NASM essentials of sports performance training
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NASM essentials of sports performance training

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offering insights into the athlete\u2019s past, present, and perhaps their future.
The assessment covers information regarding the athlete\u2019s cardiorespiratory fitness, strength,
power, and movement abilities as well as past and present medical history. Essentially, the as-
sessment offers a view of the current structure and function of an athlete.
A fundamental representation of an athlete\u2019s goals, needs, and status can be created through
the sports performance assessment. From this profile of status, needs, and goals, an integrated
sports performance program is individualized specifically for each athlete. When conducting
these assessments, it is essential to utilize a variety of observation methods in order to obtain a
balanced overview of an athlete (Fig. 3.1).
Keep in mind that the program you design for your athlete is only as good as your assessment!
The more information you know about your athlete, the more individualized the program.This en-
sures the safety and effectiveness of the program.
General and 
medical history
FIGURE 3.1 Components of a sports performance assessment.
Types of Subjective Information Provided in a
Sports Performance Assessment
The first step in the sports performance assessment is the athlete\u2019s personal medical history.
Gathering personal background information about an athlete can be very valuable in gaining an
understanding of the athlete\u2019s physical condition and can also provide insight into what types of
imbalances they may exhibit. One of the easiest methods for gathering this information is
through the Physical Activity Readiness Questionnaire (PAR-Q) (Fig. 3.2), which was designed to
help determine if a person is ready to undertake low-to-moderate-to-high activity levels (1). Fur-
thermore, it aids in identifying people for whom certain activities may not be appropriate or who
may need further medical attention.
The PAR-Q is directed toward detecting any possible cardiorespiratory dysfunction, such as
coronary heart disease, and is a good beginning point for gathering personal background infor-
mation concerning an athlete\u2019s cardiorespiratory function. However, it is only one component of
a thorough sports performance assessment. Although this information is extremely important,
asking other questions can provide additional information about an athlete. This includes ques-
tions about an athlete\u2019s medical history.
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The medical history (Fig. 3.3) is absolutely crucial. Not only does it provide information about
any life-threatening chronic diseases (such as coronary heart disease, high blood pressure, dia-
betes, etc.), it also provides information about the structure and function of the athlete by uncov-
ering important information such as past injuries, surgeries, imbalances, and chronic conditions.
Inquiring about an athlete\u2019s past injuries can illuminate possible dysfunctions. One of the best
predictors of future injuries is past injury; an athlete with a previously strained hamstring is 6 to 8
times more likely to suffer another strain. There is a vast array of research that has demonstrated
the effects of past injuries and the function of the human movement system. Beyond the risk
Questions Yes No
Has your doctor ever said that you have a heart condition and that 
you should only perform physical activity recommended by a doctor?
Do you have a bone or joint problem that could be made worse by a 
change in your physical activity?
Do you feel pain in your chest when you perform physical activity?
Do you lose your balance because of dizziness or do you ever 
lose consciousness?
Is your doctor currently prescribing any medication for your blood 
pressure or for a heart condition?
In the past month, have you had chest pain when you were not 
performing any physical activity?
Do you know of any other reason why you should not engage in
physical activity?
If you have answered \u201cYes\u201d to one or more of the above questions, consult your physician
before engaging in physical activity. Tell your physician which questions you answered
\u201cYes\u201d to. After a medical evaluation, seek advice from your physician on what type of
activity is suitable for your current condition.
FIGURE 3.2 Sample Physical Activity Readiness Questionnaire (PAR-Q).
Questions Yes No
Have you ever had any pain or injuries (ankle, knee, hip, back, 
shoulder, etc.)? (If yes, please explain.)
Are you currently taking any medication? (If yes, please explain.)
Have you ever had any surgeries? (If yes, please explain.)
Has a medical doctor ever diagnosed you with a chronic disease, such
as coronary heart disease, coronary artery disease, hypertension (high
blood pressure), high cholesterol or diabetes? (If yes, please explain.) 
FIGURE 3.3 Sample questions: athlete\u2019s medical history.
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of suffering the same injury again or compensating for an incompletely rehabilitated injury lead-
ing to another (possibly more serious) injury, a prior injury can also have effects up and down
the kinetic chain:
1. Ankle Sprains: Ankle sprains have been shown to decrease the neural control to the gluteus
medius and gluteus maximus muscles. This, in turn, can lead to poor control of the lower
extremities during many functional activities, which can eventually lead to injury (2\u20135).
2. Knee Injuries Involving Ligaments: Knee injuries can cause a decrease in the neural control
to muscles that stabilize the patellofemoral and tibiofemoral joints and lead to further
injury. Noncontact knee injuries are often the result of ankle and/or hip dysfunctions.
The knee is caught between the ankle and the hip. If the ankle or hip joint begins to func-
tion improperly, this results in altered movement and force distribution of the knee. Over
time, this can lead to further injury (6\u201314). 
3. Low-Back Injuries: Low-back injuries can cause decreased neural control to stabilizing
muscles of the core, resulting in poor stabilization of the spine. This can further lead to
dysfunction in upper and lower extremities (15\u201322). 
4. Shoulder Injuries: Shoulder injuries cause altered neural control of the rotator cuff muscles,
which can lead to instability of the shoulder joint during functional activities (23\u201326).
5. Other Injuries: Injuries that result from human movement system imbalances include
repetitive hamstring strains, groin strains, patellar tendonitis (jumper\u2019s knee), plantar
fasciitis (pain in the arch of the foot), posterior tibialis tendonitis (shin splints), biceps
tendonitis (shoulder pain), and headaches.
All of the aforementioned past injuries should be taken into consideration while assessing
athletes, as the mentioned imbalances will manifest over time, unless proper care has been given.
But remember, at best, an athlete can recall only half of their injury history, mostly the severe in-
juries. So a close examination of imbalances by the Sports Performance Professional can turn up
areas of potential risks.
Surgical procedures create trauma for the body and may have similar effects to those of an injury.
They can create dysfunction, unless properly rehabilitated. Some common surgical procedures
\u2022 Foot and ankle surgery
\u2022 Knee surgery
\u2022 Back surgery
\u2022 Shoulder surgery
\u2022 Cesarean section for birth (cutting through the abdominal wall to deliver a baby)
\u2022 Appendectomy (cutting through the abdominal wall to remove the appendix) 
In each case, surgery will cause pain and inflammation