Biomechanics and Movement Screen, Orthopedic Assessment, Muscle Restrictions and Adhesions/Restriction Evaluation.
The purpose of this exam:
What do your muscles do in everyday life?
Discover dysfunctional or poor movement patterns.
Determine muscles and joint restrictions and adhesions.
Looking at the whole picture and not just the area of pain or the specific injury.
Movement Screen
The FMS, or Functional Movement Screen, is a an innovative way of screening movement, in athletes and the general population alike. The FMS will evaluate mobility, stability, strength and coordination in a total body fashion.
It has been shown to be effective in predicting injury risk in Fire Fighters and in male and female athletes and NFL players (see the links for the studies). The FMS has been used in the US Special Forces, NFL, NBA and other high level athletics.
The Functional Movement Screen looks at seven fundamental movements, scoring them on a scale of 0-3. Research continues to suggest that a score of 14 or lower, will put people at an increased risk of non-contact injury.
Scoring
3 = able to complete movement without compensation
2 = able to complete movement with compensation
1 = unable to complete without compensation
0 = pain
Your score____________
Deep Squat Function
Purpose – The Deep Squat is used to assess bilateral, symmetrical, mobility of the hips, knees, and ankles. The dowel held overhead assesses bilateral, symmetrical mobility of the shoulders as well as the thoracic spine.
Poor performance of this test can be the result of several factors. Limited mobility in the upper torso can be attributed to poor glenohumeral and/or thoracic spine mobility. Limited mobility in the lower extremity including poor closed-kinetic chain dorsi-flexion of the ankle and/or poor flexion of the hip may also cause poor test performance
In Line Lunge
Purpose – The In-Line Lunge is used to assess bilateral mobility and stability, as well as ankle and knee stability.
Poor performance of this test can be the result of several factors. First of which is inadequate hip mobility of either the stance or step leg. Secondly, the stance leg knee or ankle may not have the required stability as the lunge is performed. Thirdly, an imbalance may be present between adductor weakness and abductor tightness about one or more hips. Finally, tightness of the rectus femoris on the stance leg may be the cause for poor performance.
Hurdle Step
Purpose – The Hurdle Step is used to assess bilateral mobility and stability of the hips, knees, and ankles.
Poor performance of this test can be the result of several factors. It may simply be due to poor stability of the stance leg or poor mobility of the step leg. However, imposing maximal hip flexion of one leg while maintaining apparent hip extension of the opposite leg requires the athlete to demonstrate relative, asymmetric hip mobility.
Rotational Stability
Purpose – The Rotational Stability test is used to assess multi-planar stability while a combined upper and lower extremity motion is performed.
Poor performance during this test can be simply attributed to poor asymmetric stability of the trunk stabilizers. If the trunk does not have adequate stability during these activities, kinetic energy will be dispersed, leading to poor performance as well as increased potential for micro-traumatic injury.
Trunk Stability Push Up
Purpose – The Trunk Stability Push-Up is used to assess trunk stability in the sagittal plane while a symmetrical upper extremity motion is performed.
Movements such as rebounding in basketball, overhead blocking in volleyball, or pass blocking in football are common examples of this type of energy transfer. If the trunk does not have adequate stability during these activities, kinetic energy will be dispersed, leading to poor functional performance as well as increased potential for micro-traumatic injury.
Poor performance during this test can be simply attributed to poor symmetric stability of the trunk stabilizers.
Active Straight Leg Raise
Purpose – The Active Straight Leg Raise test is used to assess active hamstring and gastro/soleus flexibility, while maintaining a stable pelvis.
Poor performance during this test can be the result of several factors. First, the athlete may have poor functional hamstring flexibility. Secondly, inadequate passive mobility of the opposite hip may be the result of iliopsoas tightness associated with an anterior tilted pelvis. If this limitation is gross, true active hamstring flexibility will not be realized. A combination of both these factors will demonstrate an athlete’s relative bilateral, asymmetric hip mobility. This is similar to the relative hip mobility revealed by the Hurdle Step, however, this test is more specific to the limitations imposed by the muscles of the hamstrings and the iliopsoas.
Shoulder Mobility
Purpose – The Shoulder Mobility test is used to assess bilateral shoulder range of motion combining internal rotation with adduction and external rotation with abduction.
Poor performance of this test can be the result of several factors. One of which is the widely accepted factor that increased external rotation is gained at the expense of internal rotation in overhead throwing athletes. There can also be postural changes of forward or rounded shoulders caused by excessive development and shortening of the pectoralis minor and/or latissimus dorsi muscles. Finally a scapulothoracic dysfunction may be present resulting in decreased glenohumeral mobility.
Part 2:
Foot / Ankle / Arch Mobility Screen
Tightness in the ankle may result in a loose or unstable knee/poor squat test.
Normal 5 inches or more. Your score RT______ LT______
Ankle mobility drill
Q Angle :Test for knee mobility and stability
When the Q-angle becomes excessive (very approximately more than 15 degrees in males and 20 degrees in females), the resulting actions are increased femoral anteversion, external tibial torsion and foot pronation. The resulting malalignment will increase forces to an unsual extent causing lateral patellar subluxation.
Arch Screen Arch with custom orthotics and medial wedge
Leg Lowering / Test core strength
Below 60 poor core strength
WHAT ARE adhesion?
Our bodies contain special protein structures called connective tissue, also know as Fascia. This substance connects each part to other parts and the whole, very much like a flexible skeleton. When this tissue is healthy it is smooth and slippery, allowing the muscles, nerves, blood vessels or organs to move freely and function properly. Imagine a piece of scotch tape, the smooth side is healthy fascia; the sticky side is scar tissue or unhealthy fascia. Rub the tape along your skin, both sides, to “feel” what an adhesion is like. The drag that you feel, the “pulling” sensation, is what an adhesion is like. These adhesions attach to muscles, nerves and lymph decreasing their ability to work properly. You really know when you have an adhesion on a nerve; you get many abnormal sensations like numbness, tingling or pain.
DOESN’T STRETCHING GET RID OF adhesion?
Stretching plays a very important role in the treatment and prevention of injuries but it will not break down adhesions. Adhesions, or scar tissue, are much stronger than normal healthy tissue. Muscle groups can often adhere/bind to one another preventing the normal sliding necessary for full mobility. When an individual performs a stretch, the tissue that lengthens is not the adhered tissue but the healthy tissue. This can actually cause more damage to healthy tissue resulting in the increase of adhesions. Stretching correctly is still essential, but it will never release the restrictions that are already present.
TREATMENT
Create a systematic approach to eliminate movement dysfunctions.
Identify the kinetic chain Imbalance responsible for the movement inefficiency and the biomechanical overload causing the injury or pain
Correct the Imbalance
Spinal / Extremity Hypomobility and Fixations
Spinal Adjustments / Extremity Adjustments
Free Up Muscle Adhesions
Deep Tissue / Active Release Therapy
Home Electric Muscle Stimulation
Inhibit the overactive
Self-Myofascial Release
Home Muscle Stimulation
Lengthen the overactive
Movement Prep Exercises / Dynamic Joint Mobility
Activate the under-active
Active-Isolated Muscle strengthening
Home Electric Muscle Stimulation
Integrate normal functional movement patterns
Dynamic Movements
Strength Training
Nutrition:
