There are many different ways to quantify strength in our patients and athletes, from isometric testing, to repetition max testing, to velocity-based training, and even force plates.
To be honest, RM% is cumbersome and sometimes not even appropriate.
Here’s how we measure strength in our athletes at Champion.
To view more episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold.
#AskMikeReinold Episode 260: How to Evaluate Strength in Athletes
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Show Notes
- Learning More About Strength and Conditioning
- Integrating Strength and Conditioning into a Physical Therapy Business
Transcript
Student:
Our first question is from Terry, from Wisconsin. Hi Champion team. I was wondering how you evaluate the strength of your athletes at Champion. I know that there are some options like dynamometer testing, isometric tests, repetition max testing, velocity based testing, and forced plate beta. What do you use and why?
Mike Reinold:
Awesome. All right. Great question, Terry. I liked that. And I think this is a pretty big topic nowadays. I just think as technology is starting to become a little bit more prevalent and I think all of our professions, or every profession. Then I think people are trying to always find new ways to quantify strength. Back in the day, it was a gigantic, isokinetic testing machine, which was amazing. And then it had a lot of really cool aspects to it, but there’s got to be other and better ways, but I like how Terry included a wide variety of things here. And I think he, or she, I’m not a hundred percent sure, I think they were very holistic with this on all the different ways that you can do this.
Mike Reinold:
And I like how there’s isometrics, there’s rep max, there’s velocity based. I think that this was a really good question. So I don’t know. I don’t know, Diwesh, why don’t you start with kind of where we’re at. Maybe we can talk about a little bit about some other things that we’re working towards or something, but what are we doing with our athletes here? So, mind you, this is from Diwesh’s perspective. This is going to be from our healthy athletes and our performance kind of realm. Maybe we talk about rehab towards the end, but Diwesh, what do you think?
Diwesh Poudyal:
Yeah. So for our performance side of things, when we get an athlete into the building, initially, we tend to look at a little bit more of their power output numbers in different planes. We look at their speed acceleration stuff. We do do some speed… Or strength testing if we feel like the athlete qualifies for it. So one of our easy ways to do it is actually using VVT, so we use a gym aware device. And the reason that we use that is we try to gauge an idea of where they fall on the force-velocity profile. We’re trying to try to get an insight into, is an athlete really fast, but maybe a little bit weaker? Or are they really, really strong, but maybe a little bit slower? So we use a velocity profile testing initially when we get them in through the door.
Diwesh Poudyal:
As they start training with us a little bit more throughout the course of the months, we do update their strength testing numbers. So we’ll have them work out to like a five rep max on a lot of our major movements like squat, deadlift, lunge, press, row, things of that nature. So we’ll keep an eye on how they’re progressing on all their strength stuff for the big movements that we put a ton of value in, but we also do find a lot of use in velocity based testing to get an insight into their force-velocity curve. Now stuff that we’re working on towards the future. I think we are starting to think a little bit about force plate, maybe potentially utilizing some of the fancier tech that’s out there to get even better insight into someone. So we can have even a more customized approach for our training and really influence some of the specific nature of our qualities that we’re trying to build in our athletes. So that’s kind of where we’re at right now.
Mike Reinold:
Yeah, and I think the reason why we started this kind of evolution a little bit is traditionally like rep max is… There’s a lot of negatives to rep max. If your training age is low, then you’re going to question the validity of how much he got out of that rep max session. It takes time. You don’t want to do that on day one with a lot of people. That’s really challenging and time consuming type thing.
Mike Reinold:
So with force plates now, I think force plates started more… And this is a general comment, but force plates started more with jump testing and power open stuff, but I think now we’re using them quite a bit more for isometric testing and to do different testing positions which I think is really neat. But man, it’s so much easier to just walk up to a force plate and do one rep and see what you get with that isometric, like mid-thigh pull or something, for example, versus actually going through a five rep max sequence. That’s pretty, that’s pretty daunting for lots of reasons. So I really like what we’re doing. I like how Diwesh and Jonah, one of our other strength coaches, have really taken the lead on trying to use some of this newer technology behind this.
