Athlete screening

[Elle]

Hi everyone!

In this recent video https://youtu.be/vxbBtNUO3kw?t=1656 Corbu questions the reason for the many injuries suffered by Italian athletes in the last four years. He says he will start doing a series of tests, especially on young athletes who go to the CPO (Olympic training center in Rome).

What tests would you do to your new athletes? Are there some tests that are more useful than others? What skills does a coach need to have in this area and when is it necessary to involve a physiotherapist?

Do you believe in the "Squat University" methodology? Failed test > specific exercise > passed test > ok!

[Hawkpeter]

Its worth separating the testing that is used as talent ID, from testing that is meant to reveal a pathology/asymmetry or testing that is a marker for readiness to train, either originally or return from injury. Perhaps it was posted on another thread but its probably worth mentioning the testing battery that was made public that is being used in China.



Worth mentioning that Marco Soriano was at Junior Worlds collecting data on athletes and mapping it to their competition lifts. IMTP, counter movement jump, squat jump, isometric pull from floor was all collected, so you might see a pretty comprehensive paper published in future using quite high standard athletes.

For new athletes, getting a back ground to start with is necessary, in commercial world coaching I'm taking on everybody, so its a pretty broad church of athlete. We're talking 'this-is-a-barbell' stage to pretty advanced cross-over athlete to established weightlifter looking for new coaching. Putting aside anything I've learned in the background information stage, I'm looking for things in the skill installation/skill assessment stage that might flag a deficiency. For WL skills its squatting posture, overhead mobility, breathing skill tendencies. That's an extremely simplified breakdown of what can become quite complex.

I'm mindful of turning an initial session into some sort of Gray Cook FMS but there is a bias for newbies to my gym towards people who have self identified that they need help with lifting skills. Some days it can feel like being the pied piper of mutant lifters.

As far as referring on to specialised therapists, its more medical issues that I've found myself referring on. The movement deficiencies are fairly straight forward to coach.

[Elle]

Thank you very much for the answer!

Its worth separating the testing that is used as talent ID, from testing that is meant to reveal a pathology/asymmetry or testing that is a marker for readiness to train, either originally or return from injury. Perhaps it was posted on another thread but its probably worth mentioning the testing battery that was made public that is being used in China.

I saw it, it's very interesting that tests are done to participate in a national competition. I imagine that all the athletes will have passed them without problems. I'm translating it but I'm having trouble identifying some exercises, but it's a good starting point for identifying batteries of tests to do "at home".

Worth mentioning that Marco Soriano was at Junior Worlds collecting data on athletes and mapping it to their competition lifts. IMTP, counter movement jump, squat jump, isometric pull from floor was all collected, so you might see a pretty comprehensive paper published in future using quite high standard athletes.

I'm very curious about this! I saw that he gave an interview to Evidence Strong, maybe he might have already discussed some data?

For new athletes, getting a back ground to start with is necessary, in commercial world coaching I'm taking on everybody, so its a pretty broad church of athlete. We're talking 'this-is-a-barbell' stage to pretty advanced cross-over athlete to established weightlifter looking for new coaching. Putting aside anything I've learned in the background information stage, I'm looking for things in the skill installation/skill assessment stage that might flag a deficiency. For WL skills its squatting posture, overhead mobility, breathing skill tendencies. That's an extremely simplified breakdown of what can become quite complex.

I'm mindful of turning an initial session into some sort of Gray Cook FMS but there is a bias for newbies to my gym towards people who have self identified that they need help with lifting skills. Some days it can feel like being the pied piper of mutant lifters.

As far as referring on to specialised therapists, its more medical issues that I've found myself referring on. The movement deficiencies are fairly straight forward to coach.

Yes, my question was mainly about tests that could show deficiencies that could lead to injury, like those that will be introduced by the Italian national team (which I don't know).

Okay, so you prefer not to think in terms of individual joints or muscles but in terms of skills, right? What do you mean by "breathing skills tendencies"?

[strapping]

Hi everyone!

In this recent video https://youtu.be/vxbBtNUO3kw?t=1656 Corbu questions the reason for the many injuries suffered by Italian athletes in the last four years. He says he will start doing a series of tests, especially on young athletes who go to the CPO (Olympic training center in Rome).

What tests would you do to your new athletes? Are there some tests that are more useful than others? What skills does a coach need to have in this area and when is it necessary to involve a physiotherapist?

Do you believe in the "Squat University" methodology? Failed test > specific exercise > passed test > ok!

