Monthly Archives: January 2013

The Functional Movement Screen, Corrective Exercises, Movement Patterns, and Fixing Me!

A while back, my sports med doc put me through the Functional Movement Screen or FMS. The FMS is a set of 7 physical tests, designed to capture movement imbalances between your left and right sides. Research has shown that movement imbalances are a great predictor of potential for injury. With the FMS, trainers and clinicians now have a tool to measure athletes’ imbalances. But there is more: the FMS system includes a set of corrective exercises which are designed to be used from the results of the FMS. The whole system is very templatized; you don’t need to think about which corrective exercise to use but simply employ the progressions depending on the results of the test. Another big advance that the FMS makes is that it attempts to treat imbalances via movement patterns, not individual muscles. Traditionally, clinicians would attempt to exercise individual muscles when addressing problems.
These few sentences above do not do the FMS justice; the founder Gray Cook has better discussion on his site
When I took the test, I didn’t really do any of the corrective exercises and didn’t fully understand the purpose of the FMS. Recently I started digging deeper into the FMS and what its full purpose is. I bought a ton of the FMS DVDs from Perform Better and went through them all. I realized that here could be the answer to nagging athletic problems that I’ve had through the years! For example, I have a tendency to cramp in my inner right quad by the knee on marathons – I have tried everything to cure cramps: electrolyte/salt tablets, strength training, more training, different types of training – nothing seemed to cure it. Each year I would race a marathon and inevitably no matter how hard I trained, or how many salt/electrolyte pills I would take, I would still cramp in the latter half of the race.
However, now the FMS has given me more clues at to why I might be cramping and why all those other reasons could never completely cure it. It has to do with muscle imbalances which cause me to compensate for poor movement patterns, and these muscles used in compensating eventually wipe out before the end of the marathon, causing me to cramp up.
Or at least that seems to be the theory. Certainly there is nothing left to try!
I got tested via the FMS again from my sports med doc. Then I got a series of corrective exercises to employ from the results of the FMS. For the last 2 months, I’ve been doing them multiple times a week. Although I have not retested my running again, I’ve noticed some interesting results:
1. My core control is not optimal in the push up. Working on this allowed me to correctly tense up my entire body so that when I push up, my body comes up as a single unit, with no body part lagging.
2. My left/right balance is very uneven. I have a tendency to always lean to the right, even when balancing on my left leg. I worked with some Gray Cook Bands on my one leg stance:

The other thing that helped my left leg balance was the use of a technique called Reactive Neuromuscular Training (RNT). I used a Gray Cook Band on my left knee, pulling it inward into a “mistake” which is called Valgus Collapse. When the band pulls my knee inward, my body relearns how to stop my knee from collapsing inward, firing the right muscles. So I did rear lunges and high steps onto a 12″ surface both with the band pulling my left knee inward. After a few weeks of this, this really helped my balance a ton. Before this, I would step up 12″ and I would wobble like crazy and then tip to the right. After doing this for a few weeks, I could step up now with decent balance.
Both have improved my ability to balance on my left leg.
3. A surprising result was when I was trying to improve the stability of my core in a quadriped position. There is a drill which is called Rolling Pattern.

You have to roll back and forth with one elbow touching the opposite knee.
When I did this, my right side, or right arm extended above my head, was fine. However, I had major problems with my left side, or left arm extended above my head. I worked on this for a while and finally got the hang of doing it with left arm extended.
This had an expected result in improving my swimming. I had been having a lot of trouble with my left arm spearing forward/right leg kicking in two beat kick. I could not generate the same amount of my propulsion when spearing with my right arm forward. The coordination had eluded me for months until I did this drill and got better at it. All of a sudden, I was experiencing much better propulsion on my left spear! This Rolling Pattern had somehow awakened the right core activation to initiate the right movements in the left spear action.
4. I also discovered some pelvic control issues in the active straight leg raise while lying down. To help with this, I used a Gray Cook Band to improve my core engagement while raising one leg at a time while lying down:

At the moment, I am working through some corrective exercises with the kettlebell. Gray Cook created a special FMS system that is designed with kettlebells called the CK-FMS. There are a number of great corrective concepts coming out of the kettlebell community and I am going through those one by one. One of my favorites is Kettlebells from the Ground Up 2, whose drills showed that I still had poor pelvic control in a straight leg raised position. For me, I am going through those to activate the right stabilizing muscles while swinging a cannonball with a handle on it – definitely taking some time for my body to figure out how to do that right and without messing myself up!
As a result of all this, I got certified with the FMS Level 1 a few months back. This allowed me to administer the test but I was still missing the critical FMS Level 2 which was the set of corrective exercises to give as a result of the test. I am looking forward to that this coming March in SF with the infamous Dr. Mark Cheng, one of the most knowledgeable folks in the field.
As I learn to become a personal trainer, I find that the FMS is a critical part of the equation. Gray Cook is fond of saying that he refuses to train people unless they get a minimum score on the FMS and that left and right sides of an athlete are equally balanced, or equally inbalanced. I think this is one of the most important concepts missing with personal training today, which is both an issue with trainers and with clients. Clients are mostly at fault because they just think they can go out there and train and race, regardless of their physical condition, and have no patience for doing something else. Trainers need to build a business, and clients who want to leap into training immediately often will leave trainers who don’t start immediately and recommend something else.
As a guy who has experienced first hand what can happen to an unbalanced body, I wish that someone could have put me through the FMS system before I started training for triathlon. Those corrections would have balanced my body and then could have made my racing career much less injury prone, perhaps even removing cramps during my marathons.
I look forward to continuing corrective exercises on myself, and also the FMS Level 2 course coming in March to the SF Bay!
Some other interesting observations as a result of this process and things I’m looking into:
1. I learned about mechanoreceptors on my feet and how important they are to activating the right muscles during walking and running. If they do not get the proper stimulus, then my movement pattern for walking/running can get totally messed up. I also learned that this can extend up to the ankle as well, so loosening up the ankle through dorsiflexion exercises as well as releasing tension in the feet can make a huge difference in how you perform during a workout.
2. Evaluating the difference between the left and right sides for the active straight leg raise whlie lying down can show problems in running. If one side is more restricted than the other, then the length of my stride will be different on each side, which can cause compensations and other problems when my body tries to use other muscles and body parts to equalize my stride.
3. I’m building up my spinal stabilizers, which still aren’t firing correctly. This is critical not only for the Deep Squat, but also for improving my Deadlift and maintaining proper back position during heavy kettlebell swings. Many FMS corrective exercises involve helping my spinal stabilizers to fire properly again. This has helped greatly in my deadlifting and achieve my goal of 2x body weight.
4. Maintaining proper back alignment has many more critical effects than I could have imagined.
5. Been reading up on the Janda method for correcting muscle imbalances (see Assessment and Treatment of Muscle Imbalance:The Janda Approach). Fascinating stuff!
6. Equally fascinating are the methods pioneered by Alois Brügger in Switzerland for postural correction. Very related to FMS corrections.
7. The master of backs is Dr. Stuart McGill. More stuff to dig into.
8. It also has made rethink gluteal amnesia and what it means to treat it. While glutes being weak and not firing is a big problem, they can’t only be trained in isolation as a muscle group. Merely getting them stronger and firing again doesn’t mean they will fire properly in the right sequence during movement. Again this is where FMS corrective exercises come into play, and retraining the body for proper movement, potentially starting from infant based movements on the ground to standing up.
9. Along with 8., I find the concept of not strengthening stabilizers to be eye opening. This is what therapists did before. If you injured a stabilizing muscle, they made you do weights or reps with that muscles, thinking that’s what would make it work properly again. But this is only half the equation; rehab-ing it may require manual manipulation and some training to get it functional and pain free, but it doesn’t mean the nervous system is going to fire it properly during movement.
10. This is my big learning after 9. Pain and injury can cause your nervous system to compensate and remove proper movement patterns, replacing them with patterns that will allow you to complete the movement but with the muscles and structures that weren’t designed to do it for long periods of time. Some of these movement patterns need to be re-patterned back after injury and pain.
11. Central nervous system training has come to the forefront of my mind in my own training.