Mike Reinold:
One thing I think I would add just in terms of talking a little bit about the why behind our strength testing too, is that rep max testing is awkward, but for us, we think of just tracking their normal training as also testing. So there’s ways you can do equations, and what we try to do is towards the end of different phases with our athletes, we’ll just record how many sets, reps, and weights did they use? And then we can make that standardized rep max equation just to kind of follow people. So that way there’s no testing, we’re not testing their strength. We’re almost just monitoring their performance of their strength exercises through their program. Did I say that well, Diwesh? Should I hack any of that up?
Diwesh Poudyal:
No, no, I think you said that well. We push an athlete, let’s say like week five of their training program, we might push them a little bit harder, but it’s not like, “Hey, go max effort and try to lift as much weight as humanly possible with that form.” We’re saying, “Pick a weight that’s really challenging so that we know that you have this X amount less in the tank.” But yeah, we’re not certainly in working anyone up to one rep max or even a three rep max. We try to make sure that kids are training hard and getting stronger. And we have that strength and force bucket starting to be filled, because we know that’s an important part of their development, but we also take just as much pride in the velocity testing and the force-velocity profile that we’re kind of build out from these athletes. And then hopefully when we do get a force plate, we can get even more insight into helping our athletes get better results because we know more about them and what they need.
Mike Reinold:
To me, it’s about impactful testing. We don’t test just to test. It’s impactful testing. So I like that. So just to be comprehensive with your question, Terry, but that’s kind of our overall, general strength. Now in the rehab setting, Lenny, maybe you can jump in. You’re the most experienced with this sort of stuff. Why don’t you explain a little bit, what do we do differently between our athletes that are healthy, that we’re just looking to develop a strength profile, and what do we do to try to specifically identify strength deficits in somebody that’s coming back from an injury or surgery?
Lenny Macrina:
Yeah. We use it a bunch. I know, even for Mike Scaduto, I feel like everyday he’s strength testing, numerous, numerous people, yelling at them to push harder, but we do a lot for our overhead athletes. We’re looking for obvious strength deficits, especially in their posterior cuffs. So we’ll put them… Try a couple of ratios of ER to IR and a ratio there. We ideally like about 65%, 67% of a strength ratio of the external rotators to internal rotators. So we’ll just… We’ll consistently monitor that in our athletes, especially when they start the throwing… to begin a throwing program.
Lenny Macrina:
After say a Tommy John, and then after a time, after they start a throwing program maybe every month or so, we’re monitoring their strength to see how they are progressing or regressing. I use it a lot as well in my ACL’s. So I use it, a hand-held dynamometer, just like we just talked about for the upper bodies and a lot for a lower body too, to measure quad strength, especially. I’ll do some hamstring testing as well. It’s not as, I don’t know, I guess specific for me, but I’m really focused on the quads. We know that’s the primary focus of ACL rehab. So I’ll do a symmetric quad strength test at 70, above 70 degrees of knee flection. And I had them kick into a belt that is being reinforced onto the table. So I’m not holding the hand-held dynamometer. I don’t think that’s a good way of doing it. I prefer the other way. I think Terry Grindstaff has published a paper in IJSPT about that if you’re interested .
Mike Reinold:
And just to clarify, Len, for your upper extremity and stuff, you’re talking about using a hand-held dynamometer to quantify that strength.
Lenny Macrina:
hand-held dynamometer. Yeah. Yeah. Everybody’s going to ask, Microfet, Lafayette. There’s a bunch of new ones out there too that are good. We still have the Lafayette unit that we bought a few years ago, but there are other great ones out there that we’re kind of looking at.
Mike Reinold:
We’re trying some new ones. And I don’t know. I don’t know if they’re… I don’t know if they’re winning the race yet. I don’t know that the newer, cheaper models… I don’t think we’ve felt comfortable with their results just yet, but we’re going to keep playing with those. But yeah, definitely Lafayette or Microfet are the two leaders. But Dave, what do you got?
