1. © RockyMountain HPC, Inc.

2. Optimal Performance Movement Strategies

3. Optimal Performance Pyramid

4. Functional Movement Mobility ROM / Flexibility Stability Core stability / Neuromuscular Control Assessment FMS

5. Key/critical question? Are we building strength and conditioning, rehab, fitness and skill on top of dysfunction?

6. What is FMS A series of movements designed to evaluate stability and mobility (i.e. functional movement) Uses extreme positions where weaknesses and imbalances become noticeable Ultimate goal is to identify athletes at increased risk for injury Developed by: Gray Cook….

7. What is SFMA ? Comprehensive assessment system Used to classify movement patterns Direct manual therapy and therapeutic exercise interventions Developed by: Gray Cook U. Miami, FL Greg Rose TPI Mike Voight Belmont U, TN Phillip Plisky U. Evansville, IN Kyle Kiesel U. Evansville, IN

8. Key Principles Optimum function movement (relative) Balance between mobility and stability Tightness = weakness Example: oHamstrings seemingly become tight when the core is too weak to control the pelvis oTargeting the tightness only will result in a short term gain at best

9. Functional Movement Screen Consists of 7 tasks (3clearing maneuvers) Scored 0 (lowest) through III (highest) Lowest score counts on bilateral tests Best possible score = 21 ? Discuss data currently available Athletes Municipal workers Comparison Stand-alone vs. additional physiological measures (West Point)

10. Functional Movement Screen Deep Squat Hurdle Step In-line Lunge Shoulder Mobility Active Straight Leg Raise Trunk Stability Push Up Rotary Stability 3 clearing maneuvers

11. Scoring the FMS III – able to complete task II able to complete task with compensation I – unable to complete task 0 – pain during test (or clearing exam) Max Score = 21points Also looking for asymmetry

12. Asymmetry Musculoskeletal asymmetry is a well established risk factor for injury Ekstrand & Gillquist, 1983 Knapik et al., 1991 Baumhauer et al., 1995 Plisky et al., 2006 Myer et al., 2008 Yeung et al., 2009

13. Research J Occup Med Toxicol. Apr. 2007 433 firefighters 62% reduction in lost time with intervention 42% reduction in 12 month injury rate NFL Data If FMS score is ≤ 14, and there is an asymmetry, then the probability of suffering a time loss injury increased from 15% (pre-test probability) to just over 50% Scores can be improved with a specific off season training program (SFMA).

14. Research Intrarater and Interrater Reliability Minick, KI, Kiesal, KB, Burton, L, Taylor, A, Plisky, P, and Butler, RJ. Interrater reliability of the Functional Movement Screen. J Strength Cond Res 24(2): 479-486, 2010 Teyhen, DS, Donofry DF, Shaffer SW, Walker MJ, Lorenson CL, Dugan JL, Halfpap JP, Childs MD. Functional Movement Screen: a reliability study in service members. USArmeh Med Dep J. 2010 Jul-Sept:71

15. References Cook, Gray Athlete Body in Balance, 2003 Gray, Gary Gray Institute / Nike Kraemer, William, University of Connecticut Michaud, Tom Human Locomotion, 2010 Prentise, Bill., UNC Chapel Hill Rose, Greg TPI Starrett, Kelly The Supple Leopard, 2013 Tiberio, David University of Connecticut

16. Balance and Asymmetry FMS Improving Performance and Avoiding Injury by Eliminating Asymmetries

17. Understanding Balance Where does Athletic Movement originate? How does it Respond? How can it be Improved?

18. Testing For Asymmetries Functional Movement Screen Performing the Screen

19. Deep Squat The deep squat challenges total body mechanics when performed properly Assess bilateral, symmetrical and functional mobility of the hips, knees and ankles. assess bilateral, symmetrical mobility of the shoulders as well as the thoracic spine.

20. Hurdle Step

21. In-Line Lunge

22. Active Straight Leg Raise

23. Trunk Stability Push-Up

24. Shoulder Mobility Test

25. Rotary Stability

26. Score the test Design the program

27. Specific Guidelines – Exercise Selection Proprioceptively rich program Safe Challenging Stress multiple planes Incorporate multi-sensory environment Activity specific Progressive functional continuum Ø Slow to fast Ø Simple to complex Ø Known to unknown Ø Low force to high force Ø Eyes open to eyes closed Ø Static to dynamic

28. Goal of program - develop optimal levels of functional strength & stabilization Ø Focus on neural adaptations instead of absolute strength gains Ø Increase proprioceptive demands Ø Quality not quantity Poor technique and neuromuscular control results in poor motor patterns & stabilization (injury) Focus on function Goals

29. Questions to Ask Yourself Is it dynamic? Is it multiplanar? Is it multidimensional? Is it proprioceptively enriched? Is it systematic? Is it progressive? Is it activity-specific? Is it based on functional anatomy & science?