Movement Screen Musings #1 Hypermobility, Feet & Core Strength
I have a movement screen I modesty call 'The Kershaw Strength Movement Screen.'
Every in-person client gets one and I find it's vitally important for me to decide exactly what is going to go into someone's warm-ups, training and what suggestions I am going to make for outside of the gym.
This week I performed a really enjoyable screen. I thought it would be fun to share the results from this to show people exactly what my thought process is behind it and to show coaches just how useful they can be.
Below is the report my client received. I've omitted any details that might give away who this screen was performed on. The bits written in italics weren't included in the report my client received.
The Movement Screen
Throughout the screen we are trying to find any fails (where they can't do a particular movement or a movement causes pain)
These are the things we address first with either exercise selection or a referral to the appropriate medical professional because we don't train people through pain.
General (Full Body) Hypermobility. Few/no painful symptoms
This client presented with general hypermobility which means most joints presented with more range of movement than 'normal.'
This can cause a lot of problems and symptoms but sometimes it doesn't. Luckily in this case this person has only dislocated their knee once and when they move they aren't in pain.
When someone is hypermobile you'll often see them just subconsciously tying themselves in a knot, contorting themselves idly into positions that most people can't get near....WITHOUT EVEN KNOWING THEY ARE DOING IT.
The only thing you can really do with this is to let them know they are doing it so they can catch themselves at it and gradually change the behaviour where needed.
Usually with hypermobility we want to take away some of that mobility (but not always.) Unfortunately with people who are hypermobile they are often fabulous at stretching and yoga so want to do it. I don't like telling people to stop doing something they love or that they are good at so it's often a tactic of mine just to tell them to stop pushing themselves in these activities and to use them for gentle relaxation instead of stopping completely.
Dislocated knee, Smashed/broken bones in one foot
The biggest predictor of future injury is to see what injuries people have had in the past. Usually hypermobile people have an injury list as long as this article but not in this case. The aim going forward is to keep it that way!
We'll have to carefully plan anything involving an aggressive change of direction. Particularly side steps or lateral raises. Performing movements such as these may well be possible but should be build up to carefully because of the knee dislocation.
Things To Strengthen
Ankles/Feet, single-leg work, core
Ankles and feet tend to be weak when testing people with hypermobility and today's screen was no exception here...except that when first looking at my clients feet they appeared to have very high arches, so I mistakenly thought that flat feet wasn't going to be present.
I was wrong to assume this and when watching various movement patterns it was obvious that the arches needed strengthen and the ankles could do with being significantly stronger.
This client struggles to balance during split-stance exercises such as split-squats and lunges so I know that if we strengthen both the ankles and feet of this person balance will be much easier because the things in contact with the floor (the feet) will be in a much more stable position to work from.
One of the simplest ways to strengthen the feet is to train without shoes on. This allows you to see what your feet are doing and be able to 'feel' the floor. This additional feedback helps people to know what position their feet are in.
We'll gradually be challenging the feet and ankles of this client with various standing drills until the strength of the ankles and feet isn't a problem any more.
In a few of the other movement tests I saw some core weakness or at least a lack of core positioning awareness so a couple of warm-up drills will be used to correct this very quickly.
Things To Try
Core Activation During Warm-Up
Tension Plank 3x5 seconds
The way I suggest performing these is during a warm up. Perform 3 reps of 5 seconds each generating as much full body tension as you can. Really squeeze everything as hard as you can.
This helps people to get a really vivid idea of just how much core activation is possible. I think more than 5 seconds of this tends to fatigue people too much when they come to their main compound lifts.
3 reps of 5 seconds to begin with works well to get the core ready without hindering your performance.
Bird Dog- 6 each side
Bird Dog Core Activation
This video recommends 10 each side. I'd go more like 6 each side either before or after the tension plank. It's up to you to see which feels best.
Here the aim is to keep the core stiff and to keep the lower back in one position. This is what we want to achieve when we perform big lifts such as squats and deadlifts which makes this an excellent warm-up drill to help you get the most out of your core during your sessions.
