Monday, January 19, 2015

The Argument for Screening

By: Joel Luedke

"Unless its traumatic or pathological, its preventable" -Kelly Starrett.  

We are at a time when the treatment of athletic injuries is at its best and most advanced.  The types of treatment options both in a rehabilitation setting and in the doctors office is incredible and cutting edge.  One area that has been neglected in my point of view is the area of prevention and how to best approach it.  Do we write programs that try and address an entire team?  Do we focus it on the individual?  Do we go on what we know and see on a daily basis and come up with the best comprehensive program possible?

In my own personal experience I started looking at a lot of small and subtle single joint movements as well as measuring ranges of motion (ROM) for individual muscles.  I thought what I was getting were really good number and helpful results that I could go back and test in the future.  And then I did more reading.  What's the point of having good or bad motion results for specific muscles if the individual can't move through basic motions in a full range?  Who cares if they have full motion in their hamstrings but can't sit all the way down into a full squat and hold it?  It doesn't do us any good and I was spending a lot of time looking at too small of a picture.

With this shift in thinking the question was now, what is the best screening method to utilize in order to start breaking people down and create programs for them to try and help them move better.  I started with the Corrective Exercise Specialist (CES) exam and was off to a good start but while they tested all these great motions how they suggested addressing them was by singular muscle, either as under-active or over-active.  At this point I hadn't thought a lot about Gray Cook, his book "Movement" or the Functional Movement Screen (FMS).  And then I read "Movement" and it changed my perspective on looking at motion and doing it in a much broader scale.  Continuing with this learning of movement screening on a whole I also looked at Kelly Starrett and his "Supple Leopard" book and his discussion on looking at basic movements to find faults, working on fixing that fault and then testing again.

It's through this progress of test and retest that makes screening worth doing.  You're able not only as a clinician to compare results and see how interventions are working but also it allows the athlete or patient to see those same changes and challenge themselves to get better and fix issues.  As with every athletic endeavor, running a 5K or competing for a national championship, there are always goals and testing and retesting for screening adds these goals into their routine.

It can be time consuming but it put an objective measure towards trying to prevent injury from happening and even possibly increasing performance but it is worth it.  Getting ahead of issues that could become problems is paramount and prevents us from looking at a now injured athlete and then finding out all these subtle imbalances and trying to play catch up.

*Addendum: Nothing has changed with the thoughts on the importance of screening but the more I have taken courses/classes looking at different techniques the more I think you just need to find what works for you and your athletes.  If that is the FMS, great.  Like the SFMA? Perfect.  Or if you're into something like DNS that allows you to systematically break where the main problem might be occurring. 

When it comes to the screen that is most important and using something that allows you to find the issues, make the change and make it effective for your patient/client/athlete.

If you're interested in either the "Supple Leopard" or "Movement" check their links.

Check out Kelly Starrett and Gray Cook's video on screening below.

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