics. Physiology and biomechanics are relative to the person, whereas an exercise or method is independent of those variables. Our job is to figure as rapidly and accurately as possible what someone's potential in training is.
Before we need to go into our screening process, we need to elaborate on potential. Oftentimes people associate ability with one exercise or previous experience with potential in any setting. What we mean by potential is the association with risk. Potential is less about what someone can do.
Potential to us is this: if this person were pushed to higher threshold movements and more intense protocols are they at risk?
Potential of risk really ties into a couple of things: previous injury, pain, asymmetry, and restrictions in range of motion. All of these variables have gone through extensive research to support them as reliable indicators of risk.
Previous injury is statistically proven to be the greatest cause of being reinjured.
Someone currently in pain compromises movement patterns significantly and will lead to a reinjured or possibly new injury.
Asymmetry means you are moving with left-right/anterior-posterior/superior-inferior/rotational differences. A lot of our movements are going to be bilateral (2 Feet/2Hands) if there is asymmetry we will cause adverse torque which leads to pain or injury.
Someone with restriction in ROM will adjust their body to reach ranges they cannot attain, this will certainly lead to injury.
Our job is to find these risk factors as quickly as possible. More importantly: as accurately as possible. We have strategically chosen screening methods that are both highly interrater reliable and devoid of human error. What this means to you is that it will be consistent and uninfluenced by preference or bias. As you go through Force Deck, NordBord, FMS, or class we are assessing you quickly and accurately every time. A huge part of our screening process is not influenced in any way to remain as accurate as possible. When a coach asks you to do something during the screen, they are instructed to not coach.
Our Screen Includes:
Pre Screen - Previous Injury or Surgery - Yes/No
Force Deck/NordBord - Greater than 15% Asymmetry Not Cleared
FMS
Deep Squat - 0 - Not Cleared
Hurdle Step - 0 or Asymmetry - Not Cleared
Inline Lunge - 0 or Asymmetry - Not Cleared
Ankle Clearing Test - Hurdle Step - 0 or Asymmetry - Not Cleared
Shoulder Mobility - 0 or Asymmetry - Not Cleared
Shoulder Clearing Test - Hurdle Step - 0 or Asymmetry - Not Cleared
Active Straight Leg Raise - Hurdle Step - 0 or Asymmetry - Not Cleared
Trunk Stability Push Up - Hurdle Step - 0 or Asymmetry - Not Cleared
Lumbar Extension Clearing Test - Hurdle Step - 0 - Not Cleared
Rotary Stability - Hurdle Step - 0 or Asymmetry - Not Cleared
Lumbar Flexion Clearing Test - Hurdle Step - 0 - Not Cleared
I created this philosophy within the highest levels of athletics, in my time as a collegiate strength & conditioning coach. One bad decision could be worth millions of dollars and someone’s job. At the same time, we needed to have the ability to push an athlete to the highest functional level possible. This razor’s edge forged a screening process that allowed us at the collegiate level to make rapid and accurate decisions to ensure safety and performance. If there are any of the risk factors found, we have to make alterations to the program to provide a safe and effective environment every day.
What do you if you are not cleared:
The short answer is do the Strength Program three days a week and if you want a 4th day, do Practice 4. The longer answer is built around the sciences of pain management, motor learning, cueing science, and motivational sciences.
Someone that is in pain will have to adjust the program considerably. We have progressions to each of our movements based on this framework called the 4x4 Matrix. The more surface we have on the ground, the more balanced we are with positions lying on the ground (Prone or Supine). The less surface we are in contact with the ground the less balanced we are (Bilateral, Split, or Single Leg Stance). In between, we create intermediate positions that provide stability but also challenge balance (Quadruped, Tall Kneeling, or Half Kneeling).
When someone is in pain we simply add more balance and stability by getting them in contact with the ground. We also take away joints that are potentially problematic. People with back pain, ankle pain, knee pain, or hip pain are immediately benefited when we get them in a prone, supine, quadruped, tall kneeling, or half kneeling position.
The load we place on people makes a huge difference on how we organize our bodies. If someone is in pain, has restrictions in ROM, or are asymmetrical they will find a strategy to move around those variables. We can elicit a strategy to change not only the direction of that movement pattern but how we load it. Instead of making a bad thing worse, we can correct movement patterns to strengthen and fix the underlying issues.
In terms of asymmetry, we need to acknowledge that structural balance and unilateral training are critical to strengthening without injury. Structural balance is about strengthening all movement patterns equally - if you can push it you can pull it. Unilateral training is using DBs over BBs, or training in a single or split stance over a bilateral stance. This simple and wildly effective strategy strengthens people without risk – even if they are asymmetrical.
The final factor is Range of Motion (ROM). It easily could be the most important. People with lowered ROM are leaving potential on the table during training. If you can only attain a certain ROM in your joints, those movements that utilize those joints will be compromised.
A pattern is the product of what ROM your joints have. The prep work of CARs, PAILs/RAILs, and Mobility Drills along with the post-work of Soft Tissue and ELDOA/Resting Postures/Fascial Stretching are the best strategies to increase ROM. ROM is about frequency and intensity. So the more days you do and the more focused you are while doing it, the better results you’ll get. This is why we recommend Stretch. It adds a day to flexibility and drives up the intensity in which we do it.
