Course Notes: FMS Level 2

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.

The whole weekend was kinda like this.
The whole weekend was kinda like this.

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.

Mad props to this fellow.
Mad props to this fellow.

Why Screen?

The FMS is predominately used to manage risk and prioritize exercise selection. They look at fundamental movement patterns to rule in/out asymmetries and dysfunctions, which ultimately allow someone to safely train in the weight room.  If you are unfamiliar with the FMS, check out this previous post from my review of the Movement Book

Lee Burton mentioned that his goal is to look for 0’s and 1’s; once we get to 2’s we’re good to go. This number ensures we have movement compentency as opposed to excellence, which is a requisite to loading these movements.

One thing I will say positively about this group is that they are all for doing and testing whatever you want, as long as you are consistent. But if you plan on doing the FMS, the research is done in the same manner taught in the home study course and the Movement Book.

Prioritizing Correctives

Within the FMS model, we choose corrective exercise based on a particular hierarchy. Mobility impairments are attacked first via the active straight leg raise (ASLR) and shoulder mobility (SM) tests. From those two screens, ASLR is first corrected. We go after this part first because developmentally we have leg control before we do arm control. Moreover, ASLR is purely sagittal plane, versus the triplanar shoulder screen.

Once we get good mobility, we then work on developing improved motor control via rotary stability (RS) and trunk stability pushup (TSP); done in that order.

Once these areas are squared away, we go after functional patterns. We first hit the inline lunge (ILL), then the hurdle step (HS), then the deep squat (DS).

Followed by this
Followed by this

In-depth Screening

The FMS actually started incorporating more movements to look at once you get into level 2, which eerily look like the SFMA. Likely because it is the SFMA 🙂 Here is where to screen next once you get past the basics.

  • ASLR –> Toe Touch –> crocodile breathing
  • SM –> Cervical ROM–> Impingement testing –> AC impingement testing –> Seated T-spine rotation –> Grip screen –> Crocodile breathing
  • RS –> Spinal flexion clearing –> Crocodile breathing –> Upper body rolling –> Lower body rolling
  • TSP –> Spinal extension clearing –> Crocodile breathing
  • ILL –> Ankle mobility (goal is 40 degrees in half-kneeling)
  • HS –> Ankle mobility
  • DS –> Ankle mobility –> Toe Touch

Let’s Correct

The corrections for each movement progress from mobility, to static motor control, to dynamic motor control, and finally strength. Here were some of my favorite correctives for each screen (Many videos courtesy of the IFAST folks).

ASLR

Mobility work goes after the hip flexors and performing leg-lowering patterns.

Static motor control involves working in half-kneeling, and dynamic involves patterning from double leg to single leg deadlifts. One of my favorite correctives was utilizing RNT to facilitate the lats during deadlifts.

I also liked the way he patterned the deadlift by using a squat to get into the position

Once you get the deadlifts down, load-up for strength

SM

Mobility predominately went after the t-spine via various rib-rolls and such:

Motor control involved deadlifts again, as well as various drills that involve shoulder packing:

We can progress these drill dynamically to armbars, get-ups, pushups, working toward a press in the horizontal and vertical planes. And of course, don’t forget the beastly real row:

RS

The correctives usually build on from previous one’s the further you go in the screen. Mobility involves rib rolls and ASLR derivatives. Eventually you work toward quadruped and bird-dog activities.

Once you get past the easy stuff, we go into rolling a la SFMA, with the hard-roll being next in line (Thank you Perry Nickelston):

We can then progress to single leg deadlifts, presses, and pulls.

TSP

Mobility work involves hip flexors and half-kneeling. We go after motor control via planks, mountain climbers, and quadrupedal activities. From here, we just go into pushup progressions; culminating into various presses.

ILL

The big mobility work goes after hip flexors and calves. With the famous brettzel stretches being incorporated here:

Motor control exercises go from half-kneeling building up to lunge variations. Eventually, we will load these patterns.

HS

Mobility work builds further onto previous exercises; leg lowering, ASLR, dorsiflexion. We also go into stride stretches, which are basically mobilizations in a hurdle-step position.

