Thursday Thoughts: Movement Screening and Capacity
This compilation of Thursday Thoughts was inspired by Greg Lehman's post on MedBridge's site which I recently Quick Linked back to on Tuesday's post.
The Eclectic Approach uses MDT and the SFMA to help direct treatment and streamline the evaluation. However, after a few years of combining both, it is clear that their strengths mirror their weaknesses. Simplicity makes them reliable and attractive, however, that also means neither alone catches everything that may be contributing to the patient's complaints.
The way I present attaining motor control/stability and movement symmetry (FMS/SFMA) as well as ability to load a joint repeatedly to end range (MDT) is that these are the minimum amount that you need to do higher level activities like sports or repetitive ADLs.
Having symmetry is great, and may even prevent injury if you are a firefighter, in the military, or the NFL (FMS research). However, you can move symmetrically and not have the capacity to run, lift, or perform. A runner with a symmetrical movement screen may still overstride on one side, swing their arms inappropriately as drivers, thus causing overstrike or improper crossover gait, or just plain overtrain. This is the important part about the FMS/SFMA's fourth predictor of injury - training/stupidity.
I like how Running Research Junkie refers to running injuries - a quote from his injury tab
"I have long suggested that the cause of an overuse injury in runners is the cumulative load in the tissues is beyond what the tissues can take, so the management is simply one of load management by reducing the load and/or increasing the ability of the tissues to take the load"
In other words, it's a matter of training exceeding capacity. You can have all the symmetry on a movement screen in the world, but it does not always translate to proper form in function. However, like many of the SFMA instructors state during the courses, this is the best we have right now, and if you showed us something better, we would adopt it. As a system, the SFMA/FMS are streamlined, and still direct your treatment, and if someone has 1,3 on shoulder patterns, ASLR or is FN on one side and DP on the other, you should probably take care of that to prevent future injury. You should not assume however, that making them symmetrical 2's or FN bilaterally that the patient is able to repeatedly load the area in ADLs or sport without proper coaching and conditioning.
In other news...
Mike Reinold, Chris Johnson, and yours truly will be doing our "Ask us anything" google hangout tonight at 6:00 pm PST, 9:00 pm EST. This is in thanks for your votes on Therapydia's recent Annual PT Blog awards. A link will be posted on our social media to watch. You can chime in, ask us questions live by logging into the hangout, tweet, facebook, or email us questions, and we'll try to get to them as time permits! Think of it as a PT call in show and if we get nothing, we'll just talk shop. For those of you who miss the live presentation, it will be recorded and shared on our social media.
Keeping it Eclectic....