Coach Alicia Fong

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Very interesting “FMS” article

I like to share the following article about FMS aka Functional Movement Screen.  It talks about the pros, cons and its studies. What are your thoughts?

Anyone who is interested in training, and browsing on the Internet now and then probably have hardly missed Functional Movement Screen, also commonly abbreviated as FMS, which currently is almost ridiculously hyped in the U.S.. Just as everything else from the U.S. so it’s about that you should pay the money to take a course and then get a license / a diploma that you then can show to their customers. What course would cost to go to Sweden I do not know, but education is in two days where you learn the tests and then a series of exercises that are designed to improve performance in the tests.

If you would like to be tested by someone who is licensed in the Functional Movement Screen and it will cost you around 600 SEK, ie the class with a PT-hours. The question then is whether it is worth the money? Is there any research showing that a training course in 2 days can make a random PT clever enough to determine whether it is the increased risk of injury?

I personally am not very fond of the Functional Movement Screen. I think it makes more sense than much else out there on the market but as usual when something strikes it big in the U.S., it’s an awful lot of talk and surprisingly little evidence behind. A very distinctive characters for almost all of those Americans who encountered a lot of searching on the web about exercise is that they all like to talk very much about studies and research, but almost never sees them actually refer to any studies or research.

Anyway. In this post I will look at the Functional Movement Screen and the research that does exist to try to determine whether the test adds nothing new and if it can help you as a coach or athlete to become better at what you do.

Brief Functional Movement Screen

Functional Movement Screen arrived in 1998 and is created by Gray Cook, Lee Burton and Kyle Kiesel. The first studies on the Functional Movement Screen is also performed by these gentlemen, if you will notice later, the results seem to differ a lot from when one of them is involved in the studies and when it is more independent people.

For those of you not familiar with the Functional Movement Screen and so does the seven different tests that can result in 0-3 points. 3 points are given if the movement is perfect. If the motion is carried out but with some form of compensation will be 2 points. If the test subject is unable to perform the test, he or she was 1 point and if the pain during movement, it will be 0 points. Maximum score for a test is thus 21 points and the minimum is 0 points, which occurs about every movement hurts.

One thing that is very good with the Functional Movement Screen purely scientific terms is that it is very standardized. In theory, this standardization mean that many people in different parts of the world can take the same tests and do basically the same assessment. So if you go to two different persons performing the various tests on you, you should get the same results in the two tests. If it really becomes so are studied in three different studies ( 1 , 2 , 3 ).

 

 

 

 

 

 

Functional Movement Screen is well standardized

In the first study, where Kyle Kiesel was co-author, saw a very good interrater reliability (IBR) ( 1 ). This long complicated words, how well the assessment is between two different people. Results from the study showed a rather good ability for different analysts to find the same results and the authors concluded that the Functional Movement Screen has high IBR and can be safely used by trained persons. Total overlapped approximately 70-92% of assessments for the various tests. In this study, also shared the team of an experienced team of two who both had at least 10 years of experience in Functional Movement Screen, a more inexperienced team with two newly trained assessors. Interestingly, more regular assessments of the newly trained assessors.

In the second study conducted on military performance was approximately the same result, the ( two ). This study also looked at how consistent assessment is from a single assessor. So if you have the same score by the same assessor if you do the test twice in succession. In this case the results were very good.

In the third study, the results were not as positive ( 3 ). The researchers in this study, the worse figures for IBR and they therefore recommend that the assessor should always perform the tests.

Despite the more adverse outcome in the third study is still a strength standardization of Functional Movement Screen. If we consider that it is still to some extent is a manual test that can be performed “on the ground” so the results are in good reliability. There is also a strength when you then must conduct studies on the test to see if it can predict future damage, reduce the number of injuries or even assessing how well a particular person will perform in a sport. For the fact that we know that different people consider pretty much the same means that studies can be performed in a standardized way of several different research groups.