Whether the tests are helpful or not depends on what tests are being done.
Screening for medical history and medications that can affect or be affected by training is important, regardless of who the lifter is. Worst case scenario if you don't do that is that someone dies. Just the basic screening ones off the internet (like the shortened par-q) are fine.

Movement screens? Garbage.
Biomedical tests (e.g. blood tests)? Possibly useful, possible being the key word. In most cases, not useful. I do think it's a good idea to get a blood test once a year or so, especially for athletes who struggle with fatigue.
Medical imaging? Double edged sword - possibly helpful in managing a pre-existing injury, also risk of psychological harm if not.

Data collection on training program/performance and incidence of injury? Useful, if taken into account and respected by the coach.
Performance testing (e.g. force plate analysis of lifts, isometric force testing, dynamometry)? Useful, if taken into account and respected by the coach.
Athlete wellbeing screening and monitoring (e.g. sleep, nutrition, psychological stress)? Useful, if taken into account and respected by the coach.


Squat University is stuck 30 years in the past. If you try to provide contemporary scientific literature that goes against his recommendations, he will just block you, as he has done to other clinicans who care about research and evidence. He can't have anyone disrupting and disputing his cult of personality, he'll lose money and power.

Some of his exercise prescription can be used for low level rehab, but the reasons those exercises can be helpful is often not the reason he proclaims. There are many reasons an exercise can help or harm someone, including the way that it is verbally delivered and described by the therapist/coach. Even the expectation of improvement from adhering to the advice of an "expert" can influence the outcome.There are no special exercises, and a lot of the physiotherapy "special tests" are actually not that special! (problems with sensitivity and specificity, contextual effects etc).

There are no, nada, zilch, zero evidence supported movement screens for predicting injury or reducing risk of injury. There is a lot of pseudoscientific bullshit though. Screening for pain and injury through movement is a fundamentally flawed paradigm which assumes pain/injury is because of "faulty" mechanics. In reality, pain and injury/pathology are separate but related concepts.

For an example, this metamodel of factors relating to lower back pain identified by clinicians from https://pmc.ncbi.nlm.nih.gov/articles/PMC7394249/ has become very popular on Instagram. It shows people how complex pain can be.


Pathology/injury and mechanics do matter - but so does a lot of other stuff. That's why I mentioned the screening for medical, sleep, nutrition and psychological stress issues before. Of course, this is something that must also be supported by the coach and the coach must be willing to collaborate, rather than completely dictating the process.

As for injury prevention:

• Making sure that the medical, nutrition, sleep, psychological stress factors and social support are in check. This includes not keeping a lifter down a BW category if their body wants them to move up, screening for energy deficiency (RED-S), ensuring that athletes have friends and family available for social support outside of the gym (not too enmeshed in the gym), and so on.
• The training program allows for adequate (not too low, not too high) stimulus for the individual lifter, and more importantly a combination of volume/intensity/frequency/variation that is *recoverable* for the lifter.
• Enough physical preparation exercises/accessories to keep the lifter's joints, muscles, connective tissue strong enough to handle the sport training (sn/cj). For the weightlifter, this means that "accessory" work must be hard enough to actually get stronger in those exercises. Fucking around with a piss easy 15kg dumbbell row for 6 months gets you nowhere, the weight has to increase over time.
• The training program should not have an abrupt, large, sustained change in workload. (e.g. you suck at jerks? ok now we do jerks every session. nvm elbow left the chat). Changes in workload, especially to work on a "weakpoint" must be made gradually. Adding in something new means taking something else away.

That's about as well as you can do. Otherwise, shit happens in sport. Injuries happen, injury resiliency and the ability to come back from injury is what is more important.

[strapping]

Its worth separating the testing that is used as talent ID, from testing that is meant to reveal a pathology/asymmetry or testing that is a marker for readiness to train, either originally or return from injury. Perhaps it was posted on another thread but its probably worth mentioning the testing battery that was made public that is being used in China.

There's a chance that this testing is used to make sure athletes are well rounded prior to the CNG, maybe for injury prevention or something. Or maybe for talent ID (especially with CMJ as a test). But I think that's a small chance.

Honestly, this looks like a continuation of the old bureaucratic bullshit except slightly less bullshit. Before Tokyo, the Chinese Olympic Committee made the lifters do things like a 2km rowing ergometer time trial and 20m sprint trails, or a rotating core strength machine (>10k?). Reasoning given? None.

