Selective Functional Movement Assessment (sFMA)

Introduction To
Selective Functional Movement Assessment

What is the sFMA?

The sFMA is an advanced movement-based diagnostic system that is used to assess movement patterns in people with musculoskeletal pain. The assessment involves 7 full body movement tests that are designed to assess movements that are important for our daily activities. The sFMA provides healthcare professionals with a systematic tool to reach a comprehensive movement diagnosis. It helps determine the cause of pain – not just the source – by logically breaking down dysfunctional movement patterns in a structured assessment. When the clinical assessment is initiated from the perspective of the movement pattern, the therapist has the opportunity to identify meaningful impairments that may be seemingly unrelated to the main complaint but that may contribute to the disability or pain.

Look at it this way. When a patient goes to the hospital with shooting arm pain the immediate course of action is to check their heart, not their arm. The symptoms down the arm are just a result of a problem elsewhere in the body. Similarly, the sFMA focuses on underlying dysfunctional movement to find the cause of pain, not just the source. This concept is better known as regional interdependence – how seemingly unrelated problems are actually driving the dysfunction and pain elsewhere in the body.

How does it work?

The overall goal of the SFMA is to help identify specific movement limitations that cause you pain. It can also help to determine if these movements are due to tightness, weakness or both. During an SFMA assessment our chiropractors will look at seven fundamental movement patterns that broadly assess how you move. There is a baseline criterion for each of the movement patterns that everyone should be able to achieve (within reason). This baseline criterion is graded in two ways: functional or dysfunctional, painful or non-painful. In this way we assess your ability to complete specific movements and at the same time, also critique the overall quality of your movement.  The primary focus of the sFMA is not how many repetitions you can perform but the how well you can perform a single repetition.

It’s about how well you move.

Once we figure out which movements are functional, dysfunctional, painful or non-painful we can narrow down problematic regions of the body, which may be contributing to your injury or pain.  Keep in mind, the location that you have pain is not always where the underlying issue/dysfunction lies. When one of the seven movement patterns is found to be dysfunctional we examine a subset of movements to figure out why- these are called breakouts.  The sFMA looks at simple every day actions, including the ability to touch your toes, balance on one leg or perform a squat to identify how well you accomplish basic movement. Poor movement in the body is often masked by compensations that we develop overtime and daily repetition of this can ultimately result in injury and pain. The sFMA enables us to identify and treat regions in the body that lack mobility (range of motion) or stability (motor control) allowing for accurate treatment to restore pain-free function and movement.

Example:

One of the 7 fundamental movements is called multisegmental flexion. A patient stands with their feet together and bends down to touch 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. This highlights the importance of very specific examination techniques and the examination of multiple body regions. Most people will blame the inability to touch their toes on tight hamstrings – and indeed your hamstring may feel tight – however that tightness may occur for several different reasons. Maybe your core is weak and you can’t stabilize your back as you bend forward. In this case the brain may send signals to your hamstrings to “turn on” or be tight in order to prevent the motion from occurring. Maybe your hamstrings are a little bit tight but when we watch you bend forwards your back stays completely flat and does not move at all. If you don’t have enough flexion (motion) in your lower spine you will never be able to touch your toes, no matter how flexible your hamstrings are.

This is why stretching is not always the best solution for ‘muscle tightness’. Muscles that feel tight may feel that way for various complex reasons. In this way the sFMA not only guides proper treatment but also proper rehabilitation. You may not need to stretch your hamstrings but instead you may need to work on the range of motion in your lower spine, or work on developing greater core strength.

Who will benefit from the sFMA?

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.

The sFMA is great it you:

  • Are recovering from an injury
  • Are not recovering as quickly as you would like
  • Have a chronic problem that hinders your physical activities

The 7 movement patterns tested are fundamental movement patterns that are needed to complete many of our activities of daily living. For example, multisegmental flexion (the toe touch) is required for many activities including bending, lifting (groceries, babies, furniture), weightlifting etc. People move in many ways to accomplish tasks. Sometimes these movements aren’t so obvious. The sFMA is one of the ways that we observe this movement to find the source of your pain.  The SFMA also highlights asymmetries in the body that exist between the left and right side. Asymmetries such as having a left hip that moves well and a right hip that is stiff are red flags and risk factors for injury.

It is important to remember that the SFMA is not a treatment. It is an assessment and merely one of the tools that the chiropractors at mountain health and performance utilize.  The sFMA is one of the many assessment tools that we utilize to create a treatment and rehabilitation plan that is based on the needs of each individual. Our focus on treating the underlying cause with hands on treatment and a thorough exercise program gets you moving pain-free and back into action. Following your initial movement assessment we will record your results and then repeat the assessment following completion or your treatment and rehabilitation plan. This gives us a baseline to measure progress and is a great way for you as a patient to see your movement-based results!