Mindfulness + Fitness

By: Christie McFarland

The hours I spend daily interacting with clients has revealed the significance of mindfulness and how it ties our overall wellness and fitness journey together.

Forming a daily habit which doesn’t produce immediate results is frustrating. Much like weight loss, mobility, or strength, it takes multiple, frequent inputs over a long span of time to taste the fruits of a meditation practice. Try this app, Done, to start forming small habits, everyday.

From my own experience and the observance of clients, mental clarity, a positive mindset and healthy relationships are a critical piece of overall well-being. Meditation creates the space to practice mindfulness. Mindfulness expands the space to practice acceptance, awareness, and introspection in our daily lives. This benefits ourselves and those around us, tying up the ends of our circle of overall wellness.

For my own meditation practice, I use Waking Up with Sam Harris and Ten Percent Happier with Dan Harris. Insight Timer is free and has thousands of meditations. Personally, I have found the other two options easier to progress with and less complicated to choose which meditations to practice.

Here are a few studies highlighting the effects of mindfulness meditation:

Consistency is key to reaching fitness goals:

This study showed 62 women over six months who applied mindfulness meditation practices to their routine had a much higher level of physical exercise and general movement, and a greater reduction in BMI, than those who didn’t.

Brain health is critical to healthful aging:

This study’s results showed, “Benefits may include improving brain functional connectivity in brain systems that generally degenerate with Alzheimer’s disease, Parkinson’s disease, and other aging-related diseases.”

Mindfulness and chronic pain:

This study explains mindfulness meditation’s role in mediating pain: “While meditation after brief training (less than 1 week) produces significant reductions in pain intensity and unpleasantness ratings, long-term meditation does not produce changes/differences in pain intensity but rather influences the unpleasantness dimension of self-reported pain.”

Plan your work, work your plan

Something to ponder: When you go to the gym, are you there to workout or are you there to train?

It may sound like we’re splitting hairs with this question, but at Paragon, we believe there’s a massive difference between “working out” and Training. Going in without a plan, without clearly defined goals and specific steps to take to help you reach them– that’s working out. And there’s nothing wrong that. You’ll get some stuff done, you’ll feel better when you leave, and you’ll probably even see some progress, especially if you’re a beginner.

Training is different. Training means you’ve set yourself a goal or series of goals, and now you’re on a mission to achieve them. You lay out a plan to get you to your goals, and you execute that plan.

The process of achieving long term goals is largely dependent on doing the things you need to do every day along the way. This is where our daily habit tracking on Teambuildr can be so valuable. If you haven’t checked it out yet, here’s what it looks like:

  • Each week has a different focus: Week 1 was Strength, Week 2 Sleep, Week 3 Nutrition, etc.
  • Each DAY we ask you to adhere to 3 specific tasks related to the goal for that week. These are highly achievable on a daily basis, and by checking these tasks off each day, you’re setting yourself into a very healthy habit.
  • First, log into Teambuildr. If you still need your username and password, send us an email.
  • Next, open your calendar for that day, open the questionnaire at the top of your workout, and answer the 3 quick questions. Each question is worth one point.
  • When you hit the minimum number of points for the week, you win the prize(s) for that week.

Over the course of our 8-week ParagonSTRONG program, we’re asking you to train with a purpose. Pick some goals, and set a specific plan in motion to achieve them. If you haven’t already picked your goals, it’s not too late! Check out the instructional video below on how to set appropriate goals:

Now it’s YOUR TURN! Follow the steps outlined in the above video for your own goals, and send an email to info@paragoncle.com. It should look something like this:

  1. State the goal, and the time frame to accomplish it.
  2. What steps will you take on a daily basis to reach your goal?
  3. How will you measure progress each week?
  4. How will you be held accountable?

If you think you need some additional guidance, click here to schedule a free Strategy Session with one of our certified Personal Trainers.

Thanks for reading!

Why We Assess Movement

Adam1

Let me start this post by saying stating the obvious if you’ve read any of my past writings:  I’m a fan of the Functional Movement Screen or FMS.  All new clients at Paragon Health & Fitness go through the FMS in one form or another before they’re ever asked to go through an entire exercise routine.

That being said, I do not work for Functional Movement Systems.  I do not collect any kind of commissions from them by promoting their materials.  I don’t believe that everything they do is perfect or right.  I do not use the Y-Balance Test or the Functional Capacity Screen.  I do not have any necessary allegiance to FMS, and as soon as I find something better, I have no problem jumping ship.

I am NOT writing this post to defend the FMS or anyone who works for them directly– they certainly don’t need my defending even if I were.  I am not writing this to defend anything that Gray Cook or Lee Burton or any of those guys have said over the last 8+ years since Cook wrote Movement.

I’m writing this because there seems to be a growing “anti-FMS” movement on the internet lately, and I think the majority of those behind this movement either don’t like the fact that Cook and others have found a way to become very commercially successful by branding their methods, or simply do not understand the FMS and how to implement it.

