Assessing the ‘four horseman’

By Chris Gellert, PT, MMusc & Sportsphysio, MPT, CSCS, C-IASTM

There are a multitude of asssessments at the finger tips of a fitness professional. Choosing
the most accurate and objective assessments should be the cornerstone of any fitness
assessment. The plank and the side plank are two objective tests that should be in your
fitness arsenal. First, the four point plank test challenges the erector spinae and paraspinal
muscles and the side plank test challenges the obliques and quadratus lumborum
muscles.

 

Four point plank test

Grading for both tests is as follows:

Normal: Able to lift pelvis off and hold straight 15-20 second count.

Good: Able to lift pelvis off but has difficulty holding spine straight for 15-20 seconds.

Fair: Able to lift pelvis off but has difficulty hoding spine straight for 10-15 seconds.

Poor: Able to lift pelvis off but cannot hold for 1-10 seconds.

Trace: Unable to lift pelvis.

 

Side plank test

 

 

 

 

 

 

 

 

Multifidus test

This test assesses the client’s ability or inability to properly contract the multifidi. Have the client lie prone, then palpate multifidi muscle which is ~1” above ilium. Provide instructions asking the client to extend their hip 1-2” off the table and observe what muscles the client elicits.

 

Normal Movement:

To teach the client to contract the multifidi first, palpate the muscle (figure 1) (instruct the client to perform an anterior pelvic tilt (which shortens and contracts the multifidi), and then have them lift one leg straight up into the air.

 

Abnormal Movement:

Common compensatory movement is to activate the glutes or hamstrings first, then contract the lower back (this is dysfunctional) as seen in figure 2.

Look at the pointed finger, her glute maximus is contracting before multifidi. The multifidi are supposed to fire first, followed by the glute maximus and then the hamstring musculature.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Chris received his Bachelor’s Degree in Marketing from SUNY Plattsburgh, his Master’s Degree(MPT) in Physical Therapy from Nova Southeastern University and he received his advanced Master’s Degree in Musculoskeletal & Sports physiotherapy from the University of South Australia(equivalent to a U.S. Residency). Uniquely, Chris has been a personal trainer since 1996, changed careers in 1997 from Marketing to Physical Therapy.

His passion for learning is evident and contagious. He loves to present at conferences, private seminars and fitness venues. Chris has earned the prestigious C.S.C.S. credential through the National Strength and Conditioning Association in 2002. Chris has been a practicing physical therapist for 18 years with a strong clinical background in orthopedics, sports injuries and spinal dysfunctions and a personal trainer for 20 years. He has worked in industrial rehabilitation, outpatient, and private practice settings and has also been a fitness presenter for the past 15 years. He has created five dynamic live seminars for personal trainers, physical therapists and massage therapists, five home study and five Elearning courses on human movement. He is presently working as a physical therapist,  presents at fitness conferences, teaches live seminars for PTCS and other continuing education companies while consulting on various fitness and health-related projects.

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