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Athletic development specialists dedicated to the art and science of excellence in movement

Notes from SFMA Level I

In October I had the opportunity to finally take SFMA Level I with Dr. Greg Rose, a principal creator of the system and co-founder of the Titleist Performance Institute. Overall, I'd say the value in this course lies largely within the principles underlying the system. Yes, learning the mechanics to properly administer the SFMA is important, but anyone can learn the mechanics of a test (though there are many subtleties you undoubtedly miss without some formal guidance). A understanding of principles will have a much greater effect on practice patterns. And ultimately, the mechanics of the test are really an expression of the underlying principles...

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*On the subject of PT vs chiro…“If I can walk into your practice and tell what you are, there’s a massive gap in your knowledge”

*Why was FMS created? Prevent patients from reinjuring selves in the gym -> Assess whether patient can adapt to environment

*First job for SFMA = diagnose the cause

*Goal of SFMA = get you back to FMS

*FMS doesn’t say what you need for performance

SFMA (movement health) ->FMS (movement competency) -> Y-balance (higher level movement competency) -> FCS (movement capacity) -> Sport specific (movement skill)

*How to be great...

  • Communication – this is definitely Important but patients want solutions, not to spend time in your office because you’re a nice person
  • Diagnosis – Most important -> fastest path to solve patient’s problem; gets closest to the cause
  • Treatment/exercise -> easiest to teach. Literally a monkey can perform manual therapy!! 

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*Three major causes of MSK injury (aside from red flag conditions)

  • Trauma
  • insidious onset
  • Altered motor control -> This usually comes first; If you don’t have motor control, then you have injury in addition to altered motor control

*Altered motor control must be seen in context (Usain Bolt…asymmetrical ASLR...but is this an adaptation to running turns in the 200m??...”Altered” does not have value inherently attached to it...Whether altered is good or bad depends on the situation)

*Movement testing is different than muscle testing; Exercise for movement is different than exercise for muscle (sets and reps prescription for conditioning follows different rules than practicing for skill development…these two objectives often get confused in practice)…You don’t emerge from the womb and say “It’s back and biceps day!!”

*Don't tell patient/client what they should be feeling. Guide/coach them to the desired movement, ask them what they feel when they get it right, then remind them “That’s what you should feel!!” What you think they should be feeling and what they actually feel for success might be totally different.

*If you tear something, you want it to be around a stable joint in the joint-by-joint approach (see shoulder rehab success for pitchers vs elbow rehab success)

*The philosophy on how to attack a joint problem is different than what the joint’s underlying strategy is within the joint-by-joint (just because a joint is primarily mobile or stable in the joint-by-joint, doesn’t mean all interventions will have the same intention)

*Gaps in the SFMA = it will miss wrist, TMJ, foot intrinsics

*At some chiro schools, you must complete top tier in sub-2:30 to graduate

*Where does SFMA fit into exam? (in the past, one critique of the SFMA is that it was the ONLY thing some people did….)

  • History->posture->neuro->breathing->SFMA->local biomechanical exam

*Traffic light grading system; not numerical..Why?

  • Cyriax used no numbers (You can do it or you can’t)
  • Numbers can confuse people (FMS...)

*Don’t ponder the cause of dysfunctional pattern during SFMA…Score what you see and move on, then analyze later

*Rules for breakouts 

  • Remove body parts (aka, isolate)
  • Change the stability requirements (Standing->kneeling->quadruped->lying….And there’s your 4 x 4 Matrix)

*Kyphosis can be a FLEXION problem/deficit…Many people lack lumbar flexion and thus compensate by increased thoracic flexion (Nearly everyone in the room scored DN on the toe touch due to lack of a lumbar flexion curve…Have we become too flexion phobic in the lumbar spine???)

*Mobility problems are consistent regardless of position

*Movement assessment helps you become a better manual therapist

*Most people who seem weak really aren’t weak..They’re just running the wrong motor program, which is preventing the expression of strength

*Motor programs work best with random practice (Note the word “practice,” not workout…)

*Easiest to remind you of good motor program rather than create something entirely new…This is why the neurodevelopmental sequence is so fundamental

*Feedback during exercise and be facilitative (making it easier) or challenging

*Mobility problems can manifest as stability problems

*4 x 4 matrix…

  • SFMA will tell you where to start in the 4 x 4
  • 4 x 2 is the top tier of the SFMA; beyond this you are out of the SFMA
  • If there’s a mobility problem, you don’t use the 4 x 4