Mobility, Stability, and the Like I recently attended the FMS Level 2 course after rocking the home study. In my quest to take every con ed course known to man, I got into the functional movement people because the idea of improving movement over isolation exercise interests me. I find the way they build up to the patterns very logical, namely because they liberally use PNF and developmental principles; and they do so quite eloquently. But really, I wanted to go to this class so I could meet and learn from Gray Cook. And his segments did not disappoint. While I may not agree with everything he says, he is a very brilliant man and knows movement. The only disappointment I have to say about this course was that I did not get enough Gray and Lee. I would say I probably saw them teach 30% of the time, with another FMS instructor just running us through their algorithms. I am sorry, but if you are going to advertise Gray Cook and Lee Burton as the instructors, then I want Gray and Lee instructing me! A lot of these exercises were review for me, but there were definitely some tweaks that I liked a great deal. I think if you are new to more motor control-based exercises, this course is great for you. Just make sure you are taking it from Gray and/or Lee. Why Screen? The FMS is predominately used to manage risk and prioritize exercise selection. They look
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Movement Chapter 7: SFMA Introduction and Top-Tier Tests
This is a chapter 7 summary of the book “Movement” by Gray Cook. Intro 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:
Read MoreMovement Chapter 6: Functional Movement Screen Descriptions
This is a chapter 6 summary of the book “Movement” by Gray Cook. Screening Keys The FMS is not considered a training or competition tool; it simply ranks movements. Here are the keys to a successful screen. First off, know the following bony landmarks Tibial tuberosity ASIS Lateral and medial malleoli Most distal wrist crease Knee joint line 3 repetitions are performed for each movement, and it is important to stand far away so the whole movement can be seen. When testing both sides, take the lowest score if an asymmetry is present. Here are the movements (videos courtesy of Smart Group Training). The Deep Squat Purpose: Full-body coordinated mobility and stability; linking the hips and the shoulders. Here is how it is done. Hurdle Step Purpose: Evaluate stepping and stride mechanics. Here is how it is done. Inline Lunge Purpose: Test deceleration and left/right function utilizing contralateral upper extremity patterns and ipsilateral lower extremity patterns. Here is how it is done. Shoulder Mobility Purpose: Evaluate scapulothoracic rhythm, thoracic spine and rib mobility. Here is how it is done. ASLR Purpose: Tests hip flexion, hip extension, and core function. Here is how it is done. Trunk Stability Pushup Purpose: Tests reflexive core stability. Here is how it is done. Rotary Stability Purpose: Check multi-planar pelvic, core, and shoulder girdle stability. Also looks at reflexive stability and transverse plane weight shifting. Here is how it is done. FMS Conclusions The FMS is designed to give a corrective pathway that may involve
Read MoreMovement Chapter 5: Functional Movement Systems and Movement Patterns
This is a chapter 5 summary of the book “Movement” by Gray Cook. In this chapter, Gray outlines the interconnectedness of the tests and outlines all of the different breakouts. The movements will be demonstrated in later chapters. FMS There are seven movements with different clearing examinations. 1) Deep squat 2) Hurdle step 3) Inline lunge 4) Shoulder mobility 5) Active straight leg raise (ASLR) 6) Trunk stability pushup 7) Rotary stability. The first three movements are often called the big 3, as they are functional movements that check core stability in three essential foot positions. The remaining four are considered fundamental movement patterns. Often these patterns are attacked before the first three. These screens can also be broken up into those that check symmetry and asymmetry: Symmetrical patterns Deep Squat Trunk stability pushup. Asymmetrical patterns Hurdle step Inline lunge Shoulder mobility ASLR Rotary stability. The way we work the FMS is by first attacking asymmetrical patterns before straight patterns, and primitive patterns before functional patterns. The FMS is scored on a four point ordinal scale with the following scoring criteria: 3 – Complete pattern 2 – Complete pattern with compensations/deviations 1 – Incomplete pattern 0 – Painful pattern. There are also three clearing tests that are either positive or negative for pain. 1) Impingement clearing test (shoulder mobility) 2) Prone pressup (trunk mobility) 3) Posterior rocking (rotary stability) The FMS works by creating several filters to catch for compensations and problems. 1) Pain – Signal to a problem. 2)
Read MoreMovement Chapter 4: Movement Screening
This is a chapter 4 summary of the book “Movement” by Gray Cook. What Be the Goal? Movement screening’s goal is to manage risk by finding limitations and asymmetries via two strategies; 1) Movement-pattern problems: Decreased mobility and stability in basic movements. 2) Athletic-performance problems: Decreased fitness. The FMS razor, akin to Occam’s razor, is to determine a minimum movement pattern quality before movement quantity and capacity are targeted. Movement patterns are lost by the following mechanisms: Muscular imbalance. Habitual asymmetrical movements. Improper training methods. Incomplete recovery from injury. 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.
Read MoreMovement Chapter 3: Understanding Movement
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. Changing Compensations 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
Read MoreMovement Chapter 1: Introduction to Screening and Assessment
This is a chapter 1 summary of the book “Movement” by Gray Cook. Intro 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. Screening 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
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