I think the maximum and specific strength tests (front/back squat, snatch/clean dead, push press/rack jerk/power snatch/straight leg or muscle snatch) are passable for anyone who would have already qualified for the CNG, certainly for top athletes. The CMJ and throw is a reasonable test for talent ID and well roundedness. I think anyone at that level with minor accessory training should be able to pass the >60s supine and side-lying holds off a bench. I'm not 100% sure about the climber test/ergometer test. Something like a stationary bike seems like a more logical choice.

Worth mentioning that Marco Soriano was at Junior Worlds collecting data on athletes and mapping it to their competition lifts. IMTP, counter movement jump, squat jump, isometric pull from floor was all collected, so you might see a pretty comprehensive paper published in future using quite high standard athletes.

This testing is much more appropriate IMO. I would add (if possible) knee extension isometric/handheld dynamometry to that list. Not isokinetic dynamometry, unless you have access to a sport science university or a spare 30k USD. Weightlifters can get away with weak quads for a surprisingly long amount of time and I think having that as reference would do a lot of good for a lot of athletes. Of course, there is also the poor man's dynamometer - a single leg hack squat (against a wall) with a camera and a ruler. Added weight if neccesary.

[Hawkpeter]

Regarding Soriano's data collection at Junior Worlds, I should add, I could see how coaches wouldnt want their athletes participating immediately before competition if they havent participated in something like that before. I had one of mine participate in the data collection 5 days out immediately after a training session. 15min, was already warmed up, Spanish Fed was using the event as part of a coaching course so new coaches were able to see and hear explained the utility and purpose of the process. Or, just do it after competition.

As far as the Squat U phenomena, nothing sows the seeds of pathology in an athlete like a test they've never done before. Everyone is an injury timebomb in random physical test world - particularly when there is a balance component tied into it. Alexis Leveille and Adam Meakins have done so great rebuttal over the years. I've never seen the use of Balkanising the coaching of WL skills totally from the use of fine detail motor patterning interventions.

This testing is much more appropriate IMO. I would add (if possible) knee extension isometric/handheld dynamometry to that list. Not isokinetic dynamometry, unless you have access to a sport science university or a spare 30k USD. Weightlifters can get away with weak quads for a surprisingly long amount of time and I think having that as reference would do a lot of good for a lot of athletes. Of course, there is also the poor man's dynamometer - a single leg hack squat (against a wall) with a camera and a ruler. Added weight if neccesary.

There is a spot by the wall in my gym where 2 things happen, med ball throws and hack squats.

[Elle]

Hi everyone!

In this recent video https://youtu.be/vxbBtNUO3kw?t=1656 Corbu questions the reason for the many injuries suffered by Italian athletes in the last four years. He says he will start doing a series of tests, especially on young athletes who go to the CPO (Olympic training center in Rome).

What tests would you do to your new athletes? Are there some tests that are more useful than others? What skills does a coach need to have in this area and when is it necessary to involve a physiotherapist?

Do you believe in the "Squat University" methodology? Failed test > specific exercise > passed test > ok!

Whether the tests are helpful or not depends on what tests are being done.
Screening for medical history and medications that can affect or be affected by training is important, regardless of who the lifter is. Worst case scenario if you don't do that is that someone dies. Just the basic screening ones off the internet (like the shortened par-q) are fine.

Movement screens? Garbage.
Biomedical tests (e.g. blood tests)? Possibly useful, possible being the key word. In most cases, not useful. I do think it's a good idea to get a blood test once a year or so, especially for athletes who struggle with fatigue.
Medical imaging? Double edged sword - possibly helpful in managing a pre-existing injury, also risk of psychological harm if not.

Data collection on training program/performance and incidence of injury? Useful, if taken into account and respected by the coach.
Performance testing (e.g. force plate analysis of lifts, isometric force testing, dynamometry)? Useful, if taken into account and respected by the coach.
Athlete wellbeing screening and monitoring (e.g. sleep, nutrition, psychological stress)? Useful, if taken into account and respected by the coach.


Squat University is stuck 30 years in the past. If you try to provide contemporary scientific literature that goes against his recommendations, he will just block you, as he has done to other clinicans who care about research and evidence. He can't have anyone disrupting and disputing his cult of personality, he'll lose money and power.

Some of his exercise prescription can be used for low level rehab, but the reasons those exercises can be helpful is often not the reason he proclaims. There are many reasons an exercise can help or harm someone, including the way that it is verbally delivered and described by the therapist/coach. Even the expectation of improvement from adhering to the advice of an "expert" can influence the outcome.There are no special exercises, and a lot of the physiotherapy "special tests" are actually not that special! (problems with sensitivity and specificity, contextual effects etc).

