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Assessing your Clients

Core strength: a new model for injury prediction and prevention.

Peate WF, Bates G, Lunda K, Francis S, Bellamy K. J Occup Med Toxicol. 2007 Apr 11;2:3.

OBJECTIVE: Many work in injury prone awkward positions that require adequate flexibility and strength in trunk stabilizer muscle groups. Performance on a functional movement screen (FMS) that assessed those factors was conducted and an intervention was designed.

METHODS: A battery of FMS tests were performed on 433 firefighters. We analyzed the correlation between FMS performance and injuries and other selected parameters. An intervention to improve flexibility and strength in trunk stabilizer or core muscle groups through a training program was evaluated.

RESULTS: The intervention reduced lost time due to injuries by 62% and the number of injuries by 42% over a twelve month period as compared to a historical control group.

CONCLUSION: These findings suggest that core strength and functional movement enhancement programs to prevent injuries in workers whose work involves awkward positions is warranted.

Some of my own thoughts: If you read this blog regularly, you will know that I am big on assessments, especially assessments which look at how the athlete or client moves. Gaining information about the way in which your athlete/client movements (or how the DON’T move) is extremely valuable because it allows you to determine where things are breaking down, were possible energy “leaks” are in their movement, the quality with which they move and areas that injury may potentially occur.

I use several different tests when I perform an assessment and the things that I have used over the years have sort of evolved as I have learned more or learned better ways to assess things I am looking for. Part of my assessment consists of the 7-test functional movement screen (FMS) as developed by Gray Cook. If you are a strength coach, personal trainer, physical therapist, or anyone that works in the field of sports medicine, I highly recommend Gray Cook’s book Athletic Bodies In Balance. It is just about the best $15 you can spend. The book was written for the general public (coaches, trainers and athletes’ alike) so it doesn’t get to “heady” or overly complicated. The book was written with the athlete in mind, so that the athlete could perform the tests on themselves (which can be tough, as assessing yourself is not always the best way to go), so only 5 of the 7 tests are detailed in the book. Regardless, the book is an excellent resource and will help you really understand movement.

This particular study was of interest to me because it utilized the functional movement screen (and I like to be as evidenced based as possible in my work) to assess firefighters. Because there was a decrease in lost time due to injuries, the authors concluded that a core strengthening program and functional movement training were beneficial to firefighters. The functional movement screen was used in this study to evaluate the firefighters and then they were enrolled into a training program designed by a sports medicine team. The program was designed to emphasize movements list bending, lifting and squatting that the firefighters may encounter in a work situation. The firefighters were taught “exercises which help to increase core strength and decrease mechanical load on the affected parts of their musculoskeletal system during ergonomically challenging job tasks”.

Aside from injury rates being lowered, the movement screen was also helpful in recognizing movement impairments of firefighters who had suffered injuries. A history of a past musculoskeletal injury lowered a firefighters score by 3.44 points (there is a total of 21 points available on the functional movement screen test). As well, the odds of failing a functional movement screen were 1.68 times greater for firefighters with a history of any injury.

This study gives us an idea of just how powerful a movement screen can be. Often times we get so caught up in performance based tests. What do you bench? What do you squat? What is your 40-time?

A more important question to ask would be “Why is that your bench/squat/40-time and what can we do to make it better? What are your limiting factors?”

Another thing that you can take away from this study as a strength coach or personal trainer is that, those who have been injured do not move properly! Remember, the body is all connected. Injury in one area can cause problems in another. Increased or decreased movement at one joint; will lead to increased or decreased movement at another joint. As we can infer from this study, those that have had an injury (be it sports injury or work injury) are going to need special attention when it comes to designing their program, as care must be taken to ensure that proper movements are re-learned and understood before progressing to more advanced training.