Movement Chapter 1: Introduction to Screening and Assessment

This is a chapter 1 summary of the book “Movement” by Gray Cook.


This chapter’s central point, and for that matter the whole book, is that movement needs to standardized just like all other therapeutic and performance measures. Movement is fundamental to who we are.

Despite movement being at our center, we continually classify patients and clients by body region. Unfortunately through this reductionism, much is lost. We cannot measure parts and expect that to give us an adequate picture of the whole.

Like Preparation H, Movement feels good on the Whole


Before we begin training, it is advocated that movement be screened to facilitate an optimal training environment. The screen will determine movement as one of the following three areas:

1)      Acceptable

2)      Unacceptable

3)      Painful

Movement is screened for many reasons. Gray often states that the number one risk factor for injury is previous injury. A movement screen helps find potential risk factors for re-injury. Moreover, if movement is dysfunctional, then all things built on that dysfunction could predispose one to more risk.

The screen also helps separate pain from movement dysfunction. It is widely known that when one undergoes a pain experience, motor control is altered. Because motor control is altered, we may not get the desired training effect secondary to pain. Pain screening gives us an avenue for further assessment a la the Selective Functional Movement Assessment (SFMA).

Movement screening is the first step away from quantitative analysis to movement quality; from reductionism to holism. Once we have a basic movement map we can take a look at quantity. This framework also helps us better understand the person in front of us, as humans tend to operate in patterns and sequences.

Someday I hope this is what things look like when I see a patient or client.

Reductionism creates a paradox between movement and motion. If we assume that a joint has full motion, then by reductionism movements involving the joint will be normal. This thought is often not the case. That is because movement requires motor control, which is the combination of stability, balance, postural control, coordination and perception.

Function vs. Anatomy

It is important to understand the function and anatomy do not always correlate.  Take weakness for example. Weakness can occur for a variety of reasons:

1)      Muscle inhibition.

2)      Dysfunctional stabilizers.

3)      Poor agonistic function.

4)      Increased tone.

The above three examples cannot change weakness based on strengthening alone. If you take tone for example, it is often present to protect the person from accomplishing a task. Muscles do not tighten just because.

Mobility before Stability

When treating movement dysfunction, it is important to first decrease mobility restrictions as able. Once we have established normal mobility, we can cement that new range with stability training. When mobility returns, there is a short window for motor control to be re-established. However, the appropriate stability training dosage must be given. If we go too hard, stiffness will return; but if we do not go hard enough, the pattern will not change. We are essentially hitting the reset button, then reprogramming new software.

Sometimes restarting things just works.

Five Principles of Functional Movement Systems Logistics

Here are the 5 movement tenets per Gray.

1)      Basic bodyweight movements should not provoke pain.

2)      We should not have gross fundamental movement limitations, even if pain-free. For this deficit will lead to substitution and compensation, which will decrease efficiency, which will lead to secondary problems, which will increase injury risk.

3)      Establish movement fundamentals before performance.

4)      Establish fundamental movement before complex movements/skills.

5)      Movement patterns should be mostly symmetrical.