The first studies

Knowing that a test is performed more or less the same way by different people is always interesting, but something that is far more interesting for an athlete is on the tests add nothing new. If they can contribute to either predict or damage by reducing the risk of injury. There are currently very few studies on the Functional Movement Screen, but mixed results and I will now briefly go through them all.

American footballer

The first of these studies appeared in 2007 and in that looked at American football player ( 4 ). This study was conducted by Kyle Kiesel, founder of the Functional Movement Screen, and is retrospective. With retrospective meant looking at the outcome afterwards to try to find connections. This is a form of study design that gives uncertain results should always be interpreted with caution. Study participants were 46 players in a professional club in the United States. Physical coach of this team had under study a total of 11 years of experience in Functional Movement Screen and the upcoming season, he had performed these tests on the players on the team. Using these results and injury statistics for the past season, the scientists then look at whether they could see no statistical correlation between test results and injury risk.

The mean football players of the test were found to be 16.9 points. For those who spent an injury, the mean 14.3 and for those who received no injury, the mean rather than 17.4. This difference in mean was significant. Apart from this simple comparison was made also a calculation to try to come up with a test value in the best possible way could make out the people who were in greater risk of injury while not unnecessarily included many who were not at increased risk of injury. If one were to set the threshold at 20 points so it would be guaranteed to get with virtually all of which harm themselves, but offers almost all of which do not harm themselves. The boundary is thus totally useless.

The value that was reached after the calculations was 14 points. Of those who scored below 14 points in the study were over 90% damage. Of those who had come to around 50% damage. This represents a specificity of 0.9 and a sensitivity of 0.5. They gave then some other ways of looking at this value which indicates an odds ratio of 11.7 which means that people under 14 points has an 11-fold higher risk of injury to a person with more than 14 points.

Can Functional Movement Screen predict damage in play in the NFL?

There are some very big questions of this study. In addition to being retrospective as I have said, I wonder immediately why you only included one season in the study? If the physical coach has worked with the Functional Movement Screen for 11 years should he is reasonably have data for several seasons. Perhaps it is the physical coach just got the job, we do not know. To me this feels like a big warning flag, especially when one of the authors of the study self-developed tests and has sold them commercially for almost 10 years before the study. Other problems are that you get to know very little about the individual values ​​of the test persons. The reason for this separation is to protect the players’ identity. Nor shall we know the name of the club we’ve tested. Or to put it another way, there is no way to verify this information.

In all cases, this study underpinning the value of 14 which now is established in the performing Functional Movement Screens.

For athletes before a marathon

This study is unfortunately only published as an abstract ( 5 ). In this study, we performed tests of the 60 runners who signed up for a marathon. After this, the participants each week before the race to fill out a form online where they could indicate whether they had any damage. The results of this study is far from impressive. A total of 12 pieces that had an injury of which only one participant had an overall score in 14th

After this daunting performance as tested is moving at the limit of 14 points to see if any other border could work better. The best value that was reached was then 17, which gave a specificity of 42% and a sensitivity of 57%. Still very bad and it can in principle be likened to a coin flip.

In women’s sports

Another study looked at 38 women’s sports that are either trained soccer, volleyball or basketball ( 7 ). In this study it was found that participants with a score over 14 points had 3.85 times as likely to go on an injury compared to those with 15 points and more. The sensitivity of this study was 0.58 which means that the test could find 58% of those who spent an injury. The specificity was 0.74, which means that 26% who did not went on a damage still had a profit during the 14th

All injuries except one in this study was the lower extremity and when we excluded the debt test in the Functional Movement Screen was the correlation between test results and injury risk clearly evident.

With firefighters in a year

This study involved 433 firefighters who face a new year underwent a Functional Movement Screen and then after a major intervention where the goal was to increase both bålstyrka and flexibility ( 6 ). There was no control group, but instead looked at injury statistics from the year before the intervention.

