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Optimal Performance

Movement Strategies

Optimal Performance Pyramid

Functional MovementMobility

ROM / Flexibility

StabilityCore stability / Neuromuscular Control

AssessmentFMS

Key/critical question?

Are we building strength and conditioning, rehab, fitness and skill on top of dysfunction?

What is FMSA series of movements designed to

evaluate stability and mobility (i.e. functional movement)

Uses extreme positions where weaknesses and imbalances become noticeable

Ultimate goal is to identify athletes at increased risk for injury

Developed by:Gray Cook….

What is SFMA ?Comprehensive assessment system

Used to classify movement patterns

Direct manual therapy and therapeutic exercise interventions

Developed by: Gray Cook U. Miami, FL

Greg Rose TPI

Mike Voight Belmont U, TN

Phillip Plisky U. Evansville, IN

Kyle Kiesel U. Evansville, IN

Key Principles

Optimum function movement (relative)Balance between mobility and stability

Tightness = weaknessExample:

oHamstrings seemingly become tight when the core is too weak to control the pelvis

oTargeting the tightness only will result in a short term gain at best

Functional Movement ScreenConsists of 7 tasks (3clearing maneuvers)Scored 0 (lowest) through III (highest)

Lowest score counts on bilateral tests

Best possible score = 21 ?

Discuss data currently availableAthletesMunicipal workers

ComparisonStand-alone vs. additional physiological measures (West Point)

Functional Movement ScreenDeep Squat

Hurdle Step

In-line Lunge

Shoulder Mobility

Active Straight Leg Raise

Trunk Stability Push Up

Rotary Stability

3 clearing maneuvers

Scoring the FMSIII – able to complete task

II able to complete task with compensation

I – unable to complete task

0 – pain during test (or clearing exam)

Max Score = 21points

Also looking for asymmetry

AsymmetryMusculoskeletal asymmetry is a well

established risk factor for injury

Ekstrand & Gillquist, 1983Knapik et al., 1991Baumhauer et al., 1995Plisky et al., 2006Myer et al., 2008Yeung et al., 2009

Research

J Occup Med Toxicol. Apr. 2007433 firefighters62% reduction in lost time with intervention42% reduction in 12 month injury rate

NFL DataIf FMS score is ≤ 14, and there is an

asymmetry, then the probability of suffering a time loss injury increased from 15% (pre-test probability) to just over 50%

Scores can be improved with a specific off season training program (SFMA).

ResearchIntrarater and Interrater Reliability

Minick, KI, Kiesal, KB, Burton, L, Taylor, A, Plisky, P, and Butler, RJ. Interrater reliability of the Functional Movement Screen. J Strength Cond Res 24(2): 479-486, 2010

Teyhen, DS, Donofry DF, Shaffer SW, Walker MJ, Lorenson CL, Dugan JL, Halfpap JP, Childs MD. Functional Movement Screen: a reliability study in service members. USArmeh Med Dep J. 2010 Jul-Sept:71

References

Cook, Gray Athlete Body in Balance, 2003Gray, Gary Gray Institute / NikeKraemer, William, University of ConnecticutMichaud, Tom Human Locomotion, 2010Prentise, Bill., UNC Chapel HillRose, Greg TPIStarrett, Kelly The Supple Leopard, 2013Tiberio, David University of Connecticut

Balance and AsymmetryFMS

Improving Performance and Avoiding Injury by

Eliminating Asymmetries

Understanding BalanceWhere does Athletic Movement originate?How does it Respond?How can it be Improved?

Testing For AsymmetriesFunctional Movement Screen

Performing the Screen

Deep SquatThe deep squat challenges total body

mechanics when performed properly Assess bilateral, symmetrical and

functional mobility of the hips, knees and ankles.

assess bilateral, symmetrical mobility of the shoulders

as well as the thoracic spine.

Hurdle Step

In-Line Lunge

Active Straight Leg Raise

Trunk Stability Push-Up

Shoulder Mobility Test

Rotary Stability

Score the test

Design the program

Specific Guidelines – Exercise Selection

Proprioceptively rich programSafeChallengingStress multiple planesIncorporate multi-sensory environmentActivity specificProgressive functional continuum

Ø Slow to fastØ Simple to complexØ Known to unknownØ Low force to high forceØ Eyes open to eyes closedØ Static to dynamic

Goal of program - develop optimal levels of functional strength & stabilization

ØFocus on neural adaptations instead of absolute strength gains

ØIncrease proprioceptive demandsØQuality not quantity

Poor technique and neuromuscular control results in poor motor patterns & stabilization (injury)

Focus on function

Goals

Questions to Ask Yourself

Is it dynamic?Is it multiplanar?Is it multidimensional?Is it proprioceptively enriched?Is it systematic?Is it progressive?Is it activity-specific?Is it based on functional anatomy & science?