by Peter
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by Peter
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We discuss
Stuarts background where amongst he got to work with the first team squat of West Bromwich.
- Hydrotherapy: Rehabilitation in water.
- On a day to day basis Stuart work in a clinic.
- Stuart guides us through an athlete coming to him and shares his process:
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:
Be on the lookout for : Fundamental Capacity Screen
Books:
There are no mistakes in lifes, only lessons – Robin Sharma
Stuart top 3
- Consistency – Keep going and create momentum
- Humility – accept that you dont know everything – constantly learning
- Be Open – listen to people.
The Socials
- Twitter: @stuartelwell
- Facebook: @stuartelwellphysio
- Instagram: @stuartelwellphysio
Persons of Interest
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