Nor in this study saw no connection between scores in tests and risk of injury. There was a small correlation between test results and previous injury in which those who were hurt had a slightly lower score. The real difference in score was only 0.24 points between previously injured and ‘never’ wounded so the practical usefulness here is basically none.

Youth Basketball player in a season

This study included 112 youth basketball players in which roughly half were girls and half boys aged 14-18 years ( 8 ). The results of this study was that 24% of those receiving the 14 points went to an injury, but 22% of those under 14 points was an injury. In other words, there was no difference in injury risk depending on the results that the girls and boys received the Functional Movement Screen test. The use of any value other than 14 as a border nor did it any significant results.

In the military

By far the best study published just one week ago and was performed on an aspiring military officers ( 9 ). The total includes 874 pieces of people which may be seen as a very impressive figure in terms of training studies. About half of them went through a workout that lasted 68 days and the other half an exercise period of 38 days. Before the training period all participants underwent a Functional Movement Screen, and a standard physical tests, which consisted of chins, sit-ups and well as a fitness test at 3 miles, that is almost 5 km.

The results showed that with a test result in 14 points had an injury that was 1.5 times greater than that which had more than 14 points. Overall, 45% of those who had a test result in 14 points of damage compared with 30% of those who had more points. The sensitivity of the test was 0.45 and specificity was 78%. This is not really impressive results, but we look only at these numbers, however, seems pretty Functional Movement Screen and still be able to fulfill a purpose in these contexts. However, there are two more things to do that in any case I am in really look into its benefits.

The first thing that is most telling is that when the researchers plotted the test results from damage to a graph that saw them to the risk of injury seemed to increase again among the participants who received more than 17 points on the test. The “plot up” means to put out items for each participant in a graph and then try to calculate any correlation. You’ve probably seen a graph at some point with a slanted line through the whole lot and points here and there. It is called a scatter plot.

The results of the study of military officers. Persons who scored below 14 points was the increased risk of injury but also those who received 18 points and more were in increased risk of injury.

This is quite surprising results. The person who was best on the tests proved to be more injury risk than their counterparts who were only decent on tests.

The other thing that speaks against Functional Movement Screen has something good for at least the military is that the physical tests they did at the beginning predicted which individuals were in the risk of injury as good as the Functional Movement Screen. Not only fystestet ability to predict who was at risk of injury was the same, its sensitivity was higher than for Functional Movement Screen. To put it in a very simple and obvious way. Less fit individuals are at increased risk for going on an injury when they begin to train more intensively.

Functional Movement Screen and performance

The relationship between test results of the Functional Movement Screen and performance is still not clear. There is a degree at Master’s level where the author looked at whether there was any link between performance on the test and the results of the various fitness tests like the vertical jump, sprint, throw the medicine ball and a “witty incitement” test ( 10 ). This study showed a very weak link between performance and test results. Another study conducted as part of a PhD. also showed that the disappointing results and in this also looked at differences between right and left sides to see if the Functional Movement Screen would predict that ( 11 ). Another study conducted by a graduate student in search of her PhD looked at the relationship between test results at a Functional Movement Screen and performance in 23 brandmänsanspiranter and found no significant relationship ( 12 ). The same study also did not do any correlation between test results and injury risk.

The study of military officers that I have mentioned here above was seen even where a relationship between performance on fystestet and results in the Functional Movement Screen, but even that was somewhat weak. The correlation was weak this explains why we saw a more straightforward relationship between injury risk and performance at fystestet compared with injury and scored in the Functional Movement Screen, which has said both the under 15 points and over 17 points had increased risk of injury.

Another study also conducted as part of a doctoral dissertation looked at whether you could see some form of systematic error in the Functional Movement Screen ( 13 ). Unfortunately I have not managed to get hold of this study in full text, but the abstract can be read out to more people seem to be more difficult to perform tests than shorter people. This suggests anyway that taller people are likely to be “designated” to be at risk of injury more often than shorter people, despite the risk of injury does not really differ slightly.