Motor control goes from half-kneeling to single-leg chops and lifts, all the way to single leg deadlifts. The ultimate strength exercise for this pattern is step-ups

DS

Mobility work goes after ankle dorsiflexion, hip flexors, and any SM corrections.

Motor control involves working in tall-kneeling (foam roller behind to cue upright posture) and progressing from deadlifts to squats

Eventually we work toward performing an overhead squat.

Other random exercises

I also liked how Gray added some nice tweaks to the Turkish get-up which you will see below:

“Gray”te Quotes…Get it? It’s funny because I combined Gray Cook with the word great…just read on

  • “Tightness and fatigue feel the same way.”
  • “If I could pick four exercises to do, they would be chops, lifts, deadlifts, and Turkish Get-ups.”
  • “Your people with total hips and total knees should get up from the floor.”
  • “Stabilizers have to be fast, not strong.”
  • “Everyone develops differently.” (Haha DNS)
  • “3 degrees of extra mobility leads to 300 degrees of increased proprioception.”
  • “The best entertainment you can get is results.”
  • “There’s a difference between good and bad and good and can’t.”
  • “We’re not laying down new motor programs, we’re getting old ones back.” (This was from Lee)
  • “First step in correctives is to remove the negatives.” (Also from Lee)
  • “Any wasted rep is costing you success.”
Please remove the negatives.
Please remove the negatives.

 

Chapter 15: In Conclusion

This is a chapter 15 summary of the book “Movement” by Gray Cook.

The Goal

The goal of movement retraining is to create authentic unconscious movement at acceptable levels. We can develop many methods to achieve our goals, but working under sound principles is paramount. Some of the principles Gray advocates include:

  • Focusing on how we move.
  • Look to movement to validate or refute your intervention.
  • Movement is always honest.
Of course I did my corrective exercise, I swear.
Of course I did my corrective exercise, I swear.

When designing a movement program, we must operate under the following guidelines:

  • Separate pain from dysfunctional movement patterns.
  • Starting point for movement learning is a reproducible movement baseline.
  • Biomechanical and physiological evaluation do not provide a complete risk screening or diagnostic tool for comprehensive movement pattern understanding.
  • Our biomechanical and physiological knowledge surpass what we know about fundamental movement patterns.
  • Movement learning and relearning follows a hierarchy fundamental to the development of perception and behavior.
  • Corrective exercise should not be rehearsed outputs. Instead, it should be challenging opportunities to manage mistakes on a functional level near the edge of ability.
  • Perception drives movement behavior and movement behavior modulates perception.
  • We should not put fitness on movement dysfunction.
  • We must develop performance and skill considering each tier in the natural progression of movement development and specialization.
  • Corrective exercise dosage works close to baseline at the edge of ability with a clear goal.
  • The routine practice of self-limiting exercises can maintain the quality of our movement perceptions and behaviors and preserve our unique adaptability that modern conveniences erode.
  • Some things cannot be fixed, but change what you can.
  • The brain that learns function can learn dysfunction.
  • Be safe, be satisfied, and play.
I can always tell when movement is sassified.
And I can always tell when movement is sassified.

Chapter 14: Advanced Corrective Strategies

This is a chapter 14 summary of the book “Movement” by Gray Cook.

Inputs

Corrective exercise is focused on providing input to the nervous system.  We are allowing the patients and clients to experience the actual predicament that lies beneath the surface of their movement pattern problem. It is okay for mistakes to be made, for these errors help accelerate motor learning. Minimal cueing should be utilized, as we want to patient to let them feel the enriching sensory experience.

Mistakes are good...I wouldn't be here without them.
Mistakes are good…I wouldn’t be here without them.

Motor Program Retraining

There are several different methods in which we can achieve a desired motor output.

1)      Reverse patterning – Performing a movement from the opposite direction.

2)      Reactive neuromuscular training – Exaggerating mistakes so the patient/client overcorrects. Use oscillations first, followed by steady resistance.

3)      Conscious Loading – Using load to hit the reset button for sequence and timing.

