This is a chapter 3 summary of the book “Movement” by Gray Cook.
You Down with SOP?
Unlike many other areas, movement does not have a standard operating procedure and is thus very subjective. Since movement is the foundation for all activity, it is important that we develop some type of standard for good movement.
Movement compensations are often unconscious, thereby making these patterns difficult to be cued away. It may be the case that less threatening movements and corrective exercise could be utilized to change undesired patterns.
When designing exercise, it is important to make them challenging as opposed to difficult. Difficulty implies struggling, whereas challenges are what test one’s abilities. Anyone can make something difficult, but not all can challenge.
Function of the FMS and SFMA
The goals of the functional movement systems are as follows:
1) Demonstrate if movement patterns produce pain within accepted ranges of movement.
2) Identify those without pain that are at high injury risk.
3) Identify specific exercises and activities to avoid until achieving the required movement competency.
4) Identify the best corrective exercise to restore movement competency.
5) Create a baseline of standardized movement patterns for future reference.
The difference between the FMS and SFMA is that the FMS assesses risk whereas the SFMA diagnoses movement problems.
The FMS operates in the following manner:
1) Rates and ranks nonpainful movements based on limits and asymmetries.
2) Identifies pain.
3) Identifies lowest ranking or most asymmetrical patterns; most primitive pattern if greater than one.
4) Find activities that may perpetuate the problem and take a temporary break from said activities.
5) Start a corrective strategy.
6) Reassess the test.
7) If improved keep strategy, if not recheck FMS.
8) Check exercise performance.
9) Use effective and properly paced progressions.
10) If changes occurs, retest FMS to establish norms and change corrections.
Whereas the SFMA operates as such:
1) Find dysfunctional nonpainful (DN) movements (the path) and functional painful movements (FP), which are the markers. Work on DN before FP.
2) Don’t breakdown functional nonpainful movements (FN).
3) Only breakout dysfunctional painful movements (DP) if other breakouts can’t be performed.
4) DN’s should show mobility or stability impairments that need to be addressed.
5) Check these impairments.
6) Check FP’s in loaded and unloaded positions; noting the lowest level in which pain is present.
7) Form working diagnoses based on info from DN’s.
8) Check for functional activities that could perpetuate the current complaint.
10) Reassess impairments.
11) Reassess pain breakouts. If changes occur at the lowest level, move up through the breakouts.
12) Reassess dysfunctional breakouts.
13) If baseline changes positively, keep chosen strategy.
Once the SFMA is clear, FMS at or near discharge.