Summary

This post is hardly a celebration of the Functional Movement Screen. When it comes to predict the risk of injury or performance, it appears to be an awful lot to be desired. As I see it is really not worth the money to go to a place like this test unless you’re the type who likes to make movements that it is not possible, then it is probably Functional Movement Screen, a funny thing. It should be mentioned that there are good things to Functional Movement Screen. What I like most is the exercises you learn to increase his mobility again.

If you are however looking to reduce the risk of injury, I think it is far better to just look at what you need to take on and then try to increase their strength, balance and mobility so you can handle the movement. There is also in a lot of knee injuries that studies that have demonstrated several testable factors, if they are not working properly, leading to an increased risk of ACL injuries ( 11 ). If you want to reduce the risk of athletes do you probably will want to first of all abide by these factors.

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July 21, 2011 Posted by | Uncategorized | , , , , , , , , , , , , | Leave a comment

Health tip for week July 4th

Sleeping 8 hours a night helps you lose weight

A client asked me recently if lack of sleep affects his training performance even though he doesn’t feel tire at the time of training.  The answer is YES, definitely.  Just because you are not tired at the time, it doesn’t mean that it doesn’t screw up your body (to be more specific, your hormones).  Sleeping is the main key to fixing many health issues.

“Consistently skimping on sleep for even a week or two can have the same impact on our mood and performance as missing two full nights of sleep,” says Donna Arand, Ph.D., clinical director of the Sleep Disorders Center at Kettering Medical Center in Dayton, Ohio.  “Plus, it puts you at risk for diabetes and heart disease.”

A recent survey indicates that more than 60% of Americans have average less than 7 hours of sleep.  Ideally, 8 hours of sleep is good.  Missing 30 minutes to 1 hours can surprisingly lead to weight gain because your metabolism starts slowing and hormonal changes boost appetite and cravings.

If you miss 1 or 2 hours sleep, your mood will tank and often lead to anxiety, stress and/or depression.  Other research shows that after a couple nights of only 4 or 5 hours of rest, memory and attention span notably worsen.

If you miss 3 to 4 hours sleep, our heart rate and blood pressure spike.  There’s also evidence that sleeping only 4 hours a night for just six days can impair your body’s ability to regulate blood sugar; therefore, more cravings and weight gain.

For many of our functional medicine’s patients, getting them to sleep better (at least 8 hours a night) eliminates more than half of their health issues.  One thing I noticed from our clients/patients who weren’t getting enough sleep was they had adrenal burn out or adrenal fatigue, which all lead to low cortisol and low testosterone.

So make sure you get yourself a good quality sleep every night.  Here are some suggestions:

1) Go to bed before midnight, (ideally before 10 pm) because between 10 pm to 2 am is the optimum time for hormonal regulation and repair process, everything that involves recovery.

2) Don’t work out at night because it raises cortisol and disrupts the sleeping pattern.

3) Don’t drink any drink containing caffeine such as tea, soda and coffee.

4) Turn all lights off, including computers.  Any small light can disrupt your sleep throughout the night.

5) Read a boring book (textbook) before going to sleep.

6) Drink chamomile tea.  It soothes and calms you down.

7) Take some supplements that help your sleep like melatonin, 5-HTP, and Gabba.

I hope these tips help. Getting a good night sleep makes your day goes by faster and your mood will be good.

“Stop sneaking by. Getting too little sleep is only cheating yourself”.

 

 

 

July 6, 2011 Posted by | Uncategorized | , , , , , , , , | 1 Comment

Health tip for week July 19th

Lots of people say Deadlift is one of the most important exercise.  However, there is another one that works your whole body and is under utilized which is the FARMER’S WALK.

Here is a video of what the farmer’s walk is and looks like.  I figure a video describes it best.

And now, if you want to know the progression and how to perform it properly, listen to the below link.  I can write about it but it’s best to listen because it was well discussed.

