Vail Daily column: Why you’re at risk for injury
August 4, 2014
Last week, I discussed the importance of having specific standards in fitness assessment. I used the medical community as an example of how they use basic vital signs to assess the general physical health of a person, give clues to possible diseases and show progress toward recovery. Standards are important to consider when addressing physical fitness as they give the exerciser a focal point for progressions and goals. Standards are extremely important for the trainer to determine the best exercises for specific shortcomings in the trainee's fitness. Today, I will discuss the functional movement screen and the importance of this great tool in addressing bottlenecks in human movement and risk of injury.
Snapshot of Mobility
The functional movement screen was developed by Gray Cook and Lee Burton. Gray and Lee are experts in physical therapy and athletic training respectively. The goal of the functional movement screen has evolved to capture basic fundamental movement patterns uncomplicated by specific skills. It looks at overall mobility, stability and motor control through the body, exposes deficiencies, limitations and asymmetries. It is essentially an objective bio-marker for movement health that grades seven fundamental basic human movements and helps guide the practitioner to systematically choose corrective exercise strategies to improve overall movement health. As far as I'm concerned, the functional movement screen and the selective functional movement assessment (also created by Cook) are the best standardized tools that objectively grade movement quality and exposes pain to guide the practitioner on exercise corrections and medical interventions, respectively.
The screen precisely grades seven movements with a possible score of 21 points. For any given movement that is being scored, a score of three is optimal and suggests that movement intervention isn't necessary, and loading that specific movement with external loads is likely beneficial. A score of two is acceptable and using external weight bearing loads isn't likely to cause a disruption or reinforce poor motor skills. A score of one typically exposes a movement that needs specific corrective exercise intervention before moving on to more aggressive exercise approaches. Furthermore, scoring a one and moving forward in fitness programming, sports, or activities of daily living without correcting the problem will likely reinforce sub-optimal movement quality, promote asymmetries and compensation issues often leading to pain and musculoskeletal disease processes. Gray Cook said, "Many people are able to perform a wide range of activities, yet are unable to efficiently execute the movements in the screen. Those who score poorly on the screens are using compensatory movement patterns during regular activities. If these compensations continue, then sub-optimal movement patterns are reinforced, leading to poor biomechanics and possibly contributing to a future injury." Lastly, if pain is present during any one of the seven screens, a score of zero is given. This prompts the trainer to outsource to medical practitioners to assess, diagnose and treat the underlying medical condition.
What are the implications of this screening tool for the fitness culture today? Most fitness enthusiasts perform exercises based on gym popularity, magazine approval and optimism for health improvement, and, consequently, are at risk for injury. For example, let's assume somebody squats on a regular basis because they read that squats are the best exercise for developing lower body strength and for preparing their legs for the upcoming ski season. However, on the deep squat screen, this individual scores a one because of limited ankle and hip mobility. Without the screen and corrective intervention, this trainee might continue squatting exposing himself to a future knee and back injury. Just to be clear though, if somebody possesses a movement bottleneck and scores a zero or one on a pattern, it doesn't necessarily mean that injury is inevitable — it's just a risk factor. Smokers aren't guaranteed to develop lung cancer, but cancer is a likely outcome if they don't quit smoking and make better lifestyle choices. On the other hand, what strategies are used for individuals who score twos and threes across the board? First, try to improve the twos using minimal corrective exercise interventions. Finally, if an individual scores very well, we must train them using external resistance to get them stronger and improve their overall fitness capacity.
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The bottom line is that we must be able to move well and have an objectable standard to measure this ability. It never makes sense to randomly exercise and hope that you become healthier. Without proper movement skills, and exercising without direction will likely reinforce bad habits and create risk factors for injuries. Find someone who can screen you, correct the glaring deficiencies, so you can start moving toward optimal fitness. Stay safe out there!
Ryan Richards has a B.S. from Ohio University and is a certified strength and conditioning specialist through the National Strength and Conditioning Association. He is the personal trainer at the Sonnenalp Golf Club and the owner of R2HP, an athlete consulting and personal training company. Richards' passion comes from overcoming childhood obesity and a T1-L3 spinal fusion. Contact him at r2hp.com or 970-401-0720.
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