From “In Pain” to “IN SHAPE!” Functional Manual Therapy and the Functional Movement Screen

IMG_0181By: Eric Keene PT, DPT, CSCS

Before I became a Physical Therapist, I was a Personal Trainer and Strength Coach.  I trained a variety of athletes as well as individuals looking to improve their fitness.  I loved helping these people to meet their goals.  Occasionally, something would interfere with our training sessions: pain.

Not the good kind of “feel the burn” of a muscle; rather, joint pains and sharp pains.  Even after coaching them in good form and utilizing progressive programs, a knee might hurt with squatting, a back with dead lifting, or a foot while running.  Later did they bring up that they have been struggling with these issues for years!

I was quickly finding that the “well population” really wasn’t that well at all.  These pains were getting in the way of them achieving their health and fitness goals.  I didn’t know how to help them.

This is when I was first introduced to the Functional Movement Screen (FMS).

The FMS is a series of 7 movements that helps to recognize movement asymmetries that could possibly contribute to future pain and injury.  Research has shown it to be a reliable measure – meaning an individual would get a similar score on it if tested on it multiple times.

Basically, each movement is scored anywhere from a 3 to a 0 – a 3 being the optimal score while a 0 being a painful movement.  These tests challenge both mobility and flexibility – as well as stability -only utilizing body weight movements.  If you have efficient movement in that movement pattern and are symmetrical, you score a 3 – congratulations!  If you experience pain during any of these patterns, you score a 0 – congratulations!

What?! Why would I congratulate you for a score of 0 on a movement screen that predicts future injury?  Because now we know your weakest link that could cause a future injury. 

Enter Functional Manual Physical Therapy.  This approach is the integration of functional movement with hands on treatment of muscles, joints, fascia (the layer under the skin), neurovascular (nerves and blood vessels), and visceral (your guts) structures that could be limiting function – with the ultimate goal of getting people out of pain and functioning optimally.

Let’s say you score a 0 on the Active Straight Leg raise test.  This test in part is influenced by the lengthening of the same side hamstring, strength of the same side hip flexors, as well as the down legs extensibility of the hip flexors.  The Personal Trainer will then collaborate with the Physical Therapist and right from the beginning they both know where to focus their efforts to complement one another.

With this presentation, the Physical Therapist will be able to have a pre test and post test, know to address excursion of the hamstrings, folding of the hip flexors, as well as pelvic mobility.

Once the FMS is complete and appropriate interventions from the Personal Trainer and Physical Therapist are implemented, then we can rescreen and see where improvements were as well as what still needs to be addressed.  This is a comprehensive way to help an individual go from in pain to in shape!

Elite Health Services, located in Old Greenwich, (and now Westport!) CT is a world-class provider of certified functional manual physical therapy, personal fitness, golf & triathlon performance training, massage therapy and wellness related services. Our team of highly skilled and dedicated professionals take a no-excuses approach to providing exceptional care and delivering exceptional results. To learn more visit www.EliteHealthServices.


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