Titleist Performance Institute (TPI) Golf Screening and the Developmental Hierarchies of the SFMA and FMS

The TPI Golf Screen is one of the most valuable tools in the toolbox for any golf, fitness, or medical professional who works with golfers.  Not only can the Screen help identify physical limitations that shape a player’s swing and contribute to painful movement, it facilitates communication between professionals in various fields of performance enhancement (instruction, fitness, and medical).  This team approach is at the core of the TPI game improvement philosophy.

One issue that often comes up is what to do with the screening results, particularly when someone “fails” multiple tests (for purposes of this discussion, I’ll refer to the complete package as the “Screen” but each individual screen as a “test”).  There are 13 individual tests within the Level 1 Screen plus additional tests introduced at Level 2 for the wrist, ankle, and neck.   In my opinion, trying to correct every single failure simultaneously can lead to some messy programming with a long list of corrective exercises. 

The TPI Screen consists of the following

• Pelvic tilt
• Torso rotation
• Lower body rotation
• Overhead deep squat
• Toe touch
• 90-90 shoulder and 90-90 shoulder in golf stance
• Single leg stance
• Lat length
• Upper quarter (without and with scapular stabilization)
• Lower quarter
• Glute bridge
• Reach roll and lift
• Leg lowering
• Ankle inversion/eversion
• Wrist (multiplanar)
• Partial squat/ankle eversion
• Cervical spine

TPI professionals have several options on how to prioritize their corrective interventions.  Certainly, you can combine different strategies simultaneously.

1. If the player is in pain, the first priority is to get them out of pain.
2. Address what is most relevant to the player’s swing.  A major concept upon which TPI is built is the body-swing connection.  How the player swings the club is an expression of his or her underlying movement ability. 
3. Correct the pattern that subjectively appears the worst.  This strategy makes intuitive sense, but you need a firm grasp on how to define “worst” if there are multiple failures.  As far as I know, there hasn’t been any research to grade the screen beyond the pass/fail benchmarks.  The fewer failures, the more realistic this strategy becomes.
4. Correct all the failures you see.  Big problem here is that your programs become too scattered if you try to correct everything at once.   
5. Have a prioritization scheme within the Screen.  This strategy is the main topic of this post.   

Gray Cook, creator of the Functional Movement Screen (FMS) and Senior TPI Advisory Board Member, was instrumental in creating the TPI Golf Screen as well.  It only takes a passing familiarization with the FMS to see the close similarities between the TPI screen, the FMS, and the SFMA (the Selective Functional Movement Assessment, which is the medical complement to the FMS).  

I.  TPI and SFMA

One way to organize the TPI screen is along the global movement patterns within the SFMA.  This structure won’t provide the same level of prioritization as within the FMS (more on that below), but we can begin to cluster the individual tests using the SFMA Top Tier of seven assessments.  Although the primary role of the SFMA is to identify causes of pain, the organization of global movement patterns can help refine our understanding of the TPI screen by relating the movements to global patterns seen in the neurodevelopmental process.  In bold and underlined below are the SFMA Top Tier. 

Cervical patterns (flexion, extension, rotation/flexion left and right): You can make the argument that the pelvic tilt test is a cousin of the cervical pattern assessments due to the relationship between the cervical spine and the lumbar spine.  Lower crossed posture (S posture in TPI terminology) with a pelvic restriction, will have a similar effect as a cervical restriction due to the interrelationship of spinal segments.   Just as the neck can affect the lumbar spine, the lumbar spine can affect the neck.

Upper extremity (shoulder abduction/external rotation, adduction/internal rotation):  90-90 screen falls into this category along with the 90-90 in golf posture.  Both follow the same corrective thought process but the golf posture puts more stretch on the posterior chain and is more specific to the golf swing.

Mutlisegmental Flexion (toe touch):  Bilateral and if needed, unilateral toe touch.  If someone fails the bilateral toe touch, we check unilaterally.    

Multisegmental Extension (backward bending):  Glute bridge, lat length test, and two optional tests (leg lowering and  reach-roll-and-lift) are part of multisegmental extension.  Multisegmental extension occurs as one pattern in the SFMA, but appears as separate components in the TPI screen.  Glute bridge and leg lowering address lower body extension.  Lat length and reach-roll-and-lift address upper body extension. 

Multisegmental rotation (feet together and turn as far to one side as possible):  TPI Upper quarter screen and TPI lower quarter screen break this pattern into two parts within TPI.  Upper quarter with scap restriction is also part of the SFMA breakout process.  The “old” hip screens are actually part of the SFMA breakouts, which were replaced with the standing lower quarter screen in part to make the TPI Screen more user friendly for the golf professional by eliminating the need for the student to lie down on the practice tee.  The two qualitative rotation screens in TPI (torso and lower body disassociation) fall under this pattern as well.

Single Leg Stance (stand on one foot for 10 seconds):  Obviously the single leg stance in the TPI screen is the analog for this category, although the testing procedures are slightly different.  The Level 2 TPI ankle inversion and eversion screens exist in the SFMA within the single lee stance breakouts.

Deep Squat (arms up deep squat):  Obviously…. Deep squat!  The TPI hands-behind-head-squat and ankle breakout are both part of the SFMA.  The partial deep squat/ankle eversion test fits into this pattern as well, though you can arguably place it alongside the inversion/eversion screens seen in the single leg stance breakouts.

*What about the wrist screens?  The wrist screens can fit anyplace in which we’re looking at the shoulder or T-spine, since wrist problems are often tied to joint dysfunctions in those areas.  They don’t fit quite as neatly into the SFMA framework, but if we’re to see any relationships to other screens, it would be in those places. 

