Monday, May 4, 2009

A Movement Assessment: what is it and why should i have one?

Getting rid of the Parts Model of Human Pain and Performance.
Folks on various health forums will often post "i have a weak knee; what exersises can i do to strengthen it?" or "my hamstrings are tight and it's affecting my deadlift; what can i do to loosen them up?" or "my shoulder keeps bugging me; what's good for shoulder rehab?"

All of these questions, it seems, tend to consider the site of the problem to be the source of the problem.

Folks who reply often share that perspective with proposals like "sore shoulder - here's a great book/dvd/blog on shoulder rehab." or "tight hamstrings? foam roll 'em out. it's great. do that anytime before you deadlift that'll loosen 'em right up."

But what if the site of the problem isn't the source of the problem?
Then all we are providing are classic band aid solutions where the problem will just keep coming back. We know about this in any kind of mechanical situation: the car engine is leaking oil.

If all we do is keep pouring in oil to top it up, we're not dealing with the problem. The problem may require a simple tweak on a part we're not familiar with, or it may need some more serious work. We don't know; we don't have the expertise. So we get an assessment of what the problem is, and what it will take to fix it.

We know enough to do this for a mechanical machine, and yet when it comes to our far more complex organism - our bio-electrical-mechano-organic selves, we seem to take a far cheaper attitude. Perhaps because we're so resliant; perhaps because the trad. medical establishment has let us down. And how successful - in the long term - is our tire patch/band aid approach?

Avoid Frankensteining Body Work
Here's another analogy: Pavel Tsatsouline famously decries the "frankenstien monster" approach to strength/body building that treats muscles in isolation. Frankensteining the body referring to assembling parts that are shown off as parts rather than integrated elements. Many of us have experienced the benefits of compound movement work to create powerful integrated, athletic strength and power.

Ok, so why then why then when we have a tweak, a pain, a weakness, do we suddenly move exactly to that body part, isolationist, frankensteining approach for how to make ourselves better?

Alternatives to the Parts Model approach to
Perceived Human Performance Problems

A movement assessment sees pain as a symptom only and respects the complexity of the body. As a result it may indeed be less interested in causes for a particular expression of the Whole Body saying HELP, and more interested in looking at and addressing movement patterns. A finding that's shocked and delighted me is how much improved movement/addressing movement reduces pain - many many varieties of pain.

Isn't that what Doctors Do?
Now, you might say well heck isn't that what a physio or a chiro does or even a doctor does?

The answer is yes and no: yes, if that physio or manual therapist of whatever stripe is hip to the notion of movement and how everything is connected in the body, possibly; if that physio person hears you say "i have sore shoulder" and goes right to assessing your shoulder - like site = source, then more likely no. The last time i went to see a doctor about a sore back i was prescribed muscle relaxants. Perhaps you have similar experiences?

The Movement Approach Difference:
Seeing a Whole Body in Motion; not bunches of parts.

While we tend to think of ourselves as a sore back, weak knee, tight hamstring. Or as strong biceps, weak shoulders, great back, our bodies are not so isolationist. The connections througout are rich and legion. Joints and muscles are connected with all sorts of tissue in all sorts of ways throughout the body such that "anything can affect anything." Really. Take a look at a book like Anatomy Trains for an incredible illustration of this point. A headache may be more tied to a tightness in the foot than a pain in the neck, as it were.

One of the best ways to see this interconnection manifest itself, it seems, is when we do what our bodies are designed to do: move.

When the body is in movement, it calls into play so many inter-related parts that when watched via a skilled assessor or via a good screen, show off just how well our highly integrated systems are working together - or not - and provide clues of what may need to be addressed to get us moving optimally. Consider walking: we are not only moving limbs and counterbalancing tensions; we're balancing and orienting ourselves in space. Our central nervous system is, as Z practitioners (overview of zhealth)and others learn, "always on" too, always connecting all systems. I've written before about the power of the arthrokinetic reflex and how a crinked neck cuts strength in a deadlift.

The emphasis is on movement. Address the movement and other good things follow.

