SFMA/FMS

The Selective Functional Movement Assessment (SFMA) is a series of 7 full-body movement tests designed to assess fundamental patterns of movement such as bending and squatting in those with known musculoskeletal pain. When the clinical assessment is initiated from the perspective of the movement pattern, the clinician has the opportunity to identify meaningful impairments that may be seemingly unrelated to the main musculoskeletal complaint, but contribute to the associated disability. This concept, known as Regional Interdependence, is the hallmark of the SFMA.

The assessment guides the clinician to the most dysfunctional non-painful movement pattern, which is then assessed in detail. This approach is designed to complement the existing exam and serve as a model to efficiently integrate the concepts of posture, muscle balance and the fundamental patterns of movement into musculoskeletal practice. By addressing the most dysfunctional non-painful pattern, the application of targeted interventions (manual therapy and therapeutic exercise) is not adversely affected by pain.

The Functional Movement Screen (FMS) is the product of an exercise philosophy known as Functional Movement Systems. This exercise philosophy and corresponding set of resources is based on sound science, years of innovation, and current research.

Put simply, 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 and healthcare 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 system of patient care known as the McKenzie Method® of Mechanical Diagnosis and Therapy® (MDT) is an approach that is trusted and used by clinicians and patients all over the world for common back, neck and extremity joint problems.

Most musculoskeletal pain is "mechanical" in origin, meaning that every day movements and postures cause pain. By a systematic evaluation of his patients, New Zealand physiotherapist Robin McKenzie, found that certain movements and postures can often abolish pain and restore function.

Robin McKenzie believed that most patients could learn to treat themselves if taught correctly. He felt that self-treatment empowered the patient and reduced their dependency on medical intervention. The McKenzie Method® promotes the body's potential to heal itself without medication, surgery, or other passive modalities such as heat, ice, or ultrasound therapy. It also addresses a growing demand from patients and third party payers for professional rehabilitation services that develop the patient's self-treatment skills in a cost-effective and time-effective manner.

The McKenzie Method® of Mechanical Diagnosis and Therapy® (MDT) is an internationally acclaimed method of assessment and treatment for spinal and extremity pain developed by New Zealand Physiotherapist Robin McKenzie. It has been widely used all over the world for more than 30 years.

MDT clinicians are trained to assess and diagnose all areas of the musculoskeletal system. That means that if a problem exists in or around the spine, joint or muscle, an MDT evaluation may be appropriate.

MDT is a philosophy of active patient involvement and education that is trusted and used by clinicians and patients all over the world for back, neck, and extremity problems. This approach continues to be one of the most researched physical therapy based methods available.

A key feature is the initial assessment - a safe and reliable way to reach an accurate diagnosis and only then make the appropriate treatment plan. Expensive tests such as MRI’s are often unnecessary. Certified MDT clinicians are able to rapidly determine whether the method will be effective for each patient.

In its truest sense, MDT is a comprehensive approach based on sound principles and fundamentals that, when fully understood and followed, is very successful.

Self Assessment for Spinal Pain

  • Are there periods in the day when you have no pain? Even 10 minutes?
  • Is the pain confined to areas above the knee or above your elbow?
  • Have you had more than one episode of low back pain or neck pain over the past few months or years?
  • Do you feel worse during or immediately after prolonged bending or stooping; as in making beds, vacuuming, gardening, concreting, etc?
  • Do you feel worse when sitting for prolonged periods or on rising from the sitting position, ie after watching TV or working on the computer?
  • Do you associate your pain with any one particular activity but are generally pain free when not engaged in this activity?
  • Do you feel worse when inactive and better when on the move?
  • Does your low back feel better when lying face down? (You may feel worse for a minute before the pain subsides, in that case the answer to this question is yes).
  • Does your low back pain feel better when you are walking?

If you have answered yes to more than 4 questions, your chances of gaining benefit from The McKenzie Method® is very good. If you answered yes to 3 or less questions you may require specialised assessment and treatment and you should contact a clinician trained in the McKenzie Method®

If you have any of the following

  • Sciatica
  • Arthritic pain in hips or buttocks, shoulders, or upper arms
  • Difficulty bending due to stiffness or pain in your lower back
  • Pain that starts in the back or neck and seems to spread to the buttocks or shoulders
  • Intermittent pins and needles or numbness in the feet or hands
  • Aching pain into the elbows or knees that hasn't been assisted by treatment to these areas

Then you may be assisted by a trained McKenzie clinician. They are trained to assess and diagnose all areas of the musculoskeletal system. MDT clinicians are trained to assess your problem and help you understand how you may be able to help yourself to improve your pain, stiffness or ability to do your work or daily activities.

Assessment
Unique to the McKenzie Method® is a comprehensive and logical step-by-step process to evaluate the patient's problem quickly. This mechanical examination can "classify" most patient conditions by the level of pain or limitation that results from certain movements or positions. A McKenzie assessment can eliminate the need for expensive and/or invasive procedures. Research has shown the initial McKenzie assessment procedures to be as reliable as costly diagnostic imaging (i.e., x-rays, MRIs) to determine the source of the problem and quickly identify responders and non-responders.

Treatment
McKenzie treatment prescribes a series of individualized exercises. The emphasis is on active patient involvement, which minimizes the number of visits to the clinic. Ultimately, most patients can successfully treat themselves when provided the necessary knowledge and tools. For patients with more difficult mechanical problems, a certified McKenzie clinician can provide advanced hands-on techniques until the patient can self administer.

Prevention
By learning how to self-treat the current problem, patients gain hands-on knowledge on how to minimize the risk of recurrence and to rapidly deal with recurrence if it occurs. The likelihood of problems persisting can more likely be prevented through self-maintenance.