If you have no idea what I’m talking about when I say FMS, I explained the FMS here, and also explained what the FMS is NOT here. In short, the FMS is a relatively simple, 7-movement screen, designed to look at some basic human functions and help us make decisions about the next step in your exercise program.

Recently, I’ve come across several studies like this: https://www.ncbi.nlm.nih.gov/pubmed/26502447

“CONCLUSION:

Based on analysis of the current literature, findings do not support the predictive validity of the FMS. Methodological and statistical limitations identified threaten the ability of the research to determine the predictive validity of FMS.”

To which I say…No shit.

Maybe I missed something along the way, but I’ve never looked at the FMS as a method to predict injury.  So many of these recent studies really seem to be asking the wrong questions when it comes to the FMS.  To think that a movement test, which takes approximately 15 minutes to complete, could accurately predict something with as many variables as athletic injury rate is beyond irresponsible.

So…if we don’t use it to predict injuries, why do we use it?

Let me give you an example of the FMS in use.  We recently had a small group of athletes (6 kids ages 13-15) start their off-season strength and conditioning program at Paragon, all of them working out together.  During their first visit, we had each athlete perform an FMS.

We had 2 kids who’s Active Straight Leg Raise (ASLR) test looked like this:
ASLR 3

Two other’s ASLR looked like this:
ASLR 1

The other two kids were somewhere in between the top image and the bottom image.

Now, did we humiliate and chuckle at the kids who fit into the bottom image category?  No.  Did we get our goniometers out and try to measure their degrees of hip flexion and then foam roll their hamstrings until they got to 90 degrees?  Nope.  Did we even address the “issue” with them or try to “fix” it?  No.  Because our our eyes, as long as it’s not painful, this may not even be something that needs “fixing.”  And if it does need fixing, as trainers/coaches, we very well may not be the appropriate professionals to be doing the work.  How do I know that hip doesn’t have some kind of structural abnormality that no amount of core strength + foam roll + stretch will help?  The answer is we don’t know.

What I do know is I am going to treat the kids who look like the top picture a bit differently than the kids who look like the bottom picture.  On top, I have no reason to believe they can’t learn how to deadlift from the floor, power clean, etc. from day 1.  The kids who look like the bottom picture may not learn how to deadlift from the floor day 1, but maybe a Rack Pull (picture a deadlift, but with the bar elevated from the floor), or a kettlebell deadlift from a step, etc. could be an option.

Since it wasn’t painful, I fully believe that we can work with and help all of the above, and over time, I believe that intelligent training will lead to improved movement, which may open the door for the kids who look like Picture #2 on Day 1 to do all of the things the others are doing.  In the meantime, I’m going to put those kids into a position where they can succeed and let them thrive and get stronger in those positions.

Brief aside: What if one of those movements (or any other in the FMS) had caused some kind of shooting pain, tingling sensation, or numbness?  I’m going to work with them on the patterns that aren’t painful, and suggest they go see a health care professional (physical therapist, chiropractor, MD, etc.) to address the painful pattern.  This may seem like I’m being overly cautious, and in most cases I will be more cautious than I need to be…However, and I’m only saying this because I honestly have seen it happen in my career…

How do you know that your client’s lower back is a “tight muscle” or “weak spinal erectors,” and not bone cancer?  Seriously trainers, do you think you’re qualified to answer this question?  You’re not.

Back to the athletes mentioned above– In less than 20 minutes total, I was able to put 6 kids through an FMS and found that none of them had any pain, but two of them had significantly different active hip Range of Motion than the rest of the group.  I was then able to quickly create an initial program for the entire group, with some slight modifications for those differing movement patterns.  I’m not sure how anyone could argue the benefit of such an analysis.  I’m confident that by spending 20 minutes up front to evaluate these things, I’m saving a bunch of wasted training time down the road.

So if we return to the question posed above– if it’s not for injury prediction, what is it for?  The answer is pretty simple to me– The FMS provides us with a road map of where we should go next.  It’s then our choice whether or not we follow that road map.  Just because you don’t follow a road map, that doesn’t mean you wont get to where you’re trying to go, I’d just argue that there is some kind of “cost” associated with ignoring the map.

Can your joints actively get into position to absorb and adapt to whatever stress we’re about to put on them?  If yes— get after it!  If no–either change the joints or change the stress.

 

 

 

Aerobic Exercise Isn’t Evil?

As I mentioned in my post about Functional Training, trends in the fitness industry seem to come and go, swinging back and forth like a pendulum.  Aerobic exercise is no different.

