I work in the health care field and see the consequences of injuries every single workday. This makes me hyper-aware and probably a little too paranoid of certain things. As a direct result of things I’ve witnessed:
- I refuse to ride motorcycles or ATVs.
- I always wear a helmet and wrist guards when snowboarding
- I never listen to headphones when jogging in the vicinity of cars.
- I will never climb a ladder to put up Christmas lights (also I don’t like heights)
- I have an irrational fear of chain saws and buzz saws
- I refuse to mountain bike
As readers of this blog know, I’m also fairly active and like to play basketball, weight-lift, Crossfit, and of course train BJJ. I’ve done these things long enough and bone headed enough so that I’ve suffered my share of injuries like ankle sprains, muscle strains, tendinitis, and various tweaks of this thing and that thing.
While some of these injuries have sidelined me for a few months, I’ve fortunately never suffered anything serious enough to require surgery.
I’ve also trained long enough understand the importance of perfect form in training. When doing Crossfit:
- I refuse to kip.
- I always step down from the box when doing box jumps.
- I never lift a weight that will compromise my form.
- When learning a new movement I don’t get embarrassed anymore if I just use the girl bar or even the PVC pipe during the WOD.
- I no longer mind if I’m the last person in the gym still finishing up a WOD.
I’ve learned each of these things the hard way and now have a full appreciation for the impact an injury can have and how disruptive it can be to daily life and training objectives.
These guys really introduced me to the idea of looking at the body as an entire system, and how a prior injury can lead to certain compensatory changes, that can result in a subsequent injury or pain in seemingly unrelated areas.
The notion that an injury or repeated activity can cause asymmetries in the body, restrictions in movement, and altered motor patterns, which then make the body more susceptible to injury (even in seemingly unrelated areas) really blew my mind.
An example would be a sprained ankle, causing a compensatory change in gait, which then leads to back pain or hip pain or even an ACL tear.
Or the prototypical desk jockey weekend warrior who spends all day sitting hunched over a computer and develops tight hamstrings, tight hip flexors, and deactivated gluteal muscles who suddenly tears their Achilles tendon playing a sport when the weekend rolls around.
The more I read, the more it all made sense. Especially the emphasis on addressing these issues BEFORE the injury develops. An ounce of prevention vs a pound of cure and all that. Prehab vs rehab. Put in enough work for pre-habilitation so that you don’t suffer the injury and don’t need the rehabilitation.
Needless to say, I like my ACLs and my Achilles tendons… and don’t want them to ever be torn! So if there’s anything I can do to make it so they’re less likely to be torn, then I’m all for it.
With this newfound awareness I could tell that I have a lot of underlying stuff going on.
- When I bend over, I’m about 6 inches from touching my toes and feel tight all along my posterior chain
- I can’t do the Grok squat aka Asian squat, unless my hips and feet are turned way out to the side. When I do a backsquat, I’ve found that I also need to turn my feet way out and adopt a wider stance to in order to get parallel.
- My hips experience tremendous restriction when I try to turn my feet inwards.
- I constantly walk duck footed.
- When I stand straight, you can see that there’s a weird tilt to my trunk
If I close my eyes and try to make my feet parallel, this is what they look like.
I was concerned that all of these issues combine into a recipe for disaster. Not only that, but they also affect my performance in BJJ! I attribute one of the reasons to why my BJJ guard is so crappy to my limited hip mobility.
I decided to embark on a quest to get all of these things treated. I found a reputable practitioner through word of mouth. He’s a Doctor of Chiropractics with certifications in both Active Release Therapy (ART) and Graston Technique, along with Gray Cook’s Functional Movement Screen (FMS) and Selective Functional Movement Assessment (SFMA). I also wanted a doctor who is active themselves, and not one of those overweight and out of shape practitioners that can’t really relate to someone with an active lifestyle, so I was comforted to discover that he also did Crossfit.
During my initial assessment I explained my situation and what I was looking for. Because of my background in health care and all the reading I’ve done on this stuff I could tell that he knew what he was talking about and wasn’t just someone trying to BS me.
After the interview, he performed a functional movement screen (FMS) on me. If you’re not familiar with it, this is the description of the FMS taken directly from the website:
“The FMS is a ranking and grading system that documents movement patterns that are key to normal function. By screening these patterns, the FMS readily identifies functional limitations and asymmetries. These are issues that can reduce the effects of functional training and physical conditioning and distort body awareness.
The FMS generates the Functional Movement Screen Score, which is used to target problems and track progress. This scoring system is directly linked to the most beneficial corrective exercises to restore mechanically sound movement patterns.
Exercise professionals monitor the FMS score to track progress and to identify those exercises that will be most effective to restore proper movement and build strength in each individual.”
The FMS consists of 7 basic movements.
- Deep Squat
- Hurdle Step
- In-Line Lunge
- Shoulder Mobility
- Active Straight-Leg Raise
- Trunk Stability Push-up
- Rotary Stability
If you want to try to do a self FMS without having to see someone, check out this video. All you’ll need is masking tape, a dowel rod, and a doorway.
To learn more about the FMS and what each of these movements test you can check these out:
Here are the results of my FMS.
You can see that out of a total score of 21, I scored a whopping 9!
My body is in pretty rough shape and is definitely in need of help. The circled numbers indicate the order in which he wants to approach things. We will first target my hips and ankles. Once those limitations are addressed we’ll move on to my shoulders and lastly my rotary stability. Throughout this process we’ll be repeating the FMS at periodic intervals to track my progress
Despite my crappy FMS score, the fact that I didn’t have any significant asymmetries made him comfortable enough to allow me to continue my current activities. The Dr. said that because of my underlying knowledge and how active I am, he can tell that I’ll be a compliant patient, so it shouldn’t be too hard to address these things.
He was very generous with his time and was patient in answering all of my questions, no matter how deep into the minutiae I got. The total office visit took a little under 90 minutes!
The next step is for him to formulate a personal treat plan for me, which he explained will consist of soft tissue work, joint manipulation, and corrective exercises/stretching.
This was a great start to injury-proofing my body. We’ll begin treatment during my next visit.