How to Get the Most from Your Client Assessments

By Lynne Olsen for Yoga Medicine.

As movement professionals who work one-on-one with clients, it’s important to conduct assessments that provide us with valuable information. Our ability to support our clients is only as good as our ability to gather useful information. Enter the assessment process. Here are some steps to get the most out of your assessments.

Assessments generally include two main parts; subjective, or what they tell you, and objective, or what you observe. Subjective information is your client’s self-report of factors like the onset of the condition, palliation (what makes it worse or better), quality of sensations (dull, sharp, electric), and timing of those sensations (is it better in the morning or worse). This part of the assessment process may feel natural to yoga teachers accustomed to connecting with their students. As you ask, also be sure to listen. Sometimes listening is the most potent part of the client-interaction and the most helpful thing that you can offer.

Ask & Listen

Yoga Medicine offers a wonderfully comprehensive intake form. With an acronym that’s easy to remember (OPQRST), it provides a great framework for getting to know the reason your client is there. It helps you establish their Chief Complaint, Onset, Palliation, Quality, Region, Severity, Time. As they tell you about their experience, try to keep facial expressions and reactions neutral. As part of the asking process, ask them if they have any questions for you! It’s all part of the rapport- building process.

The other half of the assessment equation comes from your observations of your clients movements and posture. If posture assessments are new to you, this can seem like a daunting process. Here is how I’ve addressed the complexities of client assessments.

Set Expectations

I always send new clients an email detailing what they should expect of our first meeting. I tell them about how the process works by explaining that we’ll start with a chat and then I’ll take them through assessments. I explain that I’ll use what they tell me and what I observe to create a personalized program for them. I ask them to dress in comfortable clothing that allows them to move and that is not too tight or baggy. I also include a health history questionnaire, a waiver, and information on my pricing.

Give them, and yourself, some time to settle in.

A yoga studio can be a foreign environment to some. When my client arrives, I offer them tea and we find a comfortable, private place to talk. At first I did this so that my client would have some time to acclimate to their new, potentially scary landscape. Then I realized that this tapered approach also gave me time to get comfortable with them. This is also a great time to begin observing your client! Watch as they walk in, move around, stand, lean, and sit.

Ask (more), watch, and then test with permission.

For the static posture assessment, have your client stand with their feet about hip distance apart and their arms by their sides. Pay particular attention to the 5 kinetic chain checkpoints: feet/ankles, knees, hips/low back, shoulders, and head. Look for any postural deviations that might contribute to, or result from, your client’s chief complaint. Examples include collapsed ankles or pronated feet, knocked or internally rotated knees, and excessive cervical extension or forward head. Also look for asymmetries like an elevated shoulder or one arm more internally rotated. Maybe they’re not putting equal weight on both legs or their clothes are bunching on one side more than the other. View them from all sides.

Since posture is also a dynamic quality, it’s important to observe your client while they’re in motion. For dynamic postural assessments, choose movements that pertain to the issue at hand, don’t elicit pain, and relate to basic functions like squatting and balancing. I like the Overhead Squat Assessment because it can convey a lot of information in a single movement pattern. It’s also relatively accessible. To assess balance and hip function, I like a simple march in place. Depending on your client’s needs, you might have them mirror simple movements like shoulder abduction or turning their head side-to-side. Keep asking if anything hurts or is uncomfortable and, if so, have them stop and point to the painful area.

Hands-on evaluations like the Trendelenburg test and Ely test can be very helpful tools in evaluating strength and range of motion. As with any manual adjustments you would offer in class, get permission before you touch your client. Start with an evaluation that you’ve done or practiced before. For example, if I know my client is coming for help with low back pain, I’ll choose two evaluations, review the possible outcomes and then practice them on a friend or family member before I meet my client. Yoga Medicine’s orthopedic modules cover several helpful evaluations for the spine, shoulders, and hips. Our job is not to diagnose, but to gather as much information as possible.

Putting It All Together

When you’re working with your client, if you’re not sure about the meaning of what you see, take good notes and then do some research when you’re done. You don’t have to have all of the answers in that first session. Again, you’re just gathering information. If, like me, you’re not enamored with hands-on assessments, keep practicing. With time, if you’re still not comfortable with them, that’s ok. There’s a lot to be learned from watching your client move. Practice watching people at the grocery store and in your classes. With time, you’ll be able to pick out common postural deviations and with continued education, know how to correct them.

Remember that the program you design for your clients is only as good as the information you gather in the assessment and your ability to interpret it. In order to get the full picture, you need to be proficient at asking, listening, and watching. Information gathering doesn’t end with the first session. Watching your client’s movements progress can be hugely rewarding for both you and your client. The initial assessment is just the beginning.

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