In recent years, traditional aerobic exercise, also known as “steady state cardio,” has come under attack in the fitness industry.  Numerous articles have been published with titles such as “Regular Cardio Will Make You Fat,” and everyone has jumped on the High Intensity Interval Training (HIIT) bandwagon.  There are several things wrong here.  First, the research claiming that “cardio will make you fat” is sketchy at best.  Second, what most people call “HIIT” is actually more like moderate-intensity short-duration training, which misses the benefits of high intensity training as well as the benefits of long duration training.  We’ll go into greater detail on these topics at a later date, but for now suffice it to say that aerobic exercise is actually a good thing for your health, and the article below provides evidence as to some benefits of cardio that may surprise you:

http://www.irishtimes.com/life-and-style/health-family/fitness/it-s-a-no-brainer-why-running-is-good-for-your-grey-matter-1.2962438

Break Through Your Barriers

By now, just about everyone realizes that exercise is important.  Research has shown that regular physical activity can:

-Decrease likelihood of cardiovascular disease
-Improve mental focus and mood
-Improve test scores in school
-Reduce symptoms of depression
-Reduce risk of falls and bone breaks among senior citizens
-Improve body composition, reduce excess weight
-Reduce symptoms of inflammatory diseases such as rheumatoid and osteoarthritis
Among many others.

This is now news to most people.  So why then do several studies, show that so few Americans exercise?  We have more access to better equipment than ever before, and the awareness of the risks of inactivity are better known than ever before…yet a recent poll done by the Centers for Disease Control (CDC) shows that about 80% of Americans do not get the recommended amount of physical activity.  How can something that has such clear benefits become so rare in our society full of rising health care costs and increasing rates of disease?

Over the last 10 years or so of working in the fitness industry, I’ve encountered several reasons people will cite for not exercising regularly, but a few stick out as the most common.  These are the most common Barriers to Exercise that seem to pop up quite often:

-Lack of Time
-Lack of Energybreakthrough-img
-Lack of Motivation
-Fear of Getting Hurt
-Intimidation or General dislike for physical activity

If you fall into the category of someone who identities with one or more of these barriers, trust me when I say you are not alone.  All of my most successful clients, people who have lost significant weight and/or have put on impressive amounts of muscle and completely changed their body image, have dealt with at least one of these issues several times throughout their journey.  The key is to not let these barriers beat you.  Find a way to break through each one of these barriers, and you will find a way to create a much happier, healthier version of yourself that you never thought was possible.  I’m going to show you how to break through each one of these barriers over my next several posts, starting with a Lack of Time.

Stay tuned.

Adam

The Twists and Turns of your Rotary Core

The final chapter in our exploration of core function is my personal favorite, the rotary core.  It’s my favorite piece to the puzzle because there are so many wonderful variations of rotary exercises out there with fantastic risk-reward ratios.

We’ve already covered:
The Anterior Core
-The Posterior Core
The Lateral Core

Through our discussion, we have already come to conclusion that your core musculature is capable of producing trunk motion, but it’s most essential role is PREVENT motion of the trunk.  The anterior core resists trunk extension.  The posterior core resists forward flexion, and the lateral core resists lateral flexion of the spine.  The more often we take our lumbar spine outside of neutral, the more we are asking for problems in the discs and surrounding structures close to the spine.  This point is not debatable and might be even more important in the case of rotation.

As world-renowned physical therapist Shirley Sahrmann states, “during most daily activities, the primary role of the abdominal muscles is to provide isometric support and limit the degree of rotation of the trunk…A large percentage of low back problems occur because the abdominal muscles are not maintaining tight control over the rotation between the pelvis and the spine at the L5- S1 level.”

So, the job of the core is to prevent lumbar (lower back) rotation in order to keep the spine neutral.  Why?  Well, remember back when we looked the anatomy of our spinal column.

We learned that the area of the neck is referred to as the cervical spine, the area of your spine from about the top of the shoulders to the bottom of the ribs is known as the thoracic spine, and the area from the bottom of the ribs to the top of the sacrum is known as the lumbar spine, as shown below:

Gray_111_-_Vertebral_column-coloured

As you can see, each vertebra is named (C for Cervical, T for Thoracic, etc.) and numbered starting with C1 in reference to the proximity to the skull.  C1 is the closest vertebra to the skull, T1 is the uppermost thoracic L5 is the lowest lumbar vertebra, etc.

How does this play into our discussion about rotation?  Each segment of your spine is capable of a certain degree of rotation range of motion.  Attempting to surpass this range of motion can and will result in serious injury, such as a tearing of the annulus of the disk, if performed repetitively over time.  This annulus tear, if left untreated can eventually lead to a disk herniation.

The lumbar spine, or lower back, is the most common site of back pain, and lumbar rotation is one of the most common causes.  The reason for this is pretty simple.  Each segment of the lumbar spine is capable of only 2 degrees of rotation.  Rotating just 1.5 degrees further than this range of motion, repetitively over time, has been shown to create the annulus tear that I just mentioned.  That is an incredibly small window with which to work and because of this, using exercises which create lumbar rotation are almost always forbidden when you see a PT for back pain, and should be completely removed from all exercise programming as a preventative measure.  There are SO MANY wonderful exercises that we can use to challenge your rotary core without creating lumbar rotation, that the use of lumbar-rotating exercises make zero sense.  Remember, people with sedentary jobs sit, often with a flexed lumbar spine, all day long and add rotation for things like answering the phone, opening drawers, etc.  This is an extremely common mechanism for back pain, and adding more rotation at the gym is a bad idea.

