Skilled core assessments for female clients

Depending on their life stage, training requirements for female clients will vary greatly. Women’s health expert Dianne Edmonds looks at how to safely assess, and build, core fitness.

If you specialise in training women, then the mantra that no two clients are the same will ring especially true. Depending on their life stage, their training requirements will vary greatly, as these three examples illustrate.

You have three new clients coming in for their appraisals this week.

Client A. Fit, keen and ready to get into her training, she has no issues with her core fitness that would be of any concern.

Client B. 2 months postnatal and keen to return to training, but she gave birth to a big baby and experienced some difficulties in labour.

Client C. 8 years following the birth of her last child, her two children were born by caesarean.

So, for their core fitness programming where would you start? What tools will you use to assess their starting point? Do you have ideas in mind of the best exercises for each of these clients?

Testing core fitness

Options for testing their core fitness could include:

1.

  • Standing core control testing with single leg lifts (photo 1)
  • Supine single leg testing building to 1+1, before double leg loading exercises are introduced
  • Testing of plank position, checking spinal and scapular control and monitoring the length of the hold time before fatigue onset signs (photo 2)


2.

  • Sitting on a Swiss ball, testing single leg lift level of control, building to extending leg or dropping to single heel lift if core control is lost (photo 3)
  • 4-point kneeling recruiting lower core, testing control is maintained with single arm reach, single leg reach, alternate arm/leg reach (photo 4)
  • Modified plank position by propping elbows on ball, testing for any signs of breath hold or feeling of pushing down or pressure on the pelvic floor.


3.

  • Testing control using standing single leg lifts
  • Lunge stability testing (photo 5)
  • Prone propping into modified plank position gaining feedback on any pressure or weakness felt in the lower abdominal area, and if so, altering to 4-point kneeling testing alternate arm/leg options with control, bridge position hold.

Assessment for starting point

Each of these clients is likely to require a different starting point for their core fitness training, so checking their baseline will help you develop their program.

Assessment includes looking at:

  • Their level of lumbopelvic control, revealed through pelvic and trunk movement
  • The number of repetitions before poor movement patterns occur
  • Any patterns indicating poor control, such as:
    • Breath holding
    • Bulging of the abdominal wall
    • Excessive use of the external obliques or rectus abdominus
    • Pressure felt in their pelvic floor.

Before reaching for the medicine ball to do seated rotations, consider where the client’s weak points are, and what might show up for them if you loaded them up too much too soon.

Client A may be fine to reach for the medicine ball, but what about clients B and C?

Client B potentially has a weakened and stretched pelvic floor which may not be fully recovered two months after a difficult birth and big baby (over 4kg is a risk factor for pelvic floor problems). Baseline work to protect her recovering pelvic floor and build core control levels up include   monitoring any resistance or load applied. For example, seated ball control work using resistance band and single leg loading would allow her pelvic floor to be supported (watching for any breath hold strategies) and provides a position for resting between sets.

Client C may still have weakness in her lower abdominal wall that needs addressing specifically through single leg work in sitting or 4-point kneeling training where she can work to recruit the lower abdominal wall while adding leg movement as loading.

Each female client is going to have specific issues revealed through using core assessment tools which then equips you to target their core training, considering factors to prevent the risk of back, pelvic or pelvic floor issues while building function and control.

MORE?
To develop your expertise in building clients’ core fitness, CLICK HERE to find out more about Network’s 5-CEC course, 100 Steps to Plank.

Dianne Edmonds is a physiotherapist working in an Obstetric GP clinic, course creator and Women’s Health Ambassador at Australian Fitness Network and the Director of The Pregnancy Centre. She has worked in women’s health and fitness for 25 years and was integral in the development of the Pelvic Floor First resources.

Acknowledgements
Acknowledgement is made to Simone Kay from Train for Life, Cairns, and Stuart Frost, photographer for use of images.