UPDATE: what are examples of what happens in a screen (motivated by question on DD)

Movement assessments say "let me see you move" - and based on watching you move, a certified screener/assessor can see where there are weaknesses/problems in that pattern. They then have a set of corrective strategies that map to tackling that issue. They work through these with you and retest that sore point (where the symptom is tweaking) to check for improvement, and iterate to narrow down on the best set for you.

So you may come in with a sore shoulder, and be asked for a history of your health, and then, in Z someone may say "let me see you walk" - to check for those patterns.

The issue doesn't have to be pain; it may be a plateau in a lift, or problem with part of a move. same thing. Let's look at how you move, assess, drill, retest that move that's your concern.

Here's another example for an assessment that you can step through:

on the Functional Movement Screen site, there's an overview that describes/shows the 7 screens of that assessment.

You go through each screen, each side of your body and get scored. Based on those scores, the person screening you suggests drills to address any asymmetry (differences in left/right side performance) or weakness. The foundational principle of the FMS is first address asymmetries, then improve performance.

In ZHealth (and here's an overview), there's a variety of assessments, but the fundamental one is to watch you walk. Given that, you may be given mobility drills (like those in the Rphase DVD) to address what's found.

Can i Just Screen Myself?
yes and no.

It's tricky because it's hard to see yourself from vary many angles. i can watch myself walk forward, but need a video to watch me from behind, which is really important. so ya maybe with video, if you know what you're looking for.

That said, Gray Cook's Atheletic Body in Balance had a shorter version of what was to become the FMS for this kind of self-assessment - better perhaps than a kick in the head.

More recently, Gray and Brett and Mark's work on the TGU in the Kalos Sthenos DVD has been proposed as "a screen" - in fact we've been talking about how the TGU compares with the FMS. SO if you rigorously checked yourself against the spec of the TGU on the DVD, at each of the 7 parts of that move, you could get a very good idea of where your weak link may be - Brett would be quick to say though that that may only show you where your weak link is in the TGU - we're not clear yet how well it generalizes as a diagnostic.

What one could do is say
  • hmm my shoulder's bugging me,
  • i'm going to do the ahtletic body in balance screen on myself and see what comes back,
  • and even if it doesn't show a shoulder issue, i'm going to run the pattern for whatever comes back in my test
  • do the corrective drills for the weak bits,
  • and retest my shoulder, see if it feels better.
The challenge would be (a) how much is your time worth to teach yourself this and try to apply it on yourself? (b) do you have the time to go through the corrective strategies, and do the application and recheck? if you do, that's great. way to go. Knowledge is power. Go for it.

One more point for consideration on the self-check - this is exactly what a lot of us do when checking out our own form in a mirror for the swing or the snatch, right? but if you've had the pleasure of being observed by someone trained to teach these moves, they'll see one little thing we might miss, tweak that and in two minutes it's as if we've gone to movement heaven.

So yes, it's very good to get body awareness, and in particular movement awareness. This is what something like the ZHealth Rphase/Neural WarmUp vids help build and what the KS DVD helps build from slightly different perspectives.

The benefit of then going to a certified trainer to have the assessment is like going to an RKC to watch your hard style swing or snatch to tweak it, or to an ikff ckt for your GS. Another pair of eyes; another depth of experience.

Isn't this an expensive luxury? I just have a tight hamstring...
That's a good question.
Let's qualify a tight hamstring first and then expensive.

In keeping with the view of our body as an integrated system - and not just a machine with replaceable parts, a tight hamstring could be caused by just about anything. Indeed, to quote Eric Cobb of ZHealth, anything can cause anything. What if it's just a signifier of something in your shoulder or foot that if it isn't addressed, that hamstring issue will keep coming back, and perhaps bring some of its friends and pump up the volume. The arthrokinetic reflex is just one example of how something happening in one part of our system has profound consequences *through out* the system.

So, if you take away one thing from this post i hope it's that a pain signal or perception of weakness may be a signal of a systems issue, and checking the system (in this case with a movement screen) is a good way to address that signal.

Note i'm not saying that we have to check the system to find the CAUSE of the problem - who knows what the cause is, and is that important? What we can do is check for what's happening in the movement, address that, and see the positive effects.

