In this all english episode #028:

We meet Stuart Elwell,  physiotherapist from UK with background in West Bromwich football team. Stuart travels across Europe and educates coaches and therapist in  Functional Movement Screen (FMS) and Functional Movement Systems.   Stuart advocates that a systems approach means that you are not missing anything. He guides us through the whole screening process, and gives us an insight about the 7 movements of the FMS. How to score, what is a good score? And what the score means.  We discuss  use FMS in a practical setting,  we  discuss heart rate variability, the most common mistakes that people do during the screen. And the common risk factors according to research. Are you a coach, physiotherapist? Must listen to! Enjoy

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Example athlete: ACL injury

He returned to training, and was discharge from care without any follow up (which is normal today). In June he did pre season conditioning. and felt his knee was not right. He felt something was wrong in knee joint. The athlete had conflicting reports from both his physio and surgoen-  who should you listen to? Stuart was the second opionon. Stuart asked: Are you in pain right now?  Athlete: “No. I just dont feel 100%”

Systems based approach means that you are not missin anything!

The FMS – did not look great. His ankle, hip and low back was not moving well. For a lateral lunge.

Functional Movement Screen

FMS is a screen. It does not diagnoze, it categorises. Stuart mentions that FMS is similar to measurement of blood pressure: “we got standards for that”. If we find movement that is risky its the first step for further analysis.

FMS try to capture fundamental movements.

As a baby, the first movement we used are lounges and diaphragm: We look at breathing. We  look at our ability to control our neck. Integrate spine. We gain Locomotion: Crawl, supine to prone, roll, transitional movement roll, quadruped, crawl, crawling transitonal postures: kneeling to half kneeling to standing

The Functional Movement Screen try to capture all those transitional postures, basic fundamental core stability and mobility requirements needed for all those positions, in a seven test procedure that shouldnt take more than 15 min

The 7 movements

We look at 7 movements and 3 top tier test and 4 fundamental movements

• Squat
• Inline Lunge
• Hurdle step
• Shoulder mobility (glenohumeral scapular mobility and Thoracic mob)
• Straight leg raise (posterior chain and spinal)
• Trunk pushup (brace our spine whilst using upper limbs)
• Rotary stability test (our diagonal pattern, our crawl and creep pattern)

 

In a screen, we don’t put barriers to movement, we put risk factors to movement. In pain?!? Don’t do it! We look for significant dysfunction. We look at commonalities.. Stuart mentions the Car analogy. FMS gave us a baseline.

“His FMS was 14 and no assymetries. “

That is meaningful data. Dont make the athlete worse. This person is finished with their rehab. FMS adds accountability to the coach.

Risk Factors

Research tells us:

• First risk factor: When someone has been injured that is the single most significant risk factor for developing a future injury
• Second risk factor: Age and BMI
• Third risk factor  Asymmetry and poor motor control. Get the athlete to basic before discharge.

Scoring:

Whats a good score? Compare it to whats a good blood pressure? We look for you to be “about” that metric.  more a recommended value not that you have to have a certain number: 14 is standard. We look for the athletes to be “good” and not make them worse. If the athlete are in pain the score is 0 and is not “fit” for movement. A 14 is 2 on each test. A score of 1 is dysfunctional. A score of 2 (helping) .

How often should I re-test?

If we see a significant improvement. ReScreen.

Come back in a couple of weeks. Or when

Symmetrical

Assymetry are normal – we write with one hand, we lunge with one side. BUT beware – it is a riskfactor!!!  Dont compare the elite with the Weekend warrior. Coach for symmetry: particularly after injury.  Injury prevention is more an art than a science. Aim to reduce the assymetry. Take the athlete from a 12

FMS Courses

6 hours online or a live seminar: Takes roughly a day –

• Level 1 = Ability to screen, and what the results mean How to do the screen,
• Level 2 = What do I need to to to correct? Improve? Programming? and optimize?

HRV – Heart Rate Variability

A means of tapping in to parasympathic and sympathic nervous system. It shoudl be balanced. It needs to be adaptive. Monitor Preparedness. To avoid burnout and avoid systemic healthproblems.

With buys lifestyles with multiple stressors, HRV gives us the ability to see what these stressors are doing

Can we change that stressor?  When should athlete recover? When can the athlete push themselves systemically.

Whats the most common mistakes that new FMS coaches do?

Stuart only seen one 21 in 10 years. Do not try to improve the screen see the Screen is a filter for Green/RED for certain movements. Programming for health. Health overrides everything. “DO NO HARM”. Another common issued ONLY screen. Do not assess.

Stuarts Tips:

• Listen
• Whats next:

Stuart top 3

1. Consistency – Keep going and create momentum
2. Humility – accept that you dont know everything – constantly learning
3. Be Open – listen to people.

The Socials

• Twitter: @stuartelwell
• Facebook: @stuartelwellphysio
• Instagram: @stuartelwellphysio

Persons of Interest

• Gray Cook 

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