Dave Tilley:
Just wanted to throw in that I’ve been doing a lot with the hip too, for the same dynamometry stuff. There’s a lot of research Mike’s course. And I used that a couple of people post labor repairs and post PAOs and had some really good results, but same kind of idea of belt fixation. Standardize it. I would say it’s easier. Definitely if use your hand for ER and IR when they’re sitting on the table, to use the belt on the ER/IR is very tough, so you can just stabilize against your own and it doesn’t budge much. So that’s my two cents.
Lenny Macrina:
I think just so people know, for us, the way I use it at least, it’s not a break test. It’s a make test. So I’m not trying to have them break my amount of force that I’m producing. It’s not like a manual muscle test. I am kind of creating a wall and having them push into this wall, which the hand-held dynamometer is on the end of it, if I’m measuring like external rotation. So again, it’s how much force can they produce? Not how much force can I break them?
Mike Reinold:
Yeah, which is funny because we’ve gotten into some interesting debates with other friend, researchers of us that swear that if you’re using a make test, it’s not valid. And I think… I still swear if you’re using a brake test it’s not valid. So I don’t know what that means. I don’t know. I mean, to me, I just want to see how much force they can produce, not how much force I can push into them. And we’ve had situations in the past where we’ve had other physical therapists we work with doing hand-held dynamometer, they get really consistent at pushing the same amount of force and the numbers just the same every time and you’re like, “How can that happen?” That’s really ironic that every number in every direction is exactly the same.
Mike Reinold:
So yeah. I mean, there’s a learning curve, and just to answer Terry’s question, how we evaluate strength, there’s a learning curve to hand-held dynamometry. And I just keep that going. I got to make an inner circle video on that. That actually just kind of reminds me of like the nuances of that, because that is one of the harder things that we teach anybody. And I tell everybody, “Your data for a year is going to be useless.” And hopefully less than that, but it’s so easy to do that poorly if you don’t have the right technique. I think the only other person I think I’d ask… I’m just kind of curious. Dan, are we missing anything? Like do you do any specific strength testing for an athlete that’s specific to their sport or event? I feel like you’d be a good person to answer that, anything we missed?
Dan Pope:
It’s funny because I was just about to note on that. I do like the hand-held dynamometers a lot. I’ve been messing around with a lot of Achilles patients recently. And I think one of the problems you’ll see is that they’ll have pretty similar strength numbers, but then you ask them to do like a standing calf raise and we’ll do like 35 on one side and they won’t be able to get full range of motion on the other.
Dan Pope:
So I do think that it’s helpful to try to get more specific and functional after a while. Like check off that… check the box off of hand-held dynamometer has pretty good symmetry. At least for me, I work a lot of barbell athletes. So I’ll do something like, let’s press overhead with a dumbbell on one side, see how many reps you can get, and then try the same thing on the other side and see if some of these strength numbers from the dynamometers are carrying over to the more functional activities. Because in my mind, we want to get those specific muscles stronger, but does that carry into the big function that the patient is trying to get back to? So I do like trying to get back to some of the rep max stuff eventually, and trying to iron out any of these asymmetries in the specific planes of motion. So overhead pressing or head pulling or horizontal pushing, pressing that type of thing. And just making sure that we’re getting strong from all angles for the activities that the athlete wants to get back to.
Mike Reinold:
I like it. I like it. And there’s always going to be a blend between like tech and science and feel, that sort of thing. I hate to say that, but as you get more experienced, you’ll definitely get a better vibe. I think Dan does a really good job of taking the objective data that he gets and then combining it with what he sees during the performance of an exercise. I think that’s a pretty neat combo. That takes some experience to develop that clinical judgment, so. Awesome. Great stuff, Terry. I think that was an excellent question, Terry. Hopefully we kind of nailed it from a few different aspects. I think there’s a lot of good ways to go about what we do there. So hopefully that was helpful. Thanks again for the question. If you have something like that, again, head to mikereinold.com, click on that podcast link, and be sure to head to iTunes, Spotify. Rate, review, subscribe, and we’ll keep doing these episodes for you. So thank you so much.