Stability Core Work At The End of 2-3 Sessions Each Week
I'd suggest throwing in core stability exercises such as these in your sessions (the dumbbell row i showed you works great too)
Pallof Press 2.0
Wider Squat Stance
I believe this stance will be much more optimal for you. See how it feels, experiment with some different stances and see which you prefer.
This particular client has very long femurs and struggles to stop their knee caving in while they squat. The ankles and feet are certainly partly to blame for this, which we've already discussed.
The squat is what this client identified as their biggest problem area so we spent quite a lot of time going over the squat pattern to try and find something more optimal.
With a wider stance it's much more difficult for the knees to cave in, the long femurs aren't as much of an issue and as long as hip mobility isn't a problem, it's often a great option for people with long limbs in relation to the length of their torso.
Low bar squatting can certainly help people with long femurs too but I didn't want to bombard this person with too much information unnecessarily.
Other Squat Variations You'll Benefit From
Dumbbell Goblet Squat (20kg plus)
Kettlebell Goblet Squat & Lowering (Great For Core Strength during a warm up for squats or as an exercise in it's own right after your main squat exercise)
Front Squat, Safety Bar Squat
While deadlifting your lower torso was twisting because of the under over grip you use. When you are as mobile as you are this can cause more issues than usual.
I would suggest using either hook grip or using lifting straps because these will allow for a double overhand grip giving you a greater ability to stop twisting, muscle imbalances and injury risk. It should also result in you deadlifting more in time.
Suggestion- Use Hook Grip or Lifting Straps When Deadlifting
This is a recent one for me. I no longer teach an under over grip for deadlifts unless the lifter feels more comfortable doing this as a powerlifter or strongman. For everyone else either hook grip or lifting straps are the order of the day to more evenly distribute the forces through the hips, shoulders and most importantly the spine.
Foot/Ankle Strengthening During Warm Up (low level) and away from the gym (as much as you like)
There are many thousands of feet/ankle strengthening exercises.
During your warm up I'd begin by doing some barefoot standing on one leg where you focus on keeping a strong arch/foot/ankle position. I'd suggest 10-15 second stands for 1-3 sets performing an extra set on the side that feels 'more wobbly.'
When this is easy you can begin doing some bodyweight reverse lunges and/or bodyweight single leg deadlifts for sets of 5 or so in your warm up. I wouldn't do much more than this in a warm up as you don't want your feet and ankles to be fatigued when you are lifting heavy.
Away from the gym or on rest days I'd encourage you to do whatever ankle strengthening stuff you fancy for a month or so just to bring up the general stability of your feet.
Supported Split Squat Variations
Hand Supported Split Squat Variation
This client struggles with any loaded split-squat variation. So we'll have a go at a few supported variations and find which variations work best. I love the safety bar variations but they won't be for everyone. I'd recommend performing these barefoot to be more aware of what your feet are doing. Wearing shoes won't make you die or anything but should help you to get the ankles and feet as strong as possible to help you with literally every single movement you'll use in the gym.
How To Fix Pronation When You Squat
How To Hook Grip
How To Squat Right For You
Joint Hypermobility Booklet For More Info 🙂
I love providing clients with further reading, watching and listening resources. Education empowers people. Empowering people is what the best coaches in the world do. I'm not there yet, not by a long way but I will keep plugging away, I'll keep helping people and together we'll make the world a fitter and healthier place.
If you'd like your very own movement screen please drop us an email or a message and we'll set the wheels in motion.
By Chris Kershaw
Chris is a Personal Trainer, Strength Coach, writer, man of small stature and reader of The Discworld Series with a decade in the industry.
He trains everyone from beginners to high level athletes. His favourite clients are people getting into the gym for the first time because they can make the biggest changes in their lives.
You can reach me through the email address email@example.com
My Instagram is Chris_Kershaw_Strength.
Thank you for reading!