On the other hand, the hips and the thoracic spine are capable of wonderful amounts of rotation, and are both highly mobile joints.  Rotation of the upper body should occur almost entirely through the thoracic spine, and people should learn how move with their chest.

Stop Doing This:

Russian twists, scorpion stretch, seated trunk rotation, full range of motion window wipers, or any other motion which produces repeated rotation of the lumbar spine.  The russian twist is an incredibly common exercise meant to strengthen the rotary abdominal muscles in which you are seated, essentially balancing on your tailbone, taking a medicine ball or other object side to side.  I’ve even seen this exercise advertised online as a way to “reduce your waist.”  Since we already know that spot reduction is a myth, I’m not going to go too far into that detail. What happens with the russian twist is essentially the same thing that happens when people sit in their chair and rotate for something at work, except they don’t do that at work for 3 sets of 40.  The hips and lumbar spine flexes and excess rotation is seen at the area of the lumbar spine.  This, again, is a primary cause for annulus tearing in the disk.

The Scorpion involves lying face down and then bringing both legs over one side of the body, then the other, without moving the upper body.  So here, we prevent thoracic spine movement (the place we actually want to move) and create it in the lumbar spine (the place we want to keep still).  Same goes for the seated trunk rotation and full range of motion window wipers.  Partial range of motion window wipers, when executed slowly and properly, can be safe and effective.  The knees should move only 15 degrees or less to each side of a vertical line, as this is the summation of the range of motion that each lumbar segment can go through.  These must be done with great care, but can be an effective trunk stabilization technique.

Start Doing This:

Birddog, Palloff exercises, chops and lifts.  The birddog is a great starting place for rotational stability training.  Get down on all 4’s, keep a neutral spine, and start moving things around.  Kick a leg, reach an arm, go slow, go fast, etc.  This is an exercise that a HUGE range of people are capable of doing, and can be made extremely challenging for the more advanced exerciser/athlete.  As you create range of motion in your extremities, your core musculature is working to resist rotation in your lumbar spine.

A Palloff Press or Palloff hold is simply attaching a band, tube, or cable pulley to an anchor point which is set to be about chest height, holding that implement in front of your chest, and extending the arms directly in front of the chest to create a rotary challenge.  The band, tube or cable is trying to pull you into rotation, while your core muscles work to resist it.  This can be done in a hold for a certain amount of time or for repetitions (pressing in and out).  This is another exercise which can be done by almost anyone, and can be made brutally hard.  You can do this standing, on your knees and even lying on your back.

Chops and lifts create a diagonal pattern of movement, either going from one shoulder down towards your opposite hip (a chop), or going from one hip up towards your opposite shoulder (a lift).  This can be done using a cable, band, med ball, rope, etc. and can be done standing, kneeling, or lying on your back, again making this a very useful exercise for many populations.  The key with these exercises, as with the birddog and palloff press, is that the movement comes from the arms and shoulders, NOT the lumbar spine.  From the bottom of your rib cage to the top of your pelvis, zero motion should occur.

This concludes our exploration of core function, so let’s sum up:

Stop Doing: russian twist, scorpion, seated trunk rotation, full range window wiper, sit-ups, curl-ups, crunches, side bends or side crunches, superman, or traditional hyperextension.

Start Doing: Birddog, Palloffs, Chops/Lifts, Loaded Carries, Side Planks, Planks, Front-Loaded movements such as squats, deadlifts, rows.

As always, thanks for reading!

Adam Reeder

acr30@zips.uakron.edu

Carries and Love Handles- The Lateral Core

Today we pick up our core training series with the lateral core system.  We’ve already talked about the anterior and posterior aspects of core training, and after today we will be left with only the rotational aspects.  The muscles of the lateral core are involved with a ton of movements, including many found in the anterior and rotary systems, but they are really isolated by a movement called lateral flexion.  This is the action of side-bending the spine, bringing one arm pit closer to the pelvis.  As we’ve talked about in previous posts, the name of the game in core training is to resist movement, so today’s post will be all about anti-lateral flexion.  When trained properly, the lateral core musculature acts to keep the spine neutral when there is a force (gravity, a weight) trying to create lateral flexion of the spine.

What muscles are involved with anti-lateral flexion?

transverse absQuadratuslumborum

Several muscles are involved in the act of resisting lateral flexion.  The two most noticeable are the internal (IO) and external oblique (EO) muscles, but also involved in the process are the transverse abdominis (TVA) and quadratus lumborum (QL).  The IO, TVA, and QL muscles are all deep muscles which lie underneath the more superficial rectus abdominis (RA) and the EO.

