Am/Pm Pain Pattern Assessment for Personal Trainers

Personal trainers are NOT physical therapists, so we don’t treat pain. But, most people have some aches or pains from past injuries to sleeping wrong to just getting older, which is very normal and doesn’t make you a rehab patient. That said, as a personal trainer, understanding yours or your client’s AM or PM pattern can give you important insights on how to design a safe and effective training program.

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Put simply, a Different (Am vs. Pm) Pain Pattern =  A Different Strength Training approach

Here’s Dr. Carl DeRosa (at 2012 Northeast Seminars Hip & Trunk Symposium) discussing the AM vs. PM Pattern and how we should proceed with strength training program for each case:

At Performance U, part of our Personal Trainer assessment is asking our clients the simple and easy question: When do you get your pain? Now, (after watching the video) you know how and why asking that simple question really helps us to determine a safe training approach based on individual needs.

Sure, some people have pain throughout day. But, that’s a different situation. And, further reinforces the importance of asking some one who gets pain: Are there times of the day where it’s worse or better? Or course, your clients will know and usually tell you before you ask anyway.

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A Movement Screen done in the AM could have different scores than one done in the PM!

The lessons Dr.DeRosa gave us (above) also go to show there’s way more to assessments than just watching a few movement patterns. Heck, based on the AM/PM pattern; you could get drastically different results depending on what time of day you give someone a movement assessment. In that, if they’re an AM pain person – They may very well tell you that certain movements hurt them, where those very same movements wouldn’t hurt them if the assessment was done in the evening.

In other words, if you don’t first find out (by simply asking) about someone’s AM/PM pain pattern, you’d likely get two different scores to your movement assessment depending on when you did the assessment. And, you may end up wasting your and your clients valuable training time and investment.

Coaching Tip: If we find out you’re an AM pain person, we’ll do our movement assessment in the PM. And vice versa.

Additionally, as Dr.Derosa eluded to in the video above, not all pain is a motor control issue. Sometime you just have inflammation (from, lets say, arthritic changes), and other times you may just be losing the fight against gravity throughout the day and could use some actual STRENGTH TRAINING exercises, not just low load “corrective” stuff.


Bio: Carl DeRosa is Professor of the Physical Therapy at Northern Arizona University and co-owner of DeRosa Physical Therapy in Flagstaff, Arizona. He has co-authored several textbooks including Perspectives in Functional Anatomy series which includes Mechanical Low Back Pain, Mechanical Neck Pain, and Mechanical Shoulder Pain, in addition to several textbook chapters, journal articles, and two home study series.

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