Superhumanradio.com – The Farmer’s Walk

Enjoy and let me know if you have any questions.

July 20, 2010 Posted by | Uncategorized | , , , | Leave a comment

Olympic Lifting

Hi everybody-

I’m sorry I didn’t get a chance to write a health tip this week but I will resume next week.

However, I am going to introduce this DVD which covers over 2 hours of frottage from a live workshop covering the aspect of introducing Olympic Lifting to personal training clients.  The DVD goes of prerequisites before even attempting to teach the Olympic lifts along with full progressions for the hang clean.

Available at Evo-Performance for only $19 plus shipping.

Here is a review from one of the trainers who bought the DVD:

Review:

I found this DVD to be absolutely fantastic as someone who’s backed away from teaching these lifts ive gained a lot of confidence in what i learned, Peter you’ve done a fantastic job breaking the lifts down for even a beginner to understand like myself. but The thing that really impressed me was the smooth transition from neurodynamics,joint mobilization,neuromuscular activation and integration were all explained precisely and blended effortlessly, sometimes other DVD’s you feel as if its a stop start process. I gained a huge understanding of how these aspects to training are applied and has got me thinking on a whole new level.Really for the price of $19.00 you cant go wrong with this product Peter you have a no B.S approach and I can see you are extremely passionate about what you do.A lot of DVDS I have have watched feels like its a rehash of old stuff,I actually learnt new aspects that I haven’t learnt before, i think this is a true hallmark of a good product.

The way in which you broke down the lifts and covering prerequisite’s was a real eye opener to me, especially the front squat stuff, I now see how incorrectly my own form was and and can now spot immediately when someone is performing it incorrectly and also how to enhance technique, thanks to you DVD! The FMS stuff was also a highlight to me only being a newbie to the whole concept you made a good case for it and made it simplistic to understand.I actually cant come up with any negatives the picture went a little bit with some audio interruptions but the quality of the information overshadowed that completely.As you said not bad for a 2 hour production for $19.00 not sure if many offer this sort of quality.

Craig

June 16, 2010 Posted by | Uncategorized | , , , , | Leave a comment

Health tip for week Feb 8th

  • Always do some kind of flexibility prior to exercising.

What is the first thing that comes in mind when the word flexibility is used?  Stretching.  Well, flexibility is a lot more than just stretching.  There are many types of flexibility training:

  1. MyoFascial Release
  2. Static Stretching
  3. Neuromuscular Stretching (Contract-Relax, Contract-Relax-Antagonist-Contract)
  4. Active Isolated Stretching
  5. Dynamic Stretching
  6. Fascial Stretching
  7. Eccentric Quasi-Isometrics
  8. Neurodynamic Mobilization
  9. Self-Mobilization Techniques

This is probably more than you need to know if you are not a personal trainer; however, I listed them to give you an idea that flexibility training is much more comprehensive.

Let’s start by understanding the role of flexibility training.  It enhances performance, prevent injuries, and correct muscle imbalances.  Flexibility is the degree to which an individual muscle will lengthen.  Flexibility is the most neglected aspect of many fitness programs.

Poor flexibility creates many health problems and can be damaging to all structures within our bodies.  It creates poor posture resulting in mechanical imbalances in your back, hips shoulders and neck.  These imbalances shift your body segments out of proper alignment.  The results are stress, strains, even worse posture and stiff tight muscles which limit your range of motion and contribute to back, neck, and pelvis pain.  Many factors limit flexibility such as bones, muscles, ligaments muscular bulk and weight.

Many people in the fitness area do not understand well the role of flexibility for enhancing performance and prevention injuries.  The order should be flexibility first.  All my clients end up with some sort of stretching routine that I encourage them to follow daily.  It helps restore balance between opposing muscle groups.  It aids in stability of joint structures and reduces injuries.