The External Oblique (EO)

The external oblique runs from ribs 5-12 down to the crest of the hip bone.  The EO is innervated by the thoracoabdominal nerves as well as the subcostal nerve. One extremely common complaint among women exercisers is the desire to get of their “love handles.”  This area of abdominal fat, found above the hip and under the ribcage, lies right ontop of the external obliques.  Because of this, many people attempt to side-crunch their love handles away, thinking that by working their external oblique, they will be reducing their abdominal fat.  Unfortunately, there is no amount of side crunches or ball twists that will reduce the body fat ontop of the muscle.  If you want to lose your love handles, the vast majority of your work must come from cleaning up your diet.  This is obviously a topic which can and will be it’s own post, but you will absolutely never out-exercise your nutrition.

The Internal Oblique (IO)

The Internal Oblique muscle lies below the EO and just ontop of the TVA.  As you can see with the picture above, the EO must be removed in order to see all of the IO.  The IO originates on the Inguinal ligament, Iliac crest and the Lumbodorsal fascia and inserts into the linea alba and ribs 10-12.  Like the EO, the IO is innervated by the thoracoabdominal and subcostal nerve, as well as the iliohypogastric and ilioinguinal nerves.  This is important to note because things that are wired together tend to fire together– meaning that when two muscles share common nerves, they tend to work together.  In this case, the IO and the EO work together to stabilze the spine.  The IO also plays a very important role in breathing, which is a topic that we will also cover in a separate post.

The Transverse Abdominis (TVA)

I spoke at length about the TVA in my post about anti-extension stability.  Check that post out for a more thorough explanation of the job of the TVA, and also know that it helps support the spine laterally as well.

The Quadratus Lumborum (QL) 

Ah, the poor QL muscle.  It gets some really bad press for a lot of things that just aren’t the QL’s fault.  One of my favorite therapists, Dr. Kathy Dooley, has a great write up on the QL here: http://www.drdooleynoted.com/anatomy-angel-quadratus-lumborum/

The QL is a muscle that is meant to help other, larger muscles stabilize the spine.  It’s meant to help the erector spinae and multifidii support the spine and keep it from flexing forward.  It’s meant to help the obliques support the spine from side to side.  When erectors, obliques, or rectus abdominis aren’t doing their job, the QL is your body’s last resort to maintaining an upright spine, and as such, the QL gets over-worked…a lot.  If you sit a lot with poor posture or if you don’t strengthen the other hip and core muscles around the QL, your QL will have to do a job it’s not designed to do.  An over-worked muscle often becomes a painful muscle, and this one of the very common reasons for lower back pain.  Since the QL plays such an important role in spinal stabilization, we certainly need to strengthen this muscle.  However, we also must make sure to strengthen the muscles of the hip and the core around it, to make sure it does not become over-worked.

Stop doing this:

side bend

Side bends, side crunches, or anything where you’re repetitively taking your spine out of neutral as you try to isolate your obliques.  I don’t care how many side crunches you do, your love handles are only going away if you change your nutrition.  Similar to the traditional crunch or sit-up, a side crunch or side bend takes the spine out of neutral and repetitively doing so can lead to back pain, disc damage, etc.

Start doing this:

side plank musclessuitcase carry

Side planks and loaded carries.  The side plank is simply holding a plank position, except on your side.  You balance between your elbow and your feet and you maintain a neutral spine with gravity attempting to pull your hips down towards the floor.  Holding this static position is the very definition of lateral core stability.  Once you can hold this position for roughly 30 seconds per side, you can start to add various movements to the side plank, or move into loaded carries.

Loaded carries are a group of tremendously beneficial exercises that just about anybody can do.  One of the most basic forms of a loaded carry is called a suitcase carry.  Simply hold a weight at your side and take a walk.  We usually carry for 50-100 feet per side set.  The weight on one side of your body attempts to pull you into lateral flexion, while the core musculature of your opposite side works to keep you upright.  The great thing about loaded carries is that they have the added benefit of improving grip and shoulder strength, while also getting the exerciser onto their feet.  This is an exercise that almost anyone can do in some capacity and has a great tendency to improve multiple areas of fitness.

Thanks for reading!

Adam

What to Expect during your FMS

What should you expect when you receive an FMS Screening?

My previous several posts have talked about movement: Why it’s important to assess movement, where the Functional Movement Screen (FMS) comes in handy, and some common misconceptions of the FMS. Until now, I’ve spoken mostly in generalities about movement and the FMS. Today I want to get a little more in depth about the individual tests of the FMS, so that when you get your first screening you have an idea of what to expect.

To review, each movement on the FMS is scored from 0 to 3. 0 indicates pain and 1 indicates a severe movement dysfunction, while 2’s and 3’s are passing scores. 5 of the 7 movements have left and right components, meaning that each side of your body is tested independently and receive independent scores.

