As chiropractors, we learn to assess, diagnose and treat conditions
of the spine and extremities that cause pain, dysfunction and disease.
As sports chiropractors, we take a step further by integrating
rehabilitation, physiotherapy, sports-performance training and nutrition
to provide a comprehensive approach to our patients. Often our focus is
primarily on the location of pain, when it also needs to be seen as a
messenger or signal.
The potential exists to become
myopic, focusing on one body part as being the problem versus thinking
in terms of movement patterns for the entire body and prescribing
specific corrective exercises or treatment that addresses a significant
dysfunction. Movement, especially moving well and often, is at the heart
not only of our early growth and development; it also remains a central
issue throughout our lives, especially for aging athletes and patients.
The Functional Movement Screen
In
rehabilitation, sports medicine and sports-performance training, much
is talked about "functional" and "core" training. Often the "What comes
first: the chicken or the egg?" question arises when defining the topic
of function and how it relates to determining what is a priority;
mobility or stability. One of the most valuable tools in addressing this
question and assessing "weak links" in the kinetic chain is the
Functional Movement Screen developed by Gray Cook, MSPT, and Lee Burton,
PhD. The Functional Movement Screen or FMS grades seven different
movement patterns to assess mobility, stability, balance, symmetry and
proper movement sequence or patterns.
One
way to look at how we function and perform is to visualize a
three-layered pyramid that separates first function, then strength/
power performance, and finally sport-specific skills. Think of the
rectangular base of a pyramid that defines how well the patient's or
athlete's body functions in terms of mobility, stability, balance,
symmetry and proper movement patterns. This base is the widest part of
the pyramid and upon which all else is built. In the middle is a layer
of strength and power performance and on top are specific
sports-performance skills.
Often
fitness is "piled" onto dysfunction without addressing the functional
base of the athlete's "pyramid." This is where potential trouble begins
and is a reason patients enter our offices. Many talented athletes can
perform at a high level because they are such good compensators.
However, they are an injury or accident ready to happen because they are
working around a pre-existing problem and simply are not aware or
neglect to train their functional weaknesses before beginning their
strength and conditioning programs. As Gray Cook says in his book
Movement: Functional Movement Systems, "Movement is how we survive,
communicate, recreate and thrive." The performance pyramid applies to us
all if we are to function well not only in sports, but also our daily
activities.
The FMS: Seven Tests
The
following tests serve as brief descriptions of the Functional Movement
Screen. The screen takes about 10 minutes to perform and is easily
integrated into your treatment schedule with your patients. The seven
tests of the FMS are each graded 0-3 with a total score of 21 possible.
If during any of the movements there is pain, 0 is the score and that
particular issue is addressed with appropriate treatment modalities
after the entire screen is performed. If one of the tests is performed
perfectly, it is graded a 3. A minimum of two points for each of the
seven tests (total score of 14) is the minimum to participate in
strength training or athletics. A score under 14 increases probability
of injury and decreased performance.
The
first screen is the Deep Overhead Squat Movement Pattern. It
demonstrates fully coordinated ankle, hip and thoracic spine mobility
and core stability with the hips and shoulders functioning in
symmetrical positions. (By the way, this test is critical especially for
your golfers.)
The second screen is
the Hurdle Step Movement Pattern Test. It is designed to challenge the
body's proper stepping and stride mechanics, as well as stability and
control in single-leg stance. This is really helpful in determining
symmetry left and right side while assessing hip mobility and balance.
The
third screen is the In-Line Lunge Movement Pattern Test. This provides a
quick appraisal of left and right function in a basic pattern and is
intended to place the body in a position that will focus on the stresses
as simulated during rotation, deceleration and lateral-type movements.
This test is done with the patient balancing on a 2x6-inch board with
their feet in line and while maintaining perfect posture.
The
fourth screen is a Shoulder Mobility "Reaching" Movement Pattern Test.
This test demonstrates the natural complementary rhythm of the
scapular-thoracic region, thoracic spine and rib cage with reciprocal
upper-extremity shoulder movements. In other words, you are really
testing thoracic spine mobility in addition to glenohumeral movement and
scapular stability.
The fifth
screen is the Active Straight-Leg-Raise Movement Pattern Test. This is
an "apparently" simple test that has the patient supine on the ground
and identifies active mobility of the flexed hip and initial and
continuous core stability while the opposite hip remains extended and
flat on the ground. Don't be fooled by the simplicity of this test, as
it also demonstrates the ability to disassociate the lower extremities
while maintaining stability in the pelvis and core.
The
sixth screen is the Trunk Stability Push-Up Movement Pattern Test. It
is used as a basic observation of reflex core stabilization and is not
used as a measure of strength, since only one repetition is required.
The goal is to initiate movement with the upper extremity without
allowing movement of the hips or pelvis.
The
seventh and last screen is the Rotary Stability Movement Pattern Test
and it is a complex movement, requiring proper neuromuscular
coordination and energy transfer from one segment of the body to another
through the torso. It has roots in the basic creeping pattern that
follows the crawling pattern in the developmental sequence of normal
human growth and locomotion. It looks like a bird dog, horse stance or
whatever you want to call getting on all fours!
The
purpose is to find the weak links in your patients and alleviate them
with specific corrective exercise strategies. When this occurs, the
individual or athlete will have greater movement efficiency, which will
lead to improved performance and a decrease in injury potential.
The
Functional Movement Screen is designed for the individual who is not in
pain or has an obvious injury. It can be easily integrated for all
patients to provide a continuum of care and rational reason to continue
with treatment, even when pain or injury has resolved. The Selective
Functional Movement Assessment (SFMA) is a different and complimentary
screen designed for the patient who has pain and requires a more
in-depth treatment protocol. The SFMA will be described in a future
article.
Skip George
dr.george@sbcglobal.net
Source: http://www.sharewellnewswire.com/know-about-the-functional-movement-screen-2318.htm/#ixzz22ymyLJz6
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