I have done the easy bit, Talking the Talk, planning what I am going to do and how I will make time for everything, but now for the hard part… Walking the Walk.
As outlined in Part 1, I am going to start by using assessments to identify my weaknesses and limitations. Initially, I am going to focus on the Functional Movement Screen and Selective Functional Movement Assessment.
We are starting with the FMS – Functional Movement Screen
I thought I would first explain a little bit about this screen…
It is worth noting this is a screen designed to assess someone who isn’t in pain. At The Health Hub, this is the screen we would typically use at the end of a patient’s treatment plan, to assess their ability to return to Sport or Training. Alternatively, we can use it for people who simply want to know how they can improve their body’s function to ensure they are able to move and stabilise correctly.
In my instance, because I have no pain, this is where we are going to start. So let’s see how I get on…
The Screen consists of these 7 tests –
- Overhead Deep Squat
- In-line Lunge
- Hurdle Step
- Active Straight Leg Raise
- Trunk Stability Push-up
- Rotary Stability
- Shoulder Mobility
How did I do? Not bad… But not great!
The higher the score the better the result if you score 3 it means you passed the exercise perfectly. If you score 2 for the exercise you can manage it with some modifications and you have guessed it if you can’t do it at all, you score a 1.
I scored 12 out of 21. It is worth noting that in studies where this is used with professional athletes a score of less than 14 puts that athlete at greater risk of injury.
The key weaknesses it identified for me were –
- Poor Shoulder Mobility
- Poor Right Leg Stability
- Limited Right Ankle Mobility
- Poor Core Rotational Strength
- Very limited Straight Leg Raise
As you can see from the screen results there are a number of areas that I struggle with. We now want to know the all-important question… Why?
This is when we use the second screen the SFMA.
Selective Functional Movement Assessment – SFMA
Other than sounding jazzy what is it? The founders of the screen (www.functionalmovement.com) define it as follows..
“It is a movement-based diagnostic system which systematically finds the cause of pain – not just the source – by logically breaking down dysfunctional movement patterns in a structured, repeatable assessment.
Look at it this way. When you head to the hospital for shooting arm pain, the immediate course of action is to check your heart, not your arm. The symptoms down your arm are just a result of a problem elsewhere in the body. Similarly, the SFMA focuses on underlying dysfunctional movement to find the cause of pain, not just the source. This concept is better known as regional interdependence – how seemingly unrelated problems are actually driving the dysfunction.”
In a nutshell, it is a full body assessment that is aimed at finding areas of “dysfunction” (not working correctly) and these could be painful or non-painful. It starts by looking at large movements like touching your toes, rotating left and right, leaning back etc. Once we have established which of those movements you can’t do, we then need to find out why. So, we start with those that don’t hurt, as more often than not, pain is the result of our body compensating for an issue elsewhere. The screen will then tell us if the cause of the problem in a specific area is a mobility issue or a stability issue.
If we use me as an example, as I have mentioned previously, I can’t touch my toes and I failed miserably on the straight leg raise test but, so far, we don’t know why. Toe touch is one of the movements in the SFMA but it doesn’t hurt, so this would be considered dysfunctional and non-painful. Then comes the fun bit, we need to try and work out why? I am sure you are all thinking tight hamstrings, maybe/maybe not…
This is the fun part, the screen then goes into an area-specific breakout to establish the exact cause of the dysfunction. In the touching-the-toes example, this could be poor hip mobility, lower back tightness, nerve impingement, core weakness, tight hamstrings and so the list goes on. However, once we have identified what the cause is, we can do something about it!
In my example, I have no pain but my inability to properly perform this movement puts undue stress on areas of my body that are then trying to move more to compensate. Have a look at this picture below –
Can you see how much I am “hinging” in my midback? This can result in poor posture and tightness in my mid back which results in it needing manipulation to free it off. However, as we can see, it isn’t the cause of the problem, instead, it is a symptom of my lack of movement elsewhere. In my case, it is because I cannot flex through my lower back and this is also having a direct result on my hamstrings. In order to truly correct this, I need to address the cause, not the symptoms. In short yes, I do also have tight hamstrings and a tight midback but if I stretch my hamstrings and release my midback, I don’t get any lasting change. Instead, to make a lasting change I need to address the cause which, in my case, is my lower back mobility.
How many of you have been told you have tight hamstrings but even after stretching every day for a month, if you were to stop stretching for 1 week you would be back to square one again? This is why I love using this screen as it helps us work out why!
Now I have only highlighted the straight leg raise and the toe touch but clearly, I failed in more than just those two areas.
In summary here is what I have to work on –
Lower Back Mobility and Stability
Right Ankle Mobility and Stability
Left Shoulder Blade Stability
Mid Back Mobility
Other than that… I am fine!
Hopefully, this helps you see how pain isn’t always an indicator of function, as although I have no pain, there are clearly several areas where I can improve. This is what I meant in Part 1 about getting into the best shape of my life. In essence, my aim is to get fit to get fit and then truly get fit! The great thing about the screens is that they also help to quantify progress, so once I have worked on these areas, guess what we do… Re-Screen!
Next time we will look at what I am doing to address these issues.
Have a great Christmas!