This month on the Back in Action blog, we will discuss:
As physical therapists, our job is to get you moving. The art comes in moving you in meaningful ways. Whether you can’t bend because your back hurts, can’t run because your hip hurts, can’t jump because your knee hurts, or can’t throw because your shoulder hurts, the common theme is that something is going on when you move.
So, what do we do about this? How do we figure out what is going on? Should we look at you stand in one place? Should we lay you down on a table and start assessing you from there? These exams can give some useful information, but if movement is the problem, we must look at how you move. More importantly, we need to see how your body moves as a whole, not just joints in isolation.
This is where the Selective Functional Movement Assessment (referred to from here on as the SFMA) comes into play.
What is the SFMA?
The overall goal of the SFMA is to identify specific movement limitations that cause you pain. It can also determine if these movements are due to tightness or weakness.
It is important to explain “tightness or weakness” in this context. Essentially, the SFMA calls “tightness” a joint mobility dysfunction and/or tissue extensibility dysfunction, and “weakness” a stability and/or motor control dysfunction.
To accomplish this, the SFMA looks at seven movement patterns that broadly assesses how you move. There is a baseline criteria for each of the movement patterns that everyone should be able to achieve. This baseline criteria is graded in two ways: functional or dysfunctional, painful or non-painful.
Once we figure out which movements are functional, dysfunctional, painful, or non-painful we can narrow down problematic regions of the body. When one of the seven movement patterns is found to be dysfunctional, we examine a subset of movements to figure out why. The SFMA calls these sub-movements “breakouts.”
One of the 7 movement patterns is called multisegmental flexion. Here, a patient stands with their feet together, bends down and touches their toes.
If you can’t bend down to touch your toes you must have tight hamstrings, right? Not necessarily. Bending forward uses many more muscles than your hamstrings. It requires core and hip strength to balance, bend forward, and shift weight in a standing position; it requires good motion in your low back; it requires good motion in your hip joints; it requires relaxation of certain muscles. Breakouts help us determine if these less-obvious areas are causing problems.
But yes, it does require good flexibility in your hamstrings.
Who is the SFMA good for?
The SFMA is good for nearly anyone who is having pain during movement. From the gardener whose back aches when pulling weeds to the marathon runner with their eyes set on Boston, the SFMA can be a useful tool to assess their movement.
Let’s look again at multisegmental flexion, and the many different activities that use this pattern.
As you can see, this movement and other SFMA tests are essential for daily life.
People move many, many ways to accomplish tasks. Sometimes these movements aren’t so obvious. The SFMA is one way we observe this movement to find the source of your pain.
It is important to note that the SFMA is not a treatment. It is exactly what it says it is: an assessment. There are any number of ways to treat a joint mobility dysfunction, tissue extensibility dysfunction, or stability/motor control dysfunction.
Check out our website or some of our other blog posts to see some of our treatments.