II.  TPI and FMS: Creating a Priority System

While the SFMA helps us group the TPI Screen movements into global patterns, the FMS can help prioritize the order in which to address movement dysfunctions within those patterns.  The seven screens of the FMS are the Deep Squat, Hurdle Step, In Line Lunge, Shoulder Mobility, Active Straight Leg Raise, and Rotary Stability.  For more detail on the FMS visit www.functionalmovement.com.

Finally, we have the functional screens: Deep Squat (which is how the baby gets from the ground to standing), the Hurdle Step (baby’s first step) and In Line Lunge (landing from the first step). 

Cervical patterns

TPI Pelvic Tilt – As was the case with the SFMA, the pelvic tilt doesn’t fit exactly into the FMS movements, especially because the FMS doesn’t specifically address the cervical spine.  However, the first thing we assess in the golf swing is posture.  Two of the TPI “Big 12” swing faults are posture flaws.  S-posture is an excess anterior pelvic tilt.   The pelvic tilt test looks for whether you actually can anterior and posterior tilt.  Dr. Greg Rose calls the pelvic tilt the most important test, so that reason alone is good enough to place it first in the hierarchy!

Mobility Screens (Shoulder Mobility and Active Straight Leg Raise)

The Active Straight Leg Raise (ASLR) and Shoulder Mobility (SM) are considered the primitive, or mobility screens.  These screens deserve attention first and under the FMS prioritization order and should be normalized before trying to correct other screens.  In terms of developmental patterns, these screens address reaching and kicking, two of the first forms of limb movement by a baby.   Below we’ll relate each TPI test to its analog in the FMS.

Reaching (Shoulder Mobility)

Upper Quarter – Checks for T-spine mobility, which is a key component of the FMS shoulder mobility screen.

90-90 – Another component of the shoulder mobility screen is glenohumeral mobility.  The 90-90 and 90-90 in golf posture address this movement pattern.

Kicking (Active Straight Leg Raise)

Toe Touch - Analog in FMS is ASLR.  Both involve hip flexion and extension, which is essentially a kicking pattern.  We perform toe touch in TPI is for uniformity with golf pros who can’t have students lay down on wet grass. 

Glute Bridge – Glute bridge is critical for hip extension.  Although more of a stability screen than a mobility screen, you can’t even get into the glute bridge position if you can’t extend the hips.    

Transitional: Rolling and pushing (Rotary Stability and Trunk Stability Pushup)

The transitional screens are ones in which mobility and stability converge in the movements of rolling (Rotary Stability) and pushing (Trunk Stability Pushup). 

Rolling (Rotary Stability)

Upper Body/Lower Body Disassociation screens can be viewed as rolling patterns for golf.  The rolling pattern itself is a primitive form of upper and lower body disassociation, which is the key component of these screens.  Before the baby can stand on two feet, it first learns to roll (at least it should learn to roll first!). 

Upper Quarter with scapular restriction – This screen is the same as the mobility pattern tested above, but with a stability component by restricting the scapula. 

Lower Quarter – Rotary stability and rolling patterns have both an upper body and lower body component.   You can break out rolling patterns via both the upper and lower quadrant.  The lower quarter test address the lower quadrant, but in a more specific pattern for golf compared to actual rolling.

Pushing (Trunk Stability Pushup)

Lat Length – Before the baby pushes itself off the ground, it needs length and stability in the upper torso.

Reach Roll and Lift – Push up requires scapular stability and lower trapezius activation to be done properly

Leg Lowering – This is one of the optional tests (along with reach roll and lift).  You could arguably place it into the kicking/extension category, but because there is more of a stability component than mobility component, I believe it best fits into trunk stability.

Functional (Deep Squat, Hurdle Step, In Line Lunge)

Overhead Deep squat – Same test in TPI. 

The TPI curriculum places great importance on the squat due to its potential effect on Early Extension in the downswing.  However, under the FMS developmental hierarchy, it doesn’t come until after the baby pushes itself into bipedal support (two feet on the ground rather than quadruped as in crawling).  However, if you look back, it is clear that hip mobility and thoracic mobility will be addressed in prior screens if there is a deficit in those areas.  Both of these patterns are parts of the global squat pattern.   Once we get to the squat, TPI naturally builds in a progression to look at T-spine and ankles if the squat is limited.  

Hurdle step – Single Leg Balance in TPI.  The hurdle step is an applied version of single leg balance.  Although you don’t remain on a single leg in the hurdle step for nearly as long as you do in the single leg balance test, developmentally we don’t stand on a single leg in the FMS hierarchy until the Hurdle Step.  The ankle inversion and eversion screens are part of this pattern, just as they were in the SFMA

In Line Lunge – There is no specific analog for the In Line Lunge in the TPI screen, but many of the components are addressed through other screens.  

…And the wrist?  Same thought process as in the SFMA.  The wrist screens can complement any issues that arise during shoulder, scapula, and thoracic spine testing. 

Summary

What I have presented is simply one way to organize theTPI Screen.  Using the principles of the FMS and SFMA, it is possible to create a prioritization hierarchy to address multiple failed tests in a systematic fashion.  Obviously if someone passes an individual test and has no related swing fault, you can move on to something else.  The main goal of creating this hierarchy is to seek ways to accelerate the learning process for the player and create the most efficient programs possible, rather than crowded programs with a long list of exercises.  The whole premise of the hierarchy is that addressing certain dysfunctional movement patterns will offer the greatest return on investment by clearing up other related patterns that occur later in the neurodevelopmental process without having to add additional correctives.

Resources

Functional Movement Systems

Movement

Titleist Performance Institute

TPI vs. FMS Performance Screen (Dr. Charlie Weingroff)