1. If one has shoulder pain and is unable to perform the MS Ext pattern secondary to the pain with the shldrs flexed – it is advisable to perform the MS Ext pattern with hands on the hips? Would you score it a DP/FP initially and move on to another DN pattern or use what you get from the MS Ext hands on hips?
Ultimately there is no wrong way to go about this. There may be an ideal approach that will help you “own” the system, but after a while, I think you can dance around a little and be even more efficient. If you can defend breaking out a painful pattern, or see a thread that can add up to the quick fix, which in this case you can, then this is totally fine in my book.
Breaking out a painful pattern is something you are more than warranted to. It’s not wrong in any way as you are simply building your case. How much time you have, and how pressing are the other culprits in the Assessment can help you decide if this is efficient. MSE is DP according to the information in the question.
Also consider what else did you learn from other patterns, particularly how/if the shoulders yield pain.
In this case, if MRE and LRF also yielded pain, and then MSE was still a DN, then address the open-scissors posture and/or ankles.
The rib-pelvis centration would leave inefficient scapular position with any overhead training yielding threat perception and impingement. If ankles were restricted into dorsiflexion, this same shoulder trouble would be from repetitive jumping or barbell snatches.
If MSE was all clear without the arms, treat the shoulders and/or neck if it is on board as well.
There is no wrong here, just varying levels of right.
Trust the system.
2. If one gets a (+) on the shldr clearing tests, however, still has a FN in the upper ext patterns, would the pattern still be considered a FN or would it now be a FP or DP?
How is a clearing test aiding in your movement grading, unless it ultimately can change your grade?
This is quite simple. The MRE or LRF are FN, and the Active Impingement and Cross-Arm Impingement are Positive.
The grading is all separate in terms of documentation. You will likely find that the Shoulder patterns do not always screen completely for painful patterns.
3. During the Big 7, if one sees other indications of dysfunction (such lumbar hinging in the MS Ext pattern, increased tone at end range, etc) but one still mets the citeria on the list, would it still be a FN or would you score it a DN?
These are always DN. There is no value in gifting a score or “scoring up.”
If you err on the side of caution, then breaking out the patterns will confirm or deny what you see in the vertical.
If there is hinging in vertical MSE but not in prone extension, this should tell you where to go – SMCD (provided other mobility breakouts were FN).
4. Do any of you using the SFMA still perform any Special Tests? They seem to be the least important of my exam now.
I see your point in suggesting special tests are least important, and I inclined to agree.
However, for those are required strict or specific documentation, they are still very important.
Special tests are also going to be of huge importance in deciding what type of intervention you use. This is actually an interesting twist on your question as many individuals see the SFMA as somehow restrictive in using the types of techniques/methods. This is quite false as the SFMA yields the audit of a pattern, and then the special tests for the commercial model you prefer will yield
This actually has a lot of gravity in my opinion if pain is changed/movement is improved in both the SFMA and the special tests. The SFMA does not have a strict treatment model attached with it. This is a common misinterpretation. You can do whatever you want; the SFMA is just a guide to ensure a complete approach.
The SFMA will tell you if need a wrench.
The special tests of your preference will tell you which size wrench to use.
Use your moves to beat this other test.