Movement Screening

I think that we would all agree that prevention is better than a cure. Wouldn’t it be great if the musculoskeletal injuries that plague us could be prevented? This idea might not be so farfetched. In order for this idea to become a reality we would need to be able to predict who is at risk of injury. This is where movement screening could provide the answer. Screening attempts to identify those who are at greatest risk of developing musculoskeletal injury based on what we have learnt from research into the aetiology of various injuries. Research cannot give us all the answers but it has shown us that when it comes to musculoskeletal injury the way that we move matters. Moving in certain ways, away from the ideal, predisposes us to developing certain musculoskeletal conditions and injuries. In an ideal world, our bodies are required to perform a rich variety of movements which balance each other out and allow us to maintain precision of movement. However, modern society is structured such that we each have defined roles that require the repetition of daily tasks and certain movements. The result is that certain movements become overworked and dominant compared to other movements, which are neglected, and movement precision is lost.

Similar to man-made machines that rely on joints and moving segments, if the body begins to loose precision in its movement, the consequences will be wear and tear. However, in contrast to a man-made machine, the body is a living system capable of growth and repair and as a result the wear and tear can be ‘patched up’ and function can be preserved. The body will always choose function (getting from A to B or supplying food, air and water) over precision and efficiency. The problem with this approach is the ‘patch up’ fix is not designed for high-level performance. So whenever we ask the body to extend itself, we essentially give it two options: (a) expose the inefficiencies of the ‘patch-up’ fix and let it breakdown, or; (b) let other parts of the body take on the extra work and risk letting them breakdown instead. Essentially a choice between two evils and either response will often culminate with a trip to the physiotherapist or your health practitioner of choice. If only this sequence of events could have been stopped in its tracks at the start by restoring movement precision. This is the objective of movement screening which aims to identify movement imprecision in its early stages. Unfortunately, it is a step all too often neglected on the way to beginning the latest get fit quick craze, which emphasises moving often not moving well. This is an important distinction because it is vital that we first learn how to move well, before we try to move often. Movement screening pioneer Gray Cook puts it simply - don’t try and build performance on top of dysfunction. As a quick aside, for those interested primarily in performance, restoring movement efficiency to the body is a quick way to shave seconds off your best time and add plates to the bar on your favourite lifts.

So what is the solution? Thankfully there are people a lot smarter than me who are passionate about finding the solution. Physiotherapist Gray Cook and his Functional Movement System team have developed a Functional Movement Screen (FMS) and a Selective Functional Movement Assessment (SFMA) that can be used to identify individuals who are moving in a manner that puts them at risk of injury and assess the cause of the faulty movement pattern, respectively (http://functionalmovement.com/). The FMS can be completed in 10 minutes and the SFMA in just 2 minutes and both can be easily implemented by a certified health professional at sport clubs and fitness centres as part of a pre-participation check-up. Professor of Physiotherapy, Shirley Sahrmann suggests that the physiotherapy profession needs to adopt a model of practice similar to that which is used by the dental profession, where annual visits to the physiotherapist are used to monitor our movement and prevent the development of musculoskeletal conditions and injuries. This would be a big shift from the current model of practice adopted by physiotherapists but shouldn’t we place as much importance on the neuro-musculoskeletal system of our entire body as we do on our teeth?

Watch this space for more on movement screening and assessment.

By Joel Fuller (Physiotherapist)