Deep Squat

The first movement on the FMS is known as the Deep Squat. The deep squat tests ankle, hip, upper back, and shoulder mobility while simultaneously challenging stability of the knee, “core,” and shoulder in a symmetrical stance. The client is asked to maintain an upright torso with arms overhead while they descend into as deep of a squat as they can comfortably reach. We use this pattern on a daily basis from tasks such as picking up a basket of laundry to standing up off the toilet.

Hurdle Step

No, you’re not jumping over hurdles…fear not. The Hurdle Step movement is a test of balance in a single-leg stance while also challenging hip mobility and “core” stability. The client is asked to maintain an upright torso while stepping over a hurdle. The hurdle step pattern is used any time we stand on one leg for any period of time.

Inline Lunge

FMS Lunge

The Inline Lunge tests the client’s ability to maintain an upright torso while going through knee, hip and ankle flexion and extension in an asymmetrical stance. In these first three tests, the client is put into what is referred to as the “3 foot positions of function”: Symmetrical, Single-leg, and Asymmetrical. Every standing position that we find ourselves in throughout the day, including athletic events, can be narrowed down into one of these three foot positions and so getting assessed in each of these positions is crucial. We use the inline lunge pattern any time we go up and down stairs.

Shoulder Mobility

The shoulder mobility test is self-explanatory. We challenge the mobility of the client’s glenohumeral (shoulder socket) joint as well as their thoracic spine (upper back) mobility in a bilateral reaching pattern. Limitations or asymmetries on the shoulder mobility test will almost always show up on one or more of the previous 3 tests, showing the importance of shoulder mobility to basic fundamental movements. An asymmetry here can be a red flag for upper body strength training. Think of an overhead pressing movement: If you connect asymmetrical shoulders to a symmetrical load (such as a barbell or even a machine such as the seated shoulder press machine), and you do this consistently, the body will favor the “good” side and it’s only a matter of time before that asymmetry is exacerbated. Eventually a shoulder injury can develop from over-use of the “good” shoulder joint.

Active Straight Leg Raise

The Active Straight Leg Raise test looks like a hamstring flexibility test, and certainly the tension of the hamstrings plays a role in your score, but there is a lot more going on here. The client is asked to raise one leg as high possible while keeping the opposite leg flat on the floor. Sounds like a hamstring test to me, but we are challenging the ability to stabilize the pelvis (“core”) while one leg remains extended on the floor and the other leg goes through an excursion. We see this well…all the time. Any time you take a step whether you’re walking, jogging, sprinting, going up and down stairs, etc., your body has to subconsciously stabilize your pelvis while one leg strides and the other stops you from falling on your face. This happens naturally in the ideal situation, but as we incur injuries and age, we start to lose some of our ability to efficiently complete this basic task. An intervention which improves the Active Straight Leg Raise can have a profound effect on the rest of our basic movements.

Trunk Stability Push-Up

The Push-Up test is another deceptive movement. It looks like a test of upper body strength and certainly if we asked you to do more than 3 of these we would be getting into an area of strength and/or muscular endurance. For the purposes of this test, however, we are again looking at your ability to maintain a rigid torso- a common theme for the FMS- while producing movement in your extremities. This movement pattern shows up at various times throughout the day and is often taken for granted until the ability to perform it is taken away. Ask anyone who has been bed-ridden for a period of time or any senior citizen who has fallen. They’ll tell you how hard it can be to push yourself up out of bed or to get from the floor to a chair or couch. This test is not just for the elderly or sick though. Just about any athletic endeavor requires the individual to reflexively stabilize their spine. Think of the lineman in football who will either reflexively stabilize their spine or crumble to the ground every time they’re hit. It’s another process we don’t think about doing- until we can’t.

Rotary Stability

The final FMS test is called the Rotary Stability test.  The test takes place with the client in a quadruped or “all-fours” position on the floor.  The client is asked to maintain the natural alignment of their spine while flexing and extending their hip and shoulder simultaneously.  This is an assessment of core/spinal stability in the presence of extremity motion.  It does not look all that “functional,” but is a very good window into the function of an individual’s deep core musculature.  Our last 2 tests- Trunk Stability Push-Up and Rotary Stability- also represent important landmarks in our development as humans throughout the life cycle.  Our ability to push ourselves up from a prone position and to crawl are seen very early on in life and are two skills that tend to drastically diminish in adulthood.  Improving these two natural human movements can have a very large carry over to quality of life as we age.

There you have a very basic rundown of the tests found on the FMS.  I highly recommend getting screened before you start an exercise program, and if you’re already participating in an exercise program it’s a great idea to get screened now.  If you’ve hit a plateau in your progress, examining movement can be a complete game-changer.

Thanks for reading, and use the email address below to schedule your first screening!

Adam Reeder
acr30@zips.uakron.edu

Movement Screening Explained (part 2)- what the FMS is not

My last post outlined the basics of the Functional Movement Screen (FMS), why it’s important and what it tells us.  Today, I want to clear up some common misunderstandings that I see around the internet in regards to the FMS and explain what the FMS does not do.

