The Selective Functional Movement Assessment (SFMA) is a comprehensive assessment used to classify movement patterns, identify regions for further local biomechanical examination, and ultimately, direct manual therapy and therapeutic exercise interventions. The SFMA is a system that helps rehabilitation professionals incorporate a movement baseline into their musculoskeletal examination. It complements the clinician’s orthopedic exam which determines the medical diagnosis, or the SOURCE of your pain. The SFMA helps determine the CAUSE of your pain.
The SFMA uses a concept called Regional Interdependence: the concept that seemingly unrelated impairments in another anatomical region may contribute to or be associated with the patient’s primary complaint. For example, if a person has a slouched posture with limited upper back extension along with poor hip extension, then the low back will have to do the work of both of those areas. That can cause joint and disc injury or muscular pain from overuse in the low back. The SFMA helps create a pattern-specific perspective of how each individual moves so we can prescribe the appropriate therapeutic treatment.
By examining several fundamental movement patterns we can determine which are functional and which are dysfunctional. We will then break down those dysfunctional movements by systematically taking away challenges to determine if the problem is with posture, core stabilization/alignment, motor/muscle control, or joint/tissue mobility.
The Joint-By-Joint Rule states “The body works in an alternating pattern of stable segments connected by mobile joints. If this pattern is altered – dysfunction and compensation will occur.” If an area is restricted, especially one that should be mobile, your brain will learn and develop a motor pattern to move around that restriction. This will cause an otherwise stable area to become mobile and lead to injury as in the back example above.
So one of the rules in SFMA and our clinic is never bring a mobility problem to a stability issue. We follow the three R’s, Reset-Reinforce-Retrain. Resetting is where I mobilize the joint or tissue that is restricted. Reinforce is where we train the patient to maintain that mobility. Retrain is developing a new and appropriate motor pattern based on your level of motor control so that you move well. That sometimes means starting on the ground, then moving to a kneeling position, and finally to a standing position. Each level requires more stability and control and if you can’t do something on the ground you probably won’t be able to do it standing. You have to learn to crawl before you walk.
Just because your movement is pain free doesn’t mean that it’s not dysfunctional.
You need to move well before you move often. If you move well you throw out a signal of integrity to the environment like the surface your moving on and that sends a signal back through your body to your neurological system and your brain can learn and adapt and develop. Your body will transform and adapt to the environment and tasks that you ask it to do. If you ask the body to go in environments or perform tasks that you aren’t ready for you won’t get good signals and you will develop compensations. This is what happens when you move often, but aren’t moving well.
The SFMA helps determine the cause of your injury or pain through a . Causes can be mobility problems, motor control and stability issues, poor posture, etc.
The SFMA starts with global movement patterns with key baselines
It simply creates a more pattern-specific perspective of how each individual patient moves in relationship to their anatomical information and their medical diagnosis.
Anatomical information means that each patient has specific structural integrity that must be considered. Each patient also has a medical diagnosis that involves both indications and contraindications. However, anatomical information and medical diagnosis are not enough information to prescribe intervention