4)      Resisted exercise – Makes patterns more stable and durable.

When you can deadlift that much, most anything is stable and durable.

Movement Chapter 13: Movement Pattern Corrections

This is a chapter 13 summary of the book “Movement” by Gray Cook.

Back to the Basics

Mobility deficits ought to be the first impairment corrected. Optimizing mobility creates potential for new sensory input and motor adaptation, but does not guarantee quality movement. This is where stability training comes in. In order for the brain to create stability in a region, the following ought to be present:

  • Structural stability: Pain-free structures without significant damage, deficiency, or deformity.
  • Sensory integrity: Uncompromised reception/integration of sensory input.
  • Motor integrity: Uncompromised activation/reinforcement of motor output.
  • Freedom of movement:  Perform in functional range and achieve end-range.
FREEDOM!!!! Of movement. And if the Road Warrior says we need to move free I listen.

Getting Mobility

There are 3 ways to gain mobility:

1)      Passively: Self-static stretching with good breathing; manual passive mobilization.

2)      Actively: Dynamic stretching, PNF.

3)      Assistive: Helping with quality or quantity, aquatics, resistance.

Getting Stability

In order to own our new mobility, we use various stability progressions to cement the new patterns. There are three tiers in which stability is trained:

1)      Fundamental stability – Basic motor control, often in early postures such as supine, prone, or rolling.

2)      Static stability – done when rolling is okay but stability is compromised in more advanced postures.

3)      Dynamic stability – Advanced movement.

We progress in these stability frames from easy to further difficult challenges.

Assisted → active → reactive-facilitation/perturbations

I would black my face out to if someone was having me do this exercise.
I would black my face out too if someone was having me do this exercise.

Since stability is a subconscious process, we utilize postures that can challenge this ability while achieving desired motor behavior. We can also group the various postural progressions into 3 categories:

1)      Fundamental – Supine, prone, rolling (requires unrestricted mobility).

2)      Transitional – Postures between supine and standing such as prone on elbows, quadruped, sitting, kneeling, half-kneeling.

3)      Functional: Standing variations to include symmetrical and asymmetrical stance, single leg stance.

The only legit way to practice single leg stance.

Movement Chapter 10: Understanding Corrective Strategies

This is a chapter 10 summary of the book “Movement” by Gray Cook.

Mistakes, I’ve Made a Few

When we are talking corrective exercise design, people often make 4 mistakes:

1)      Protocol approach: Exercise based on category.

Problem – 1 size fits all.

2)      Basic kinesiology: Target prime movers and some stabilizers.

Problem – fails on timing, motor control, stability, and movement.

3)      Appearance of functional approach – Use bands and resistance during functional training.

Problem – If the pattern is poor, adding challenges to it can increase compensation. There is also no pre-post testing.

4)      Prehabilitation approach – Prepackaged rehab exercises into conditioning programs as preventative measures to reduce injury risk.

Problem – Design is based on injuries common to particular activities as opposed to movement risk factors.

Several, so it seems.

There are also certain mistakes that are often made when utilizing the FMS and SFMA:

1)      Converting movement dysfunction into singular anatomical problems.

2)      Obsessing over perfection in each test instead of identifying the most significant limitation/asymmetry.

3)      Linking corrective solutions to movement problems prematurely.

The overarching rule is to address these movement deficiencies first, as we do not want to put strength or fitness on top of dysfunctional movement.

 

The Performance Pyramid

When designing an exercise program, we look for three areas to improve performance: Movement, performance, and skill.

performance pyr

It is important that program design is based on the individual’s needs and has these qualities in a hierarchal fashion. For example, if one performs excellent on functional performance capabilities but has poor foundational movement, injury risk may increase.

 

Program Design

When implementing corrective exercise, it is important to provide the correct stimulus amount. We want the individual challenged, but not struggling for dear life.

  • Too easy – >30 reps with good quality.
  • Challenging, but possible – 8-15 reps with good quality and no stress breathing. There is a decline in quality secondary to fatigue towards the end of rep ranges.
  • Too difficult – Sloppy from the beginning and only worsens.