FMS Deep Squat

The FMS is NOT:

-A test of strength, endurance, body composition, cardiovascular fitness, etc. All of these qualities may or may not be important to find out depending on who you are and what your goals are, but they should come after you find out how well you move. Remember, move well first, then move often.

-A predictor of performance. Scoring high on the FMS does not mean you’re a better athlete than somebody with a lower FMS score, nor does it mean you’ll lose weight quicker, or achieve any of your other fitness goals any faster than somebody else.

-A judgement of your character. People with little to no exercise experience tend to develop all kinds of anxiety about the FMS until I explain this point to them. “I’m so out of shape, I’m going to do terribly!” is something that I hear very often prior to a movement screening. The FMS is not meant to award the high achievers and punish those who are out of shape. I explain the FMS as more of a pass-fail test than a graded exam.

  • Did you score a 2 or a 3 on all of the movements in the screen? Great, you passed. Now get to work. There are no bonus points awarded for making a 2 into a 3 and I wont spend a great deal of time trying to do so. If one of your life goals is to get a 3 on the Active Straight Leg Raise and right now all you have is a 2, by all means I’m not going to stop you from trying to improve it, but just know that there’s no reason to think that getting that 3 will make you a stronger deadlifter, make you less prone to athletic injuries, or make you less likely to slip on that patch of ice on your steps.
  • Did you score a 1? You fall under the line of passing the test, and that means that putting you into this pattern is going to exacerbate your dysfunction and perhaps lead to injury. Now let’s make an intervention to clean that movement pattern up. This intervention could come from an endless array of possibilities- mobility, motor control, soft tissue, etc. This is where your coach is invaluable. How do you get from dysfunctional to functional to training as quick as possible? And remember, passing the screen isn’t the end goal, it’s more of a starting point. We just need you to be a 2 or better to be able to safely say “okay- now let’s get to work on your goals.”
  • Did you score a 0? That’s okay. There are still things we can do to help improve your fitness, we just aren’t going to use that particular movement pattern. Let’s get you set up with a really good medical professional and see what exactly is going on. People hate this result, but it’s incredibly necessary and incredibly powerful. Going to see your doctor or physical therapist is not a death sentence to your fitness and in this case it’s actually the fastest and safest way to achieve your goals. Whenever trainers/coaches/instructors act resistant to refer a client with pain to the appropriate medical professional for fear of losing a client, my response is always: “You can’t guarantee that that lower back pain isn’t cancer.” While this may seem like an extreme reach when we’re talking about a very common complaint (back pain), the fact is that pain can often be the only present symptom for a number of very serious diseases, including cancer.

One more thing to add about the FMS: There is a total score which can be generated by adding the scores from each individual test. This total score is where much of the debate exists as to whether the FMS is an accurate predictor of future injury. Several studies have examined the correlation between total score on the FMS and future injury incidence in certain athletic populations, and I’ve cited some such studies at the end of this article. I’ve used the FMS for several years now, and have never paid any particular attention to the total score on the screen. In my opinion, the movements are so different from each other, and athletic injuries vary so widely in nature, that simply combining the scores together and running some statistical analysis of injury incident vs. total score does not seem to make much sense. Due to the way the test is scored, high scores in a few movements can overshadow dysfunctions or asymmetries on other patterns.

For example, a male football player may score as such:

Deep Squat- 2

Hurdle Step- 1 left, 2 right

Inline Lunge- 1 left , 2 right

Shoulder Mobility- 3 left, 3 right

Active Straight Leg Raise- 3 left, 3 right

Trunk Stability Push-Up- 3

Rotary Stability 2 left, 2 right

When totaling score, you take the lowest score per test so, this person with a 1 left, 2 right Hurdle Step would score a 1 for that test. The total score of this screen comes out to 15, a relatively high score and usually the cut-off point for “high” vs. “low” scores in research. This person creates their high score by nailing shoulder mobility, active straight leg raise, and the push up, but I have some serious questions about their hurdle step and inline lunge, two tests which create a functional, on-your-feet demand for both mobility and stability. I would be much more concerned about this individual from an injury standpoint than somebody who had nothing but 2’s across the board with no 3’s.

I believe that an athlete playing with movement pain or severe movement dysfunction probably puts that athlete at a higher risk of athletic injury, I just don’t think a sum total of scores in the FMS is the way we should be looking at injury risk. I focus entirely on individual movement results and look at each movement as it’s own small piece to the injury risk puzzle.

The FMS is a wonderfully simple and valuable tool that can be administered in under 15 minutes and is quite reliable from test to test (see citations 2 and 3 at the end of the article). It can and should be used as a pre-participation screening prior to engaging in sport or exercise and can also be used to monitor movement progress over time, especially if dysfunctions show up at that first visit. If your trainer doesn’t use the FMS, fire him…just kidding. If he or she doesn’t use the FMS just make sure they’re doing SOMETHING to assess your movement quality the first time you meet them. Remember, that doesn’t mean “how many push-ups can you do in a minute?” Quality, not quantity. If you’re not assessing you’re just guessing, and movement is far too important to guess on.

