Corrective Exercise/Functional Movement Screens

Question 1

Corrective Exercise General Philosophy

Answer 1

• Imbalance between muscles that are over active/shortened and muscles that are under active/inhibited/lengthened which leads to dysfunction = leads to injury
• Altered Force Couples At the Joints
  ~ Abnormal Movement Patterns
  ~ Instability
• Synergistic Dominance (muscles that help)
  ~ Synergist compensates for an
  inhibited prime mover.
  ~ Ex. Psoas shuts down gluteus
  maximus (RI) so hamstings work
  harder to control movements mostly
  controlled by the inhibited gluteus
  maximus.

Question 2

General Process of Corrective Exercise

Answer 2

• Assessments: Determine areas of dysfunction.
  ~ Movement Assessment
  ~ Range of Motion Assessment
  ~ Muscle Strength Assessment
• Treatment: determines which muscles are over or underactive
  ~ Inhibit: Decrease activity of over
  active muscles.
  ~ Lengthen: Restore normal muscle
  length of over active muscles.
  ~ Activate: Reeducate underactive
  muscles.
  ~ Integrate: Retrain over active and
  underactive muscles to work within
  the kinetic chain

Question 3

Movement Assessments

Answer 3

• For each assessment observe the major joints and note abnormal movements.
  ~ Foot and Ankle
  ~ Knee
  ~ Lumbo-Pelvic-Hip Complex (LPHC)
  ~ Shoulders/Cervical Spine
• This determines baseline

Question 4

Inhibit

Answer 4

• You can use any rehab or modality appropriate in relaxing the over active muscles.
• NASM suggests self-myofascial release
  or painful/trigger points w/ a ball or a foam roller

Question 5

Lengthen

Answer 5

• Can use any technique you prefer to lengthen over active muscles.
• NASM prefers static or neuromuscular stretching

Question 6

Activation

Answer 6

• You can use any mode of strengthening as long as it isolates the correct muscle and uses full ROM.
• NASM tends to recommend pulley exercises w/ 2 sec isometric holds at end range and 4 sec eccentric phase

Question 7

Integration

Answer 7

• Any exercise that uses the previously over active and under active muscles
  together and w/ entire Kinetic chain

Question 8

Functional Movement Screen General Philosophy

Answer 8

• Inefficient movements cause compensations which move a joint in unnatural manner
  ~ The body will always sacrifice quality
  for quantity.
  ~ Compensatory movements lead to
  microtrauma.

Question 9

Functional Movement Screen

Answer 9

• Designed as a screening tool performed on individuals without recognized pathology
  ~ Goal is to identity those at risk of
  injury: those able to exercise safely
• Consists of seven tests which are graded from 3 - 0
  ~ 3 - perform functional movement
  pattern
  ~ 2 - perform functional movement
  pattern with a compensation
  ~ 1 - inability to perform the movement
  pattern
  ~ 0 - pain with movement

Question 10

The Seven Tests

Answer 10

• Squatting
• Stepping
• Lunging
• Reaching
• Leg raising
• Push-up
• Rotary Stability

Question 11

Selective Functional Movement Screen

Answer 11

• Screen tool used to reveal functional limitations that may be the cause of pain/condition.
• Top Tier Screening
  ~ Identifies if there’s a problem and the
  problem region
• Breakouts
  ~ Identifies more specifically where the
  problem is
  ~ Follow specific logic:
  > Remove body parts
  > Change stabilization
  Requirements
  > Compare active and passive
  movements
• Scoring if Tests
  ~ Functional or Dysfunctional
  ~ Pain or No Pain
  > FN (Functional No Pain): nothing
  needed
  > FP (Functional Pain)
  > DP (Dysfunctional Pain)
  > DN (Clear First)

Question 12

Testing Rules

Answer 12

• No Warmup
• Believe what you see.
• Be picky - they can do it or they cannot.
• No Shoes
• Show patient the movement you want.

Question 13

Top Tier Tests

Answer 13

• All tests are performed.
  ~ Typically no real idea of where
  regional limitations are so good to
  look everywhere at first.

Question 14

Breakouts

Answer 14

• When a top tier test scores dysfunctional and no pain (DN) breakout tests are used to help determine the more specific source of the movement dysfunction.
• If able to do breakout actively then the movement is functional.
• If unable to do active and passive is full ROM, Neuromuscular Control is the issue
• If unable to active and passive is limited, then mobility is the issue

Question 15

General Tips for Selective Functional Assessments

Answer 15

• When breakouts are dystunctional, usual evaluation techniques can help determine specific source of limitations.
  ~ If pt. fails eval = use a breakout test
  to determine specific issue (mobility
  or NMC)
• Treat DN before DP and FP.
• Address mobility before NMC.