Originally posted on April 13, 2011
Pain does the craziest thing: it turns off the muscles you need to continue to move normally. Paradoxically, it can keep you from getting to the root of your problem. Every patient with an injury wants us, as PTs, to treat the painful area. Why not? Why would we do anything else? It’s the obvious problem….or maybe it isn’t the problem at all.
Take Sarah: Sarah likes to run. Lately she has developed pain in her left lower leg. Her pain started seemingly out of the blue. We did an SFMA screen. Sarah cannot perform a deep squat. She can stand on her left leg, eyes closed, for 10 seconds, but on her right leg, she can stand six times longer. She has the mobility in her legs to be able to squat, but she does not have the stability in her hips and core to allow her to do it.
In minutes we uncovered the problem. This is the beauty of a functional screen.
Sarah’s hips don’t do a good job stabilizing her, so her lower legs and ankles are in over-drive trying to control motion. Those little muscles just aren’t designed for such demand and Sarah has developed tendonitis. Ultrasound, massage, and stretching might help, but unless Sarah strengthens her hips, the pain will recur. Seem unlikely? Maybe. But as PT’s we see this sort of thing everyday.
After an injury, no matter how slight, or even with poor posture, movement changes. Your body, a master of compensation, continues to move, but in a different way. You might be a little stiff, but soon, it feels like the new normal. Only an expert would notice. The core muscles have likely been turned off; so you are walking around like a time bomb, ready to blow apart with the slightest stress.
Selective Functional Movement Assessment is a comprehensive assessment system that classifies movement patterns. These tools uncover movement dysfunctions which, though rarely painful, are the real culprits in perpetuating pain. Once faulty movement patterns are identified, exercises can correct the specific problems. Your body starts to move in a coordinated way, each part in synchrony with the others, just like you did as a kid.
There are two different evidence based movement screens, Selective Functional Movement Assessment (SFMA) and Functional Movement Screens (FMS). For more information on the screens, check out the website.