Be aware that over-stretching is not always good either.  Over-stretching ligaments can produce unstable joints.  This can alter the normal length-tension relationships, which leads to synergistic dominance and faulty movement patterns.  This initiates the Cumulative Injury Cycle and places unwanted stress on the entire kinetic chain.

It is important to keep in mind a person’s body structure and his/her current state of flexibility, then design the flexibility routine accordingly.  The general rule is “stretch the tight muscles, don’t stretch everything for the sake of stretching”.  If you don’t know which muscles are tight, seek professional help.  Most trainers will be able to help you.

At AF Performance Center, we are offering 2-day Flexibility Seminar February 20 and 21.  This seminar is great for all trainers, physical therapists or anybody who want to learn about flexibility in depth.  You will learn all 9 different types of integrated flexibility listed above and more.  Call 310-895-5385 or visit www.evo-performance.com for more information.

February 8, 2010 Posted by | Uncategorized | , , , , , , | Leave a comment

Health tip for week Oct. 19th

  • Avoid doing leg press because it’s dangerous.

Doing leg press machine is not only really bad for you but also not functional.  The leg press is when you sit on the machine at a 45 degree with your back against a pad and your feet on a platform.  You push the platform until your legs are straight and lower the platform by bending your knees again.

leg_pressWhy is bad?

  1. It is dangerous on your lower back.  We need mobility in certain areas of our bodies and we don’t need that in our lower back.  We need stable lower back.  If the hips do not move properly, our low back eventually will hurt.  Dr. Stuart McGill, a low back specialist, states that “any flexion or extension will create a disc to blow.”  It might not happen the 1st, 2nd, or 50th time you perform this exercise, but eventually your low back will “hurt”.  A physiologist, Dr. Michael Yessis, also concurs that the potential danger in this exercise is seen when you, in an attempt to get a greater range of motion, bring the knees in close to the chest on the lowering phase. This, in turn, rounds the lumbar spine and because of the heavy weights typically used, the pressure acting on the spinal discs increases greatly. The high compression forces can cause disc rupture or other low back injury.
  2. The exercise is a completely nonfunctional movement.  Where in real life do you have to push out with your feet to move a heavy object and your back is locked at a 45 degree?  It’s more likely that we are standing on the ground lifting a heavy object, pushing ourselves off the floor (in other words, jumping off the floor), and/or squatting and carrying a heavy object.  There are many other situations but not one leg press movement will imitate any movements that are actually useful in real life.
  3. It causes knee pain and increase injuries in the future.  When you are in a sitting position and pushing heavy weights with your leg, you are strengthening lower body muscles but not teaching certain muscles to stabilize your body.  Muscles have more than one function.  In this situation, your gluteus (butt or glutes) muscle, for instance, will shut down.  There is no way you will fire up those glutes while sitting down.  One big function of the glutes is to stabilize the hip and the hip stabilizes your knees.   So, the leg press causes a neurological dysfunction in your lower body.  Also, the fix position you are forced to be when doing the leg press will cause degeneration and weariness in your knees.  Every time you do a rep in the leg press machine, you are in a fixed range of motion.  The machine fixes you and forces you to do the same exact mechanics/movements in your knees all of the time; therefore, degenerating and wearing out your knees.  While doing squats, the knees always bent slightly different every time and move accordingly to how your body is built.

Recommendation: Do squat instead of leg press.  First, doing leg press is easy.  People love to load up the machine with lots of plate and then say they lifted heavy.  If any of these people could squat even half of what they use in the machine, I would be impressed.  “You get to lift a whole lot of weight without actually accomplishing anything here”, a friend told me this once and it applies here for leg press.  A squat offers all the benefits but a fraction of the dangers.  If you have existing lower-back problems, customize your squat. There are so many different types of squats, find the one that is appropriate and functional to you.  Ask a trainer if you don’t know which ones to do.  The body is meant to function in a certain way so let’s train it the way it needs to be trained.

October 20, 2009 Posted by | Uncategorized | , , , | Leave a comment