There are no, nada, zilch, zero evidence supported movement screens for predicting injury or reducing risk of injury. There is a lot of pseudoscientific bullshit though. Screening for pain and injury through movement is a fundamentally flawed paradigm which assumes pain/injury is because of "faulty" mechanics. In reality, pain and injury/pathology are separate but related concepts.

For an example, this metamodel of factors relating to lower back pain identified by clinicians from https://pmc.ncbi.nlm.nih.gov/articles/PMC7394249/ has become very popular on Instagram. It shows people how complex pain can be.


Pathology/injury and mechanics do matter - but so does a lot of other stuff. That's why I mentioned the screening for medical, sleep, nutrition and psychological stress issues before. Of course, this is something that must also be supported by the coach and the coach must be willing to collaborate, rather than completely dictating the process.

As for injury prevention:

• Making sure that the medical, nutrition, sleep, psychological stress factors and social support are in check. This includes not keeping a lifter down a BW category if their body wants them to move up, screening for energy deficiency (RED-S), ensuring that athletes have friends and family available for social support outside of the gym (not too enmeshed in the gym), and so on.
• The training program allows for adequate (not too low, not too high) stimulus for the individual lifter, and more importantly a combination of volume/intensity/frequency/variation that is *recoverable* for the lifter.
• Enough physical preparation exercises/accessories to keep the lifter's joints, muscles, connective tissue strong enough to handle the sport training (sn/cj). For the weightlifter, this means that "accessory" work must be hard enough to actually get stronger in those exercises. Fucking around with a piss easy 15kg dumbbell row for 6 months gets you nowhere, the weight has to increase over time.
• The training program should not have an abrupt, large, sustained change in workload. (e.g. you suck at jerks? ok now we do jerks every session. nvm elbow left the chat). Changes in workload, especially to work on a "weakpoint" must be made gradually. Adding in something new means taking something else away.

That's about as well as you can do. Otherwise, shit happens in sport. Injuries happen, injury resiliency and the ability to come back from injury is what is more important.

Thank you, thank you, much appreciated!

The problem with tests is that not only do you have to identify which ones have the right sensitivity/specificity, but you also have to know how to perform them and have them performed.

This is why I often send the people I train to a trusted specialist, who can give me much more precise information than I could get myself. I really like the Chinese approach (I don't know if it exists elsewhere, here in Italy it doesn't): there is the weightlifting coach and the strength and conditioning coach who takes care of all the issues not directly connected to snatch, clean and jerk and squat. In the absence of collaborators, a weightlifting coach often does everything (even an orthopedic/physiotherapist and nutritionist). I don't want that to be my case.

The Squat U approach has always left me perplexed because of its "simplistic" nature: positive FABER test? Ok, do this exercise and... oh the Faber test is now negative, you are cured!

I have no idea what kind of test Corbu is referring to (I imagine he will also get help from the national team specialists) but I fear an approach similar to that of Squat U, which is now quite popular here.

[brian.degennaro]

SquatU's approach is sadly infiltrating a lot of the lifting-sphere. It does not help that Mirabai is one he uses to promote himself. I wonder if he edited Wikipedia himself to state that he is one of her coaches.

I agree with strapping that tests and movement screens are largely useless. Make sure to have an intake on general health and background, then watch them move for a few sessions. It becomes evident quickly what weaknesses you need to shore up (flexibility/mobility, general strength, specific strength, power, etc). Our eyes are very powerful assessment tools if we use them and train them. You can identify someone's shape just by watching them warmup or if you use specific exercises/drills as primers for a session such as jumps or muscle lifts or tall lifts or what have you. These measures can be used both to encourage a heavier or more intense session (strike while the iron is hot) or to lower the intensity of a session and pivot exercises if you notice a large, out of the ordinary, decrease in performance.

[strapping]

Thank you, thank you, much appreciated!

The problem with tests is that not only do you have to identify which ones have the right sensitivity/specificity, but you also have to know how to perform them and have them performed.

This is why I often send the people I train to a trusted specialist, who can give me much more precise information than I could get myself. I really like the Chinese approach (I don't know if it exists elsewhere, here in Italy it doesn't): there is the weightlifting coach and the strength and conditioning coach who takes care of all the issues not directly connected to snatch, clean and jerk and squat. In the absence of collaborators, a weightlifting coach often does everything (even an orthopedic/physiotherapist and nutritionist). I don't want that to be my case.

