March 3, 2012

Elevating Your FMS: Combining Effectiveness and Efficiency

By Leo Shveyd, Advanced Wellness in San Francisco, CA

You are about to spend ten minutes (or perhaps less based on your efficiency) screening a new client. One wise person I know says “better is better”, while another says “better, faster, cheaper”. So how can you be better (meaning obtain better information), yet save yourself and your client valuable time? The purpose of this article is to examine this exact question and provide some insights.

If your client is twenty-five years or older, you can be fairly sure they are done growing. Prior to performing the Hurdle Step(HS) and In-Line Lunge(ILL), you must measure the tibia length (from the floor to the ischial tuberosity). The Shoulder Mobility (SM) test requires a hand length measurement (from the middle finger to the first crease on the wrist of the dominant hand). Once you have completed the measurements, write those numbers down. Since the numbers are unlikely to change, you will save yourself time by not having to re-measure should you need to retest down the road.

Another way to be more efficient with the FMS is learning where to stand and what to look for while screening. By screening many people, you learn that many faults or compensations will occur with a higher frequency. With that knowledge, you want to position yourself to see those occur. Gray Cook advises “leaning in”, while Mel Young (a San Francisco based Physical Therapist) has pointed out to me that the client is paying you for your “eyes”. Let’s take a look at where to stand so that you can have the best opportunity to view potential faults in the various tests:

  1. Deep Squat (DS): In the DS test, I prefer to first stand on the side of the client as I feel this is where I have the greatest likelihood of viewing a movement flaw. Should the client look good from the side, I next view the person from the front and, on the third attempt, from the back.
  2. Hurdle Step (HS): Brett Jones, an FMS Instructor, prefers to stand to the side of the client to analyze the level/movement of the hips when initially screening for a score of “three” versus a “two”. I, on the other hand, make sure the client’s shirt is tucked in and prefer to stand straight in front of the person, allowing me to view the same area. This may be a slightly different approach; yet this is the power of the FMS: it is a tool that you use to the best of your ability.
  3. In-Line Lunge (ILL): For the ILL, I like to stand at a slight angle, on the side opposite the front leg (i.e. facing the client’s left side if their right leg is forward). This allows you maintain peripheral vision of the stick and both heels. If the person can demonstrate stick contact in all three points (tailbone, mid-thoracic and back of the head) while keeping the stick vertical and returning to the starting position, I move to my left and try to view the movement from the front to see what happens to the front knee during the test.
  4. Shoulder Mobility (SM): This one is also very straightforward and therefore, needs no explanation.
  5. Active Straight Leg Raise (ASLR) & Trunk Stability Push Up (TSPU): For both the ASLR and the TSPU, standing on the side of the client’s body will provide the best viewing opportunity.
  6. Rotary Stability (RS): The RS position varies depending whether you are screening for a “three” or a “two”. In the “three” test (quadruped unilateral extension, flexion, extension), I like to position myself at the client’s head (on my hands and knees), shading to the side of the body that is leaving the ground. This will enable you to see if the client maintains a level torso, leg and arm over the board, while being able to touch elbow to knee. In the “two” test, viewing on the floor from the leg extended side on my hands and knees provides the best viewpoint.

Without an effective and efficient screen, it becomes much more difficult to get your clients moving better. I hope these tips are helpful in gathering more effective information more efficiently. This is the prerequisite to understanding how to apply the appropriate movements, in a reasoned sequence, at the appropriate levels, while minimizing risk through the elimination of movements that may be harmful.

For more information about Leo Shveyd and Advanced Wellness, please visit http://www.advancedwellness.com.