SFMA, the T-Spine, and Cyriax

The SFMA Upper Extremity Patterns - MRE & LRF - tests shoulder gleno-humeral and scapular mobility vs. stability. Why then do most of the corrective exercises for the Upper Extremity Pattern include shldr/GHJ, scapular, and thoracic rotation movements. [If we are assessing for it], why are we not assessing thoracic rotation during the Upper Extermity Patterns?So whether it's the Upper Extremity patterns of the SFMA or the Shoulder Mobility Screen in the FMS, even though there is no direct instruction or visual movement of the t-spine, it is very much accounted for in the movement, as is the neck.In order for the shoulder to move freely in the glenoid, the scapula needs to set, and there is a subtle to see but appreciable degree of thoracic rotation.



That being said, I'm sure there may be some instances where things fall through the cracks, but when thoracic extension or rotation is the biggest problem in the SFMA, the DN of MSE or MSR will overwhelm the MRE or LRF as the most DN.In the FMS, the T-spine is screened to some degree in 6 out of the 7 movements.Secondly when you review the breakouts for Multi-Segmental Extension, you will have Lumbar Locked Rotation w/MRE and Lumbar Locked Rotation w/LRF. This culls out the scapula's influence on the expression of rotation.Multi-Segmental Rotation has Lumbar Locked w/IR Active and Passive. This does not measure out the scapula's influence, but it does give a clear, and I think, valid view of thoracic rotation.

So if MRE was your DN to run with, and it was the same passive loaded, but then active unloaded, it goes to FN, then you actually do know thoracic rotation or extension is the problem because that is the segment you pulled out of the equation. That situation is probably thoracic stability, and best trained with Arm Rolling, Rolling Shoulders, Armbar, or Getups.The Flow Charts call that situation SMCD, which is correct because there is an inconsistency, but you will get to the root of it all because you would already know what MSE and MSR looked like.Whether it's the SFMA, FMS, or whatever it is that you champion, it boils down to measuring against contrasting environments.Active vs. PassiveLoaded vs. UnloadedPainful vs. Non-PainfulFunctional vs. DysfunctionalThis quick and easy contrast ultimately tracks back to the father of all rehabilitative interventions, Dr. James Cyriax.How the hell did we get from T-Spine in the SFMA to Dr. Cyriax???