November 2019 Links and Review

Every week, my newsletter subscribers get links to some of the goodies that I’ve come across on the internets. Here were the goodies that my peeps got their learn on in November. If you want to get a copy of my weekend learning goodies every Friday, fill out the form below.  That way you can brag to all your friends about the cool things you’ve learned over the weekend.

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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. 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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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. 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

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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. 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.

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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. 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 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

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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. 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.   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

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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. 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

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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 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)     

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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. 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.

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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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