Functional movement screening: the use

“The rehabilitation professional must realize that in order to prepare individuals for a wide variety of activities, screening of fundamental movements is imperative.”

I agree with this statement. I disagree that we yet have a tool that can screen all individuals from all sports. This screening tool has yet to prove its worthiness of use on athletes.

I recently was certified by USAW as a weightlifting coach. I really like what they use to screen participants before allowing them to train the weightlifting lifts of the clean and jerk and snatch. They use the basic movement patterns, without load or speed, that are needed in order to perform the entire lift safely.

This makes logical sense, but I don’t think a study has been performed to see if this is a good/bad thing to do prior to allow safe lifting.

The FMS is proposed to be a screening tool for athletes and tactical workers. I’m not sure this one tool can encompass all of the movements required in life.

It’s still a good thing to learn about, not for use as a screen, but instead to better understand how the body as a system can move through the spectrum of very stiff and weak through very mobile and supportive.

“Many individuals train around a pre-existing problem or simply do not train their weaknesses during strength and conditioning (fitness) programs.”

If a person is unaware of a problem, this is also a problem. I would be all for a low cost screening tool, which everyone is required to have tested on a yearly/decade basis.

For instance, someone that lacks ankle mobility may not know that they are unable to squat without something under their heels. They may not know that this leads to increased use of the anterior chain, which increases knee stresses. They may not utilize their hips and may round their back when performing their repetitive squatting activities.

There are so many possibilities for a person to lose mobility, that this should be screened. The problem is that we have yet to know an effective screening tool.

“The perception of many past researchers is that no set standards exist for determining who is physically prepared to participate in activities”

If there are no standards, then everyone can participate in a physical training program. This is only partially true. There are some standards, but not many.

1. The person must be breathing

2. The person must not be at a major risk of death if participating in an exercise program

3. Start exercising!

“…the main goals in performing pre-participation, performance, or return to sport screening are to decrease the potential for injury, prevent re-injury, enhance performance, and ultimately improve quality of life”

This is what makes a universal screening tool so hard to find. I don’t even think we have a tool for different positions of the SAME sport because the requirements are so diverse. I keep bringing up the USAW screening tool, but that’s because the athlete, in the end only needs to be safe enough to perform TWO movements. The screening tool has more movements than needs to be performed. If this were to hold true for any other sport, the screening tool would be too long to be useful.

“…intended purpose of movement screening (1) identify individuals at risk, who are attempting to maintain or increase activity level (2) assisting in program design by systematically using corrective exercise to normalize or improve fundamental movement patterns (3) providing a systematic tool to monitor progress and movement pattern development…(4) creating a functional movement baseline”

I can agree with all of the above stated. Im not sure if research supports these statements, but they sound pretty good.

I do like the idea of creating a movement baseline, but that baseline measurement will need to be extensive enough to capture relevant information to that patient.

“The FMS (TM) is comprised of seven fundamental movement patterns (tests) that require a balance of mobility and stability (including neuromuscular/motor control)”

This is true. The seven movement patterns tested are adequate tests for ADL’s but I don’t know if it goes far enough to test anything other than a persons baseline movement.

“The term ‘regional interdependence’ is used to describe the relationship between regions of the body and how dysfunction in one region may contribute to dysfunction in another region”

I speak with many PTs throughout the week that know this term and can recall this term, but don’t apply this term on a daily basis when working with people. For example, a significant loss of dorsiflexion (ankle flexibility) will keep the knee from bending and shifting towards your toes. This will in turn cause you to learn more forward with your hips.

A loss of movement at your shoulder can make you move your back more when reaching overhead.

This is the term regional interdependence at play.

“Programmed altered movement patterns have the potential to lead to further mobility and stability imbalances, which have previously been identified as risk factors for injury”

This is where I start to deviate a little from the article. There are way too many logical jumps being made without proof that a screening tool is predictive of injury.

“…an important factor in prevention of injuries and improving performance is to quickly identify deficits in symmetry, mobility, and stability because of their influences on creating altered motor programs throughout the kinetic chain”

I don’t agree with this.

Everything here forward is my opinion and I don’t have any proof that it’s true: we live in an asymmetrical world. We start off as one handed or one footed. We play sports that drive this asymmetry. It’s hard to say that moving towards a more symmetrical society will improve performance in asymmetrical sports or activities.

I personally don’t think it happens.

There are many saying that at a young age that kids shouldn’t specialize, and I would agree with that, but at what age does specialization become more appropriate. I remember hearing stories about Ken Griffey Jr (one of the greatest baseball players of all time with baseball being a very asymmetrical sport) playing basketball in order to improve mobility and hand eye coordination.

It’s a theory that working towards symmetry improves performance, in just not at that point yet.

“Scores serve to tell the professional when a person needs more investigation or assessment”

The score on the movement screen does not predict injury. It just states that the person doesn’t move like the ideal.

For instance, my shoulder mobility for the internal/external rotation test is not ideal. That’s expected for me because I have shorter arms and am overweight. The investigation of this test is that I have to lose weight in order to see if that has an effect on my testing. The same “problem” of being overweight can affect the rotary test in quadruped as the belly can get in the way of the test. “Problem” solved. It may not be a muscle/joint problem at all.

Read the article to see the testing and what the authors propose that the test is measuring.

Link to article

Categories non-professionals, PTs, Written BlogsTags , , , , , ,

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