As physical therapists, our job is to get you moving. Our treatment is effectively a puzzle, where the solution is why you can’t move in the way you need. 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 there’s an underlying cause for your difficulties.
So, what do we do about this? How do we figure out what is going on? Routine exams can give some useful information, but if movement is the problem, we must look at movement. 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, or SFMA, comes into play.
What is the SFMA?
The overall goal of the SFMA is to identify specific movement limitations, and 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 assess how you move. These movement patterns are compared against a baseline criteria of how most people should be able to move. Movements are 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.”
For instance, one of the seven 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 lower 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 helpful for nearly anyone who experiences painful 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.
People move many, many ways to accomplish tasks. Sometimes the mechanics behind these movements are not so obvious, but the SFMA is one way to uncover the mystery.
It is important to note that the SFMA is not a treatment. It is exactly what it says it is: an assessment. However, as an assessment, it provides guidance on where treatment can begin.