Stuck with 1’s

[When you are working with someone with congenital deformities when they can not possibly score a 2 or 3 on an FMS screen], what does the the 14/21 benchmark mean for predictor of injury for him?  Do we throw out the….screens due to anatomy?  What is our scoring baseline?

Often I, and I’m sure others, are asked how the screen can or should be modified for predictable circumstances.  Some of these situations can be elderly, neurologically injured folks, unique body types like longer spines or femurs, and in this case a congenital deformity.  It’s fairly common sense to expect certain scores are going to be completely incapable.

And that’s totally fine.  Keep the Screen the way it is.

Or maybe you wouldn’t even use the FMS if every movement was challenged because your “other” Screen, your common sense, was more useful to predict risk.  Remember, we are not at a stage of thought here for the FMS where we are gathering data and crunching it for a cut point.  The basic genesis of the FMS is to screen for risk with a fitness conditioning program.  If you believe there is risk, the idea is that you make changes to try to beat that risk.  The changes will be long-term if the performance is not something that can be ammended.

I mean how stupid would it be to not change up a program when someone had no arm?
I tend to think the TSPU would be a 1 for this individual.

The symmetrical 14/21 standard doesn’t change, and the 0-3 scoring system doesn’t change.  You use a red light-yellow light-green light approach for each of the movements of the Screen.  In some cases, modifications are going to be based on common sense pink elephants rather than subtle flaws that need to be found under discriminatory conditions.  Worse comes to worse, you skip the FMS, give them a 7, and work on ASLR and SM following the algorithm.

Functional, foundational, fundamental.  These semantics all lead to discord.
The fact of the matter is that the FMS is intended to be a species-related tool.  It applies to everybody, whether the research supports the prediction level or not.  Consider the movements arbitrary.

I hope no one thinks research is required for a perception of risk.  The FMS is not for active folks, not for athletes, not for folks that train with kettlebells.  It is intended to be a standard for all humans, just like an EKG, blood pressure, skin check, eye exam.  Lower than the standard is acceptable in certain populations.  If the screen you choose shows up below industry standard, something moving forward is likely to be changed.

If you are not sold on the research as a predictor injury predictor, revert to its original intent, a predictor of risk.

It’s really not that complicated.

This is all it's about.

  • July 22, 2011

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Lauren Reply

Agreed! I had a patient who wanted to do Crossfit but had a stroke as a child…. I used the movements as a frame to observe movement quality for what he needed to do in the gym, I think Gray would say not to score him at all. Also, for the older population, I think the lunge isn’t the best but gives you the idea as a clinical how to assess how the patient would get up off the floor if they fell or to make sure it’s appropriate to give them floor exercises when no one is around to help then get up, then I use it as a training tool. They don’t like it but it makes sense!

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