A long time ago some of the guys I worked with and I found what we thought was a hole in the continuum of training. We were working in rehab, working in fitness and performance, and decided there was a problem with how we made decisions and did programming.
If you’d prefer to listen instead of read,
here’s a longer version of this article,
Episode 36 of Gray Cook Radio,
[audio:Episode-36.mp3]
I was inspired to look at things in a different way—from a functional standpoint.
Screening always comes before testing, and often testing comes before assessment.
An assessment means assembling the data you have, putting it against your expertise, and coming up with a professional judgment. In most situations, an assessment comes after screening tells you if there are problems, and after testing defines those problems.
In the assessment you take your educational background, your professional wisdom, the particular situation, the time constraints, other historical information like a medical history or previous problems…and put all of that together. That’s an assessment.
I wanted to see those three stages applied to making people move, whether it’s making people move from a performance standpoint, a fitness standpoint or even making them move again after rehabilitation.
We saw holes in the continuum because assessments and testing weren’t used in a systematic way. There was nothing like a Functional Movement Screen until we came up with it. So we came up with a movement screen, and now we have a movement screen to put people into categories.
One of those categories is dysfunction—not just imperfection…dysfunction. If you have a ‘1’ anywhere on the movement screen—whether it’s symmetrical or asymmetrical—if any of your scores contain a ‘1,’ we consider that dysfunction.
That’s a movement competency problem.
And now we can at least discuss the words ‘function’ and ‘dysfunction’ with a baseline. Somebody has to set a baseline before we can have actionable discussions about dysfunction. Without that, our dysfunction levels or gauging of dysfunction are judgment calls.
We couldn’t build houses if an inch wasn’t an inch and a foot wasn’t a foot. It would be really hard to read x-rays if we didn’t agree on what constitutes a fracture. We need to have a gauge and a baseline for function.
That’s what the Functional Movement Screen is, and here’s the rub: We often find people who have dysfunction, yet aren’t plagued by problems.
So, what does dysfunction really mean? Are these people exceptions to the rule, or did we make the rule wrong?
We call this functional dysfunction.
I don’t really like talking about body parts; I’d rather talk about movement patterns. But when we talk about a limited active straight leg raise test, people often see that as tight hamstrings.
Just for the sake of argument, let’s talk about tight hamstrings, even though we agree there’s more going on in the leg raise test than tightness in the posterior chain.
Here we go.
Your tight hamstrings allow you to run a fairly respectable 5K. They have allowed you to get a kettlebell certification, and to enjoy skiing the slopes in the wintertime, all without a major problem. What’s happening is you’re partly relying on that tightness, because maybe that tightness is covering up another problem.
This is the most important information you can get from the Functional Movement Screen. The first thing you need to consider is that unless the person is plagued with issues, when you uncover a dysfunction on a movement screen in an otherwise apparently happy, healthy person…before you try to change it, hold yourself back. Remind yourself to wait a second.
The person is leaning on this problem, whether it’s tightness or an asymmetry. If it’s not causing readily visible problems, the client is in some way using the low back stiffness, the upper body asymmetry, the anterior chain tightness or the hip flexor tightness.
It’s part of function.
If you put this person on a corrective path and take that dysfunction away, you could actually complicate things.
Let’s go back to our tight hamstring example. We often find tight hamstrings coupled with tight hip flexors and weak glutes. If we were to stretch hamstrings and create some mobility, we don’t just send people out into activity with 15 degrees of extra hamstring flexibility. That would be inappropriate, because everything has been leaning and relying on that tightness.
Part of the corrective algorithm we have is, when you make some length, add some strength.
Once your active straight leg raise comes out of dysfunction and when your toe touch is considered normal, we take you right into deadlifting.
Deadlifting requires you to lengthen your hamstrings to a respectable point and makes you engage your glutes, probably far more than you would in a squat where you may have learned how to squat with other muscle groups.
We try to build into every one of our corrective strategies not just a way to undo that which is wrong, but to realize those dysfunctions are being used. We always consider things like that, and that’s a very important path to follow.
Don’t kick out that crutch without replacing it with something else.
It is not uncommon to find people who are operating at a certain level and still have dysfunction. Maybe they’ve never had an injury and aren’t really concerned about injury risk. What other professional principle would I need to lean on to say we still shouldn’t remove that dysfunction?
Here’s what I’ll tell you: The other reason you want to get that dysfunction off board is because if people plan on changing their exercise or they want to improve in any way, they’ll be going outside of their current abilities.
If they want to be exposed to a new experience, if they want to increase the speed, distance or cadence of their runs, if they want to press more, if they want to do something completely different like stand-up paddleboarding, MovNat or another similar activity, they could have a problem.
Those dysfunctions not only increase risk, but they also reduce adaptability—the ability to easily learn and move from one activity to another while the body molds itself in a new direction.
When we see people with dysfunctions, we think two things right off the bat. It may explain some of the injuries they’ve had in the past, but also, if they’ve never had an injury it means they’ve probably learned, perhaps unconsciously, how to work around the dysfunctions.
If people are very satisfied with everything in their lives and we find a flaw on the movement screen, the responsible thing is to say, “This is a dysfunction. It puts you at risk for injury and it reduces your adaptability, but if you’re never going to do anything more than you’re already doing, probably your best defense right now is never change anything.