Rarely does increasing difficulty equate to increasing resistance. Oftentimes you may advance the exercise position, decrease the base of support, or add more movement complexity.

You may have to remove some activities that feed into dysfunction from one’s current programming, lest you wish to not change the movement pattern. Often how quickly one changes his or her ability to move depends on how diligent one is with corrective exercise.

Realize that corrective exercise should only be supplemental and temporary to what one is doing. It is supposed to be corrective in nature, not preventative.  Moreover, movement scores can decrease with hard training, so continual reassessment is important.

I do active leg lowering and wall ankle dorsiflexion while I'm taking NO Xplode bro.
I do active leg lowering and wall ankle dorsiflexion while I’m taking NO Xplode bro.

The corrective exercise pathway should proceed as follows:

1)      Exercise selection is driven by screen and assessment.

2)      A thought out framework gives you the best possible choices.

3)      Retest, note positive or negative changes, and then use results to modify next session.

4)      Reassess once an obvious change is noted to see what the next priority is.

Ain’t no need to question the Authority

Movement Chapter 9: Analyzing the Movements in Screens and Assessments

This is a chapter 9 summary of the book “Movement” by Gray Cook.

While I have broken up these sections into patterns, much of what Gray talks about does not involve the patterns themselves, but are still good points to know. Ergo, much like the book itself, this post may seem a little disjointed 🙂

The Deep Squat

One’s inability to squat is not considered a single problem. Instead, a disconnect is present between the body and the brain in the squatting pattern. Our brain sees things in patterns, and the squatting pattern essentially gets smudged. Before performing the squat as an exercise, we must first groove an optimal movement pattern.

Preferably while listening to someone groovy like Marvin Gaye

One interesting point regarding the squat is that as an exercise it is often a top-down based movement. However, when we learn to squat in development, the movement occurs bottom-up. So one way to train the squat is by starting from the bottom of the squat and working to standing. This method ensures full mobility to perform a full deep squat.

To relate the SFMA to the squat pattern, Gray is very clear about not training the squat if one cannot touch his or her toes.

Hurdle Step and Single Leg Stance

These two movements simultaneously test mobility and stability of both legs. Oftentimes in these patterns you will see a high-threshold strategy (HTS), in which a hyper-protective core response occurs. Research demonstrates that this stabilization strategy can cause poor motor control to occur. These tests also are basic precursors for stepping, running, and climbing.

In this section Gray also mentions that he does not recommend assessing static postures; namely because posture is dynamic and changing.

Inline Lunge

The inline lunge is more a test of control and efficiency as opposed to strength.  Because we talk about control, we must discuss stability. It is important to note that stabilizers do not necessarily need to be strengthened, as these muscles will never be able to overpower prime movers. Instead, these muscles should be trained for endurance, timing, or quicker action.

 

Shoulder Mobility Reaching Test

These tests assess reciprocal arm patterns and thoracic spine mobility. The movement is challenging because opposing movements end up borrowing mobility and stability from other segments, thus potentially impairing these qualities.

Thoracic extension is necessary to perform this pattern. However, oftentimes people will compensate with thoracic flexion. This compensatory pattern can rob the scapulae of ground to help stabilize the movement.

 

Active Straight Leg Raise

There are several necessary components to perform this movement optimally:

  • Adequate down leg extension (otherwise substitution with anterior pelvic tilt and lordosis occurs).
  • Adequate mobility and flexibility of the elevated leg.
  • Pelvic stability prior to and during the movement.

Another interesting tidbit from this section was that research has demonstrated that one’s ability to perform a sit and reach correlated with arterial flexibility.

 

Core Stuff

The pushup, rotary stability, and rolling patterns all assess core functioning. In particular, the pushup looks at reflexive core action, rotary unilateral and diagonal patterns, and rolling the ability to separate upper and lower quadrants.

It’s all in the reflexes.

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 temporarily ceasing potential risk activities. Many things can perpetuate faulty movement, so it is best to control as many variables as possible. Here are some possible activities that may be compromised if one scores lower than a 2 on the screen.