Now as to expense, it's unfortunate that movement assessment isn't part of medical insurance. But until it is, yes it's a choice as to how you spend your hard earned cash.
A qualified/certified trainer may well cost you as much as going to see a chiro or related therapist for an assessment. As with other disciplines/services, you get what you pay for, so a question may be:
  • What is your pain free movement worth?
  • What is a strategy that will help reduce the likelihood of the next injury worth?
  • What's your ability to train optimally worth?
  • or simply to get through the day without sore shoulders and/or a headache worth?
The price of a dinner for two? of a pair of sneakers? of a lighter kettlebell?

Likewise, seeing a pro movement specialist and trainer for 30-60mins can give your performance a huge boost that well pays for itself in terms of time taken to make these strides (and ability to make them without pain).

And there's other options:
with the CK-FMS (overview of cert), folks need to do a case study: they need someone they can see usually at least twice to assess and follow up. Search for a ck-fms in training and offer to be their case study. Some folks will also trade services for services, or have student rates. So ask. Packages are a great way to get even more value from your session. More on this next.

Optimizing the Benefit of a Screen: buyer's market.
There are a ton of personal trainers available - all dying to train YOU.
A growing number of smart trainers are adding movement assessment certifications to their tool box. You can look around for trainers that have such qualifications to go with your training - and you can check out what you think of those screens.

The RKC has hooked up with Gray Cook and Brett Jones to extend the Functional Movement Screen Certification to the CK-FMS. This cert material goes well beyond what's offered at an FMS cert, and is only available to RKC's - so with a CK-FMS, you have a top hard style kettlebell trainer and someone who knows how to run the FMS and who has done at least one deep case study on how to apply this approach from diagnostic to corrective strategies for that client.

Likewise, you'll find an increasing number of RKC's (and others) who (also) have Z-Health training. That trainer has a range of movement assessment tools and strategies available to them, too.

Both the FMS and ZHealth sites list certified trainers at least by location if not by name as well. It's relatively straight forward to check for someone who looks good via google and see what all their qualifications are, along with that particular cert, and see if that person looks like a match for your intersts.

What i like about the ZHealth listing for instance, is that you'll find physio's, rolfers, chiropracters, at least one MD, who care about fitness training, and have done advanced level Z certification, too. So what's your comfort level? if you want someone with a medical background also trained in movement assessment, you have choices.

So whether you're looking for kettlebell trainers or certified strength and conditioning coaches, or physical therapists, or chiropractors to help you with your fitness performance and health and well being, really the choice is yours. One of my most popular requests is for a movement assessment combined with a kettlebell movement check/tune up. I love that. It's a great package and a great way to optimize your training dollar/pound/euro/etc.

What does a movement assessment get someone, really?

In the FMS, Gray Cook talks about identifying your weakest link in order to address this link so as not to build function or strength on top of dysfunction.

In Z-Health, Eric Cobb talks about efficient, pain free movement.

The motivation in each case is similar:

- when you take away "the site is the source of the problem" perspective, you start to see a body in motion - not a collection of parts that can be assessed in isolation, but complex connected interrelated components.

From this perspective, the bod's really complicated: anything can cause anything. So an optimal way to look at the body is not at one part that may be saying something (on behalf of everything else), but at a whole organism in motion. The pragmatic consequence is a movement assessment that:

  • looks at you as a whole person who moves, and seeing that whole person move, help assess and improve that movement so that it's at its best. The usual consequence of this is improved overall performance and reduced pain.
  • provides you with strategies to address any movement issues to help improve your movement performance, and again the results of this are better overall movement; less pain; reduced risk of injury.

So if you have a tweak or a perceived weakness in a limb or have hit a plateau, consider these as signals not just to poke at a part, but as a call from your body to look at your whole self, and a great way to look at your whole physiological self is when it's in movement.

Guaranteed if you do this for yourself you'll be happier and healthier for it. And you'll find most trainers do offer guarantees of satisfaction, too.

1 comment:

Adam said...


My movement screen was eye opening to say the least. First what was suprising is that i am not as flip floped as people think. Second was my ALSR is terrible (already mostly corrected this week)

I think EVERYONE should strive to get screened, it can you save you a lot of pain in the long run


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