In my next post I’ll go into greater detail on the individual tests and what they mean.

Thanks for reading!

Adam Reeder

Scholarly articles reviewing the FMS:

1) Chorba, R. S., Chorba, D. J., Bouillon, L. E., Overmyer, C. A., & Landis, J. A. (2010). Use of a functional movement screening tool to determine injury risk in female collegiate athletes. North American journal of sports physical therapy: NAJSPT, 5(2), 47.

2) J Orthop Sports Phys Ther. 2012 Jun;42(6):530-40. doi: 10.2519/jospt.2012.3838. Epub 2012 May 14.

3) J Strength Cond Res. 2013 Apr;27(4):982-7. doi: 10.1519/JSC.0b013e3182606df2.

3) Kiesel, K., Plisky, P. J., & Voight, M. L. (2007). Can serious injury in professional football be predicted by a preseason functional movement screen?. North American journal of sports physical therapy: NAJSPT, 2(3), 147.

4) Lisman, P., O’Connor, F. G., Deuster, P. A., & Knapik, J. J. (2013). Functional movement screen and aerobic fitness predict injuries in military training. Med Sci Sports Exerc, 45(4), 636-643.

5) Parchmann, C. J., & McBride, J. M. (2011). Relationship between functional movement screen and athletic performance. The Journal of Strength & Conditioning Research, 25(12), 3378-3384.

Movement Screening Explained (part one)- What is the FMS?

In my last post I explained why movement is such an important entry point for fitness, health and well-being. I gave an example of how a simple movement screen could potentially save valuable training time while making sure that you, the client, are given the most appropriate exercise program.

Today I want to discuss one simple and highly effective way to screen for movement pattern qualities: the Functional Movement Screen or FMS. Keep in mind that this is just one of the many screens available and it’s a great idea to check out as many screening procedures as possible before you decide which is best for you. The FMS is the best one that I’ve ever used, as it gives us a relatively quick, objective analysis of how well you move. I fall into the camp of people who truly believe in the value of this particular screen, and I’m not afraid to admit that. I will save a detailed explanation of each individual movement tested in the screen for a later date and instead I will give a general explanation of the FMS and why it’s an important step to take before you start an exercise program.

What is the FMS?

-A series of 7 individually-scored movement patterns designed to identify movement dysfunction or painful movement.  It was developed by Physical Therapist Gray Cook and his colleagues.  Cook is one of the top minds in rehab and performance today.

FMS-hurdle-step

-A scoring system from 0 to 3.

  • Any movement which produces pain on the FMS results in the score of 0 and is cause for further investigation. This could come from a referral to a licensed medical professional such as a physical therapist. This is the most important finding in a movement screen and makes client-coach communication essential. If a pattern is painful, it should be treated as a medical issue rather than a fitness issue, and as such it shouldn’t be part of your typical exercise program. This does not mean you have to stop working out, and doesn’t even mean that you’ll never train this pattern. It simply means that a fitness solution is not appropriate for what is a medical condition.
  • Any movement that is screened to be dysfunctional but not painful receives a score of 1. This is cause for further investigation but the solution can often be found without referring out to a medical professional. We will still avoid loading this pattern (meaning, adding resistance to it), but we don’t have to avoid it all together. If your trainer/coach is good at what they do, they can often remedy this problem fairly quickly without losing out on valuable training time.
  • Any movement that is not painful and not severely dysfunctional, but not quite perfect receives a score of 2. There may be a flaw in the movement pattern but it isn’t severe enough to raise a red flag and we can safely load this pattern. If this is the person’s lowest score on the entire screen we may spend some time addressing this pattern in warm-up or homework, but we wont spend a ton of training time on it.
  • Any perfectly executed movement receives a score of 3. There is no pain with the pattern and no dysfunction present. This pattern is good to go. Since the FMS is done “cold,” meaning the individual is not permitted to warm-up prior to the screen, we don’t even have to address this pattern in a warm-up. We can, of course, but all of the hardware and all of the software is present for this person to perform this pattern essentially right off the street.

-The FMS also includes a series of “clearance” tests which simply ask the client to report any pain with shoulder impingement, spinal flexion or spinal extension.

There you have it.  That’s the FMS.  An objective, unbiased view of movement quality which can be administered within the first 15 minutes of meeting your trainer.  It gives us valuable information about your mobility, stability and motor control and gives us an accurate baseline of your movement health.  My next post will aim to clear up some common misconceptions of the screen and explain what the screen does NOT do.  If you think you could benefit from a Functional Movement Screen and it’s resulting exercise program, contact me with the information below:

Adam Reeder
acr30@zips.uakron.edu