In addition to recognizing risks, it’s also important to recognize the individual GOALS and then use appropriate assessments.
How many people – healthy or otherwise – are really interested in their VO2max? Lactate threshold? Heart rate recovery time? Bench press 1RM? Degrees of internal rotation of [name your favorite joint]?
While there are numerous reasons for trainers to have understanding of these (and other) objective measurement tools, in my experience, most people have very subjective goals – they simply want to “look” or “feel” better.
When “feeling” is what’s most important, measure it! Start with a question like “how do you FEEL about your nutrition today?” or “how do you FEEL your workout went today?”
Have ’em answer on a scale of 1 to 10… or a sad-to-smiley face continuum 🙂 Watch how the trend changes over time.
When “look” is the goal, how much risk is there in taking regular progress photos? Using a ‘standardized’ favorite outfit as a measuring stick?
Instead of using high-risk – or inappropriate – assessment tools just because YOU like/understand them, the latest corporate buzz-speak for this is “meet them where they are.”
If fitness really is a journey, you can use your other assessment tools as strategic “lookout points” along the way.
My assessment take many things into consideration. My question to you; Do you mean Risk Stratification (7 Stratifications defined by ACSM), Injury? Surgery? Post-Op? Meds? Risk assessment can encompass many things, thus my assessments encompass gathering information on all of these. This may determine what “physical testing” I do if any at all. Most importantly I modify my program based on this information.
When I meet a new client for an assessment, I have already talked to them and thereby have determined whether I will require a physician’s approval. Even if it appears in the conversation that it may not be necessary, I tell people that I may require it after all if anything comes up during the assessment.
For the assessment itself, I have a whole ‘laundry list’ of items that I like to determine and assess. What I always do is taking pictures against a grid, take a video for a gait analysis, take blood pressure and use the Futrex for determining body composition. But even here are already the first modification: if I deal with very overweight clients, they may not be comfortable having their picture taken. I may also forego the body composition because at high levels of obesity it can be inaccurate. There is a piont when it does not add much to my knowledge and only makes a new client feel uncomfortable.
So to summarize my answer: it depends.
As for other assessments: I decide on the spot which to do or not. My rule is to err on the side of safety. I cannot remember the last time I had somebody do push-ups for 30 seconds.
On the other hand: I like to compile as many ‘tangible’ data as possible so that I (and – more importantly – the client) can see measurable progress.