You shed that mindset with the game on the line. You must do all in your power to get that player back on the court tonight, expediting the return process to the nth degree.
I had a problem.
Figuring out the most efficient way to treat an ankle sprain was needed to help our team succeed. I searched the literature, therapeutic outskirts, and tinkered in order to devise an effective protocol.
The result? We had 12 ankle sprains this past season. After performing the protocol, eight were able to return and finish out the game. Out of the remaining four, three returned to full play in two days. The last guy? He was released two days after his last game.
It’s a tough business.
The best part was we had no re-sprains. An impressive feat considering the 80% recurrence rate¹. Caveats aside, treating acute injuries with an aggressive mindset can be immensely effective.
After wiping the tears and coming to the stark realization of our (ir)relevance in performance, we must ask where do we fit in? Do we matter?
I’ve asked myself this question many times. It is hard to answer when tactical over-utilization begets repetitive stress injuries; a poor night’s sleep, Slurpies, and donuts make someone ill; or a contact play ends a career. What could I have done differently? What was my role?
Though these questions have required skill development in special physical preparedness, sports science, and stress management; improving general qualities is pertinent in certain scenarios. It is these times in which rehab and training is of utmost importance, and we regain our relevance.
This is a chapter 7 summary of the book “Movement” by Gray Cook.
The SFMA’s goal is to assess functional capabilities. This system is based on Cyriax differentiation and grading principles. Instead of describing things as strong, weak, painful, or painless; the following descriptors are utilized:
Functional nonpainful (FN): Unlimited movement and able to complete a breath cycle at end-range. Called the dead end.
Functional painful (FP): Called the marker, reassessed.
Dysfunctional nonpainful (DN): Limited, restricted, impaired mobility, stability, or symmetry. Labored breathing with movement also implicates this choice. Called the pathway, where treatment occurs.
Dysfunctional painful (DP): Called the logical beehive because we do not know if pain is causing poor movement or vice versa. It is an unreliable place to work unless acute situations.
SFMA corrective and manual therapy lie in treating the FP’s and DN’s. The order at which things are treated also matters, so the order listed below for the top tier tests is also typically where treatments should hierarchically begin.
Cervical spine patterns (CSP)
Upper extremity patterns (UEP)
Multi-segmental flexion (MSF)
Multi-segmental extension (MSE)
Multi-segmental rotation (MSR)
Single leg stance (SLS)
Overhead deep squat (ODS)
We then operate the SFMA in the following fashion:
Ideally, the FMS would be part of the basic tests performed when one is looking to participate in sport. Prior to any athletic engagement, a medical exam is performed to clear someone to participate. This exam is often followed by performance and skills tests. Gray feels that the FMS belongs between these two tests, as there is an obvious gap from basic medical screening to high performance.
It is not to say that we must only train movement patterns. Rather, all the above qualities can be trained in parallel. The real goal is to manage minimums at each level and make sure improving one does not sacrifice quality at the others.
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.