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:

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Movement 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

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Movement 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

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Movement Chapter 2: Anatomical Science Versus Functional Science

This is a chapter 2 summary of the book “Movement” by Gray Cook. Funky Muscles There are anatomically two basic types of muscles; shunt and spurt. Shunt muscles compress and produce structural integrity because the distal attachment is far from the moving joint. Spurt muscles produce movement because the distal attachment is close to the axis of rotation. While these two muscle types are present, they can vary depending on the function performed. For example, if we perform a movement in the closed chain, the spurt and shunt roles become reversed. Focusing on a single muscle group causes us to lack understanding of the supporting matrix behind superficial muscle action. Muscle function depends on body position and joint in action. We can see this point illustrated in Lombard’s paradox, which involves the coactivation of hamstrings and quadriceps when performing a sit to stand. These muscles are antagonistic to one another at their respective joints, yet movement is produced. The resultant effect is the quads and hamstrings becoming global stabilizers. Muscle activity is task specific, therefore Gray purports four types of muscles: 1)      Global Stabilizers: Multi-joint muscles contracting to produce stability and static proprioceptive feedback. 2)      Global Movers: Multi-joint muscles that produce movement and dynamic proprioceptive feedback. 3)      Local Stabilizers: Deep segmental muscles (1-3 segments) that produce stability and static proprioceptive feedback. 4)      Local Movers: Single joint muscle that produce movement and dynamic proprioception. These different muscle types require different training modalities.  The example given is stabilizer muscles. These muscles cannot

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Movement 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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