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December 3, 2020

How Functional Movement Assessments Guide Chiropractic Treatment

How Functional Movement Assessments Guide Chiropractic Treatment

If you’ve been following the Team Elite blog, you know that our treatment approach does not follow the “typical” chiropractic adjustment model. We don’t just crack some joints, throw on some heat and e-stim, and call it a day; every patient receives a comprehensive, head-to-toe evaluation that helps us to identify areas of dysfunction and to determine how we should proceed with our treatment.

We use the Selective Functional Movement Assessment (SFMA) which assesses movement and asks the questions “is the movement functional?” and “is it painful?” to give us a complete picture of how someone moves, what hurts, and how we can address the underlying causes.

How the SFMA Works

Using the SFMA, we take an objective look at seven fundamental movement patterns that give us valuable information about how a person moves. These movement patterns include:

  • Cervical (neck) patterns
  • How far can you look up, down, and side to side?
  • Upper extremity (arm and shoulder blade) patterns
  • How far can you reach your hand up behind your lower back, or down behind your upper back?
  • Multi-segmental patterns
  • Can you touch your toes?
  • How far can you reach your arms back behind you?
  • How far can you rotate your whole body each way?
  • Can you balance on one foot? Can you do it with your eyes closed?
  • How well can you squat with your feet together?

What a Functional Movement Screen Tells Us

We don't worry about any functional and non painful patterns, but the presence of pain and/or dysfunction tells us something needs to be addressed. Once we have this global assessment, we can start to fine-tune our evaluation. If someone exhibits restricted movement while standing up, we put the person in a more supported position — on their back, for example — and repeat the test.

If the movement improves, we know that person's ability to complete the movement exists, but he or she has what we call a motor control issue. Our next step will be to teach them how to stabilize better, so they can complete the movement in any position.

If, however, the movement is still restricted, then we will work with the person relaxed, and try to move them through the movement passively. If they have full motion, this again points to a motor control issue. If the restricted movement persists, we focus on manual therapy to treat the likely tight joint or muscle.

How We Use SFMA

In this way, the SFMA becomes a roadmap for our treatment. We have many tools in our toolbox: motor control and stability exercises, soft tissue treatments like Active Release Technique, Cupping, Kinesiology Tape, Instrument Assisted Soft Tissue Mobilization such as Graston, and joint approaches like spinal adjustments.

The SFMA results tell us which tools we should be using and where to use them. For example, your shoulder may be tight and painful, but this could be caused by dysfunction in your upper back; if we only treated your symptoms and focused on the shoulder alone, we would miss the source of your issue entirely. Instead of diving in with cookie-cutter treatments, we figure out your dysfunctional areas and the cause of the dysfunction so that we can use the right tools at the right time in the right place.

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