“However, the minute you expect your body to do something different, to go a little further, enjoy a weekend hike or do something that’s not natural and routine, that new function will help you continue to grow and help your body move in a different direction.”
It’s absolutely true: You can be dysfunctional and still function. Just don’t plan on changing too much because your body has spent a long time getting to that function.
That’s the big irony in the Functional Movement Screen. We see dysfunctions in people who are moderately fit. We see dysfunctions in the world’s best athletes. We see dysfunctions in people who have been sedentary.
As long as those three groups never want to do anything different, the dysfunctional injury risk and the limitations to adaptability probably don’t play as importantly as they would if they were going to try to get more fit, perform better or switch up their routines in some way.
We’ve seen groups with low screens and high screens. When people with low screens get injuries, it takes them longer to get back to normal activity…if ever. This is simply because there are other problems on board that affect rehabilitation.
That’s my spin on two rehabilitation and fitness terms we’ve tried to help define by using a consistent baseline.
If you haven’t already read it,
the Movement book is the next step
in your movement screening education.
No Moving Parts
I love the concept of ‘no moving parts.’ No moving parts to me is yet another way to say we’re not a bunch of body parts moving around.. We’re movement patterns, and the parts are key components.
When there’s a problem, obviously we talk about problematic the body part. But I’ve always tried to say and I tried to articulate this in the Movement book: You’re always greater than the sum of your parts.
If you’d prefer to listen instead of read,
here’s a longer version of this article,
Episode 37 of Gray Cook Radio,
[audio:Episode-37.mp3]
We’re moving patterns. Parts are within that.
We don’t talk about a car as nuts and bolts, but those are very important in holding that car together as it goes down the road. There’s no point going down the road when we have to stop and talk about a particular nut or bolt.
We would do that when the car is stopped and we’re investigating a flaw, a problem somewhere. When we’re going through mountain turns, we just appreciate the way the car handles.
But no moving parts means something else. I’ve spent the last five years of my life investing myself in three activities that don’t involve any moving parts. I’ve been into paddle sports, in particular stand-up paddle boarding. I’ve been trail running and I’ve been into kettlebells.
The kettlebell is an old piece of resistance equipment. It has no moving parts, and the majority of the lifts either keep you on your feet or get you to your feet. Think about that. A windmill, a swing, a snatch, a clean, a squat and even the getup all have you working on your feet.
There are no moving parts on the kettlebell. You have to have the skill to flip that kettlebell into place in a clean or a snatch. You have to balance that kettlebell. You and your patterns account for this rigid ball of metal and you make it flow beautifully through the air.
If we compare that to modern fitness and weight-training equipment, we see those always position you. We have cams and levers assisting you with what you do. The skill level needed to work out on a piece of equipment is nowhere near as great as when you work out with a kettlebell.
The kettlebell begs you to be more skillful. A lot of time and practice goes into safely performing and functioning with a kettlebell to get a workout. You have to think more, and you have to practice more.
What I mean by practice isn’t training or working out. It’s making the moves look good—making them look good.
Let’s flip things for a minute. Think about trail running. If you’re running barefoot or in minimalist footwear, other than whatever you have on your feet, you don’t need a machine to run trails.
I love mountain biking, but I found myself on a bike trail thinking, I’m on this expensive piece of equipment, and except for the downhills I could probably make better progress on my feet. The bike is unnecessary.
This doesn’t mean I’m against biking, but at my age with everything I have going on, I like a simple life. Not needing to take a bike along, or deal with the moving parts and tune-ups all of these machines inevitably need is not even on the table anymore.
Once again, I’m not relying on a machine with moving parts. I’m using my movement patterns.
And there’s stand-up paddleboarding. This isn’t a machine. It’s basically two pieces of sculpture. The paddleboard is designed to slice through the water, yet be supportive enough to balance you. Then if it’s designed correctly, the paddle makes it easy to feel like you’re planting your paddle into quicksand. When you pull on the paddle, you’re not moving water. You’re moving the paddleboard. There’s a lot of skill involved.
There’s a lot of skill involved in all three of these activities. Getting that kettlebell to look good takes a lot of skill. Bringing respect to a trail run takes a lot of skill.
Every spring and summer, Christopher McDougall’s book Born to Run makes me think about the amazing stories and analogies of getting into a natural environment and getting that short, choppy, very efficient cadence in running. Running is a skill. Learning how to run almost silently demonstrates a good management of energy expenditure.
There’s a rhythmical, skillful way to train with kettlebells. There’s a rhythmical, skillful way to perform a trail run. There’s a rhythmical, skillful way to get on a stand-up paddleboard and just detach.
In a lot of these activities, I am totally engaged. I’m managing my entire body the whole time. And in every one of these activities, I’m on my feet.
Yeah, I fall off the paddleboard. I’m not saying I haven’t slipped and fallen during a trail run. For the most part, I’m in a functional position and I’m moving. It’s just amazing to interact with these three activities and realize that my gear is minimal. The gear I do have has no moving parts. If I’m going to make these activities look good, it’s because my patterns are better.
I hope you like my spin on this. I don’t mean to bore you with my three favorite fitness tools. As I age, I like to simplify, but I also like to tap into self-limiting activities because in many cases, I’m coaching myself.