  • ASLR:  Heavy closed-chain loading activities, running, plyometrics.
  • Shoulder mobility: Heavy or overhead pushing/pulling movements.
  • Rotary stability: Conventional core training, high threshold training that requires core control.
  • Trunk stability pushup: Heavy upper/lower extremity loads; vigorous plyos.
  • In-line lunge: Exercises and loads involving the lunge pattern
  • Hurdle step: Exercises and loads involving the single leg stance pattern
  • Deep Squat: Exercises and loads involving the squat pattern.
Loads? The way you’re moving you don’t need loads.

The Basic FMS

Now I know what you are thinking. “Zac, there is no way that some of my clients can perform all these tasks.” Well, Gray has an answer for you.  The FMS does not have to be performed in its entirety, and can be progressed in the following fashion:

BASIC FMS: ASLR, shoulder mobility, and pain-clearing tests.

and then

Rotary stability along with flexion and extension clearing tests

and then

Pushup test if appropriate.

and then

Hurdle step

and then

Inline lunge & deep squat.

Movement 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.

FMS…Deal with it.

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.

Take that you 1 on the inline lunge.

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)      Decreased movements – Even though these movements go less than full ROM, compensations can be caught with multi-joint movements.

3)      Asymmetry

4)      Intentional redundancy to reduce error; consistent findings implicate mobility issues, inconsistent finding implicate stability issues.

Will soon be for sale on zaccupples.com...until Gray sues me.
Will soon be for sale on zaccupples.com…until Gray sues me.

SFMA

The SFMA is not talked about in much detail in this chapter, but here are the top tier assessments:

1)      Cervical spine patterns.

2)      Upper extremity movement patterns

3)      Multi-segmental flexion (MSF)

4)      Multi-segmental extension (MSE)

5)      Multi-segmental rotation (MSR)

6)      Single leg stance (SLS)

7)      Overhead deep squat

From here each component has different breakouts. I have updated these as much as possible based on the recent SFMA course that I have attended.

Cervical breakouts

Active/passive supine flexion → active OA flexion→ active/passive cervical rotation → C1-C2 rotation → extension

Upper extremity breakouts

Active/passive prone patterns → Supine reciprocal patterns → Active/passive 90/90 internal/external rotation → Active/passive shoulder extension and abduction→ Active/passive elbow extension→ Active lumbar-locked extension

MSF breakouts

1 leg forward bend→ Long sit toe touch → ASLR→ PSLR → Rolling → Prone rocking → Supine knee to chest (KTC)

MSE breakouts

SPINAL: backward bend → single-leg backward bend→ prone pressup→ active/passive lumbar-locked (Internal rotation [IR]) → prone on elbows unilateral extension-rotation

LOWER EXTREMITY: FABER → Modified Thomas test → Prone active/passive hip extension → rolling

UPPER EXTREMITY: Unilateral shoulder backward bend → Supine lat stretch with hip flexed/extended → lumbar-locked (external rotation [ER]) extension-rotation unilateral → active/passive Lumbar-locked (IR) extension-rotation unilateral

MSR breakouts

SPINAL: Seated rotation → lumbar-locked (ER/IR) active/passive rotation-extension → prone on elbows unilateral rotation-extension

HIP: Seated active/passive ER & IR → Prone active/passive ER & IR

TIBIA: Seated active/passive ER/IR

SLS breakouts

Vestibular/core: clinical test for sensory interaction balance (CTSIB)→ Vestibular shake test → half-kneeling narrow base → rolling → quadruped diagonals

Ankle: Heel walk/toe walk → Prone passive dorsiflexion/plantarflexion→ Seated active/passive inversion/eversion

Overhead deep squat breakouts

Interlocked finger behind neck squat → Assisted deep squat → half-kneeling dorsiflexion→ Knee to chest holding shins → knee to chest holding thighs

Rolling

Upper & lower prone to supine and supine to prone

Who knew Fred Durst could actually be useful.

Movement 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.

But movement ain’t one.

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:

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.

Oh gosh that hurdle step is going to be awful after this.

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.

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.

Like Preparation H, Movement feels good on 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 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.