Functional Movement Systems (FMS) & Selective Functional Movement Assessment (SFMA)
This week was exhausting due to the snow and slush that fell our city but simultaneously I was invigorated by the arrival of a text-book. Gray Cook is a manual therapist, strength and conditioning coach, lecturer, and author. His book “Movement” has shifted by methodology of assessing the human frame. Rather than jumping straight into orthopedic evaluations that often provoke pain, ‘Movement’ suggests assessment of multi-segmental movement patters to get a gross picture of how the body is moving and where some of the limitations (pain or no pain) might be. This type of assessment is perfect as a pre-exercise training assessment and as a diagnostic tool for clinicians when diagnosing a mechanical condition.
Functional Movement Systems (FMS)
7 Movement patterns will be assessed in the FMS protocol to get an impression of any physical limitations (with pain or no pain). These 7 movement patterns are:
1.Deep Squat
2.Hurdle Step
3.Inline Lunge
4.Shoulder Mobility (ala the Apley’s Scratch Test)
5.Active Straight-Leg Raise
6.Push Up
7.Rotary Stability (quadruped w/ movement)
Some of these are more appropriate in the gym setting with certain apparatus needed but, in truth, I can use all 7 in the office to get an impression of core stability, movement patterns, areas of limitation, and obviously areas of pain.
Selective Functional Movement Assessment (SFMA)
The SFMA has occupied my time all week. Not only have been incorporating these assessment approaches into my patient encounter routine, but I’ve also become a computer programmer programming the tests into my computerized note taking software (ChiroWrite). Arg! It’s tedious. But, I’m almost done.
The SMFA will start with Top Tier tests to identify areas of the body to look at more closely. These top tier tests include:
1.Cervical Patterns (active neck bending and rotating)
2.Upper Extremity Patterns (active Apley’s Scratch Test)
3.Multi-Segmental Flexion (arms overhead and attempt to touch toes)
4.Multi-Segmental Extension (opposite of flexion in #3)
5.Multi-Segmental Rotation (active twisting of the body)
6.Single-Leg Stance (standing on one leg)
7.Overhead Deep Squat (ala in the FMS)
Any pain or limitation in each of the above leads to a series of tests to identify more precisely the area of pain/limitation (it’s actually quite basic stuff, but it’s laid out beautifully in the book and lends itself to precision assessments and diagnostics). Following any functional assessment comes the eventual neurological, orthopedic, and sometimes the dreaded pain provocative tests.
And that! is what I learned in chiroPractice this week. See you in the office. Happy shoveling.