When someone is not cleared and we are asked what do I do? Our response is always going to be Strength and Stretch (our monthly video). It is not to be dismissive, it is because that is the answer. We designed it as such for you to have all the tools at your disposal to help your potential for movement. Consistency is the most important aspect - show up as recommended. Three times a week for Strength gets you: three sessions of CARs, PAILs/RAILs, Corrective Exercises, 4x4 Matrix Based Movements, Soft Tissue, and Flexibility. Add to that at least one Stretch Class you have literally everything you need to improve your FMS.
Something to consider when you are not cleared. It takes time to fix these things. Pain, reduced ROM, and Asymmetries did not happen overnight. It will take considerable time to fix. Consistency spread out over a long period of time will be the best chance of fixing this. Creating feedback loops to fix these problems from better overall habits to moving with purpose and control is a process - remember it is not what, but how.
The other part is there are certain things that make axial loading with BBs contraindicated. Orthopedic things like herniated disks, surgical repairs on hip or shoulder, and constant reinjury in training are all glaring red flags. We have to be honest in saying that it makes no sense to choose an exercise that will cause harm. It is not a matter of if, but when you will get hurt doing exercises that we directly load the spine such as BB squat or BB Deadlift. It would be way easier to say, “who cares, go for it,” but for the best interest of you and your safety we have to be honest that being cleared is not going to happen.
The end result you covet is not exclusive to barbell-related movements. If we can load movement patterns safely and appropriately we can accomplish any goal. Changing body composition or body mass has nothing to do with a specific exercise. It has everything to do with how you can do it over a longer period of time.
Training is a means to an end, the question is do we understand what that end is? Over the last 20 years, we’ve demonstrated that these methods work – with the highest level of athletics and people who just started training for the first time. Trust the process and take solace that someone is putting your safety above everything else.
What happens when you don’t believe us.
We made this process for a specific reason: safety. A common misconception with exercise is that it is whatever the person is paying for. The reality is that this approach has led to a lot of people getting hurt.
We can assuredly say a couple of things, one specifically is that Allegiate is extremely low risk. Meaning that if you come to Allegiate three times a week, the prescribed amount of sessions we recommend, your chances of getting injured are extremely small. Like ridiculously small. Like 1 in 1000 small. In fact, we want that number to be even smaller in terms of risk, more like 1 in a trillion.
We can compare this number readily to other fitness concepts. We know that crossfit has a higher injury rate than other fitness concepts. Weisenthal in 2014 found that on average 20% of the participants that participated in CrossFit were injured during training. This study included 386 participants that exclusively were participating in CrossFit. Criteria for injury were:
1. Total removal from CrossFit training and other out-side routine physical activities for >1 week
2. Modification of normal training activities in duration, intensity, or mode for >2 weeks
3. Any physical complaint severe enough to warrant a visit to a health professional
There’s way more here:
Hak (2013) found that 74% (Sample size of 132) of CrossFitters suffered at least one injury during CrossFit
Sprey (2016) Found that 31% (Sample size of 622) of CrossFitters suffered at least one injury during CrossFit
Summitt (2016) 24% (Sample size of 187) of CrossFitters suffered at least one injury during CrossFit
The most important variable to someone changing their body composition or health is: consistency over a longer period of time. A person that can adhere to a program three times a week for 52 weeks will achieve better results than someone that goes six days a week for 26 weeks. Apples to Apples - the longer more pragmatic approach works better in terms of physiology.
We can adhere to a program like HIIT or Bootcamp that allows you to come 3-6 days a week, but you are not going to get what you want. Traditionally, these concepts use stationary exercise pieces like bikes or treadmills combined with bodyweight exercises. This makes the potential for risk much higher. Now if you take someone with pain, reduced ROM, and asymmetries doing 1000s of redundant movements for the sake of fitness – they will inevitably break down.
What is the common characteristic between crossfit, HIIT, and bootcamp or any group exercise format? No screen. That is the reason we do not want to push someone to Team without a screen. The person that has the associated risk factors pushed to any threshold of speed, force, or capacity is under increased risk. All we want to do with our screen is know just how much risk there is. Ask yourself, have you ever been screened at another gym?
The truth is that Crossfit or bootcamp is not more risk than our Team Class. The difference is the screen we use to evaluate the risk beforehand. Take for a moment what it means for us to say you are not Cleared to go to Team. It means we are intentionally saying we are more concerned about your safety than what we may gain from you as a customer. We are aware that this may come off in a way that is not empathetic to your needs and we want to ensure that you are heard and appreciated.
But the reality is that you do not readily associate the risk of doing something the same as we do. We know the negative outcomes of not having a screen that is both valid and reliable. And the outcome is bad. We also understand that getting better is not exclusive to an exercise or method. Improvement is a relative thing that as long as we understand the underlying risk as well the principles that guide adaptation we can accomplish anything.
Sources:
Hak PT, Hodzovic E, Hickey B. The nature and prevalence of injury during
CrossFit training. J Strength Cond Res. 2013; https://doi.org/10.1519/JSC.
0000000000000318.
Sprey JWC, Ferreira T, de Lima MV, Duarte A, Jorge PB, Santili C. An
epidemiological profile of crossfit athletes in Brazil. Orthop J Sport Med.
2016;4:1–6.
Summitt RJ, Cotton RA, Kays AC, Slaven EJ. Shoulder injuries in individuals who participate in CrossFit training. Sports Health. 2016;8:541–6.
Weisenthal BM, et al. (2014) Injury Rates and Patterns Among CrossFit Athletes. The Orthopaedic Journal of Sports Medicine, 2(4), 2325967114531177 DOI: 10.1177/2325967114531177