Related, the Chinese men's weightlifting S&C coach (Nathan Stockley, UK) and Physiotherapist (Sam Stewart, Australia) did a podcast a few years ago but I don't think it got many views.

I'm not sure of any other national teams who have in-house allied health professionals all under one roof. Some particular gyms are lucky enough to have that but it's much more common in well funded sports than in weightlifting.

As with any field really, it helps to talk to people and form connections/relationships where you can. I'm in the fortunate position that I can do basic assessments for injury screening when athletes have problems, but if I'm not getting where I want with management I will refer to the relevant specialist (e.g. physiotherapist, medical doctor).

This applies often with nutrition. I know enough about nutrition to know what to do and give general advice, but I'm not a dietitian which means that I'm not legally able to provide dietary plans and more importantly, I don't have the time as a coach nor the knowledge to really create an effective plan for behaviour change around food. This is especially true when people have body image issues or eating disorder history - very common in weightlifting. Referring out to sport dietitians is unfortunately expensive and takes time, but I strongly recommend it to athletes who struggle with dietary management. I also recommend dietitians over nutritionists - dietitians are more expensive, but they have a postgraduate education and a lot of mandatory clinical hours. Nutritionists are a half and half mixture of people who try to keep learning all the time, and people who learn nothing outside of their biases.

More commonly in most scenarios, it's the individual athlete who seeks out help - from MSK professionals, sport psychologists, sports dietitians, GPs and sometimes sports physicians (usually for more serious injuries that may require surgery). This multidisciplinary approach is good, but unfortunately rarely ever results in true interprofessional collaboration. Half the time I can barely get an email back and I am instead relying on the athlete's memory of their appointment. I'm afraid true multidisciplinary collaboration usually only happens in hospitals and the Chinese team.

-

IMO regarding the S&C coach role, I think weightlifting coaches are very well positioned to learn how to become an S&C coach. S&C is made unnecessarily complicated by acronym collectors. From a weightlifting perspective, S&C is basically speed training (jumps/hops, throws) and general strength training/bodybuilding training.
1. Progressively jump higher, further or quicker. Progress from extensive to intensive jumping over time. This is great to incorporate towards the end of a warmup, before lifting.
2. Progressively get stronger and lift more weight in the 5-20 repetition range in all joints/planes of movement and positions, especially the ones ignored by weightlifting (e.g. dynamic rotational or lateral ab work, hip flexion/adduction training)
3. Probably some cardiovascular work in zone 2 is good for general health and wellbeing.

That's it. When people prescribe hyperspecific exercises that look like mid-flight rocket surgery, they're usually trying to sell their S&C expertise rather than actually just load up a tissue or system. A couple of exercises, done consistently to work on weakpoints, 1-2x a week for 1-3 sets of 5-20 reps and gradually progressed over time.

The Squat U approach has always left me perplexed because of its "simplistic" nature: positive FABER test? Ok, do this exercise and... oh the Faber test is now negative, you are cured!

I have no idea what kind of test Corbu is referring to (I imagine he will also get help from the national team specialists) but I fear an approach similar to that of Squat U, which is now quite popular here.

Your instincts are partially right and wrong regarding his methodology being oversimplified. What the patient sees isn't (should'nt be) the clinician's thought process. Testing, exercise prescription and review should always be as simple as possible, but the thinking behind them must be complex in order to make the intervention simple. There have been times where I've prescribed 3 simple exercises for about 10-15 reasons.

Once you have ruled out red flags (medical emergencies), a lot of testing and exercise prescription is basically about managing patient expectations, loading in an ideal zone for the patient/condition to rehabilitate whilst time heals the body. It's like the old quote from the 1800s: “The art of medicine consists of amusing the patient while nature cures the disease.”

Exercise analgesia can occur with many different exercises, not just his pet favourite exercises. It's a temporary effect but you can use it as a powerful tool (and placebo) to get people training/moving confidently and progressively, which as long as you're within the Goldilocks zone (not too much, not too little) can help with rehabilitating the athlete and movement. My preference is to use the desired task e.g. squat to test for or provoke pain, and retest afterwards. You can use a FADIR/FABER to assess hip pain in the squat, or you can do a bodyweight or weighted squat and tell me when the hip hurts (e.g. ROM or load provocation etc).

Italy has some awesome physiotherapy and sport science professionals, so the expertise does exist in the country but it needs to be accessed and listened to.