Identify Why You Have Pain Using the SFMA
Symmetry is important to people whether we know it or not. Our bodies strive to be symmetrical in movement, but this is not always possible. This harmony of movement should be balanced between movements on the left and right sides, but also needs to present within the functional range-of-motion of your joints. You need to have the appropriate amount of flexion and extension of each of your joints. Moving asymmetrically can make us prone to injury. Being able to assess your movement and identify asymmetries allows your clinician to treat your pain and help you to avoid future injuries. The Selective Functional Movement Assessment (SFMA) does just that. The SFMA is a very useful and unique tool designed for clinicians to utilize in order to help you get back to your normal, pain free life.
As the name implies, it is a movement-based tool that clinicians can use to guide them to the best treatment for your pain. The SFMA allows the clinician to identify the exact cause and not just the source of your pain.
What makes the SFMA unique?
The SFMA was designed to evaluate complex functional movements based on how the different areas of the human body interact during athletic and everyday activities. It considers posture, balance, muscle strength, and movement patterns to diagnose musculoskeletal defects which are not typically recognized using traditional examination techniques.
The SFMA goes beyond the usual medical assessment of musculoskeletal injuries because traditional exams are based almost solely on pain elicited by certain body motions or challenges. These exams are crucial to determine if the problem is the result of a serious loss of integrity to a joint or related to a damaged group of muscles. So, if you push here and twist there and something hurts, it gives you the diagnosis. Yet, this medical process has limitations. What happens when the tests are not conclusive and the imaging is not clear cut?
Remember how the head bone is connected to the neck bone and so on? These bones and joint do not work in a vacuum. Even though nearby areas of the body are interconnected to each other in a concept called regional interdependence, neighboring anatomical structures are not properly evaluated to see if they might contribute to a person’s main problem. During a complex movement, each joint and related muscle has a role to play and depends on the rest of the team to do their jobs. Anatomical structures that are apparently not relevant to the actual complain, could actually be the causative agent of the main complaint.
The SFMA begins by systematically looking at 7 basic movements, from your head to your toe. These motions appear simple but actually require good mobility and command of the body. The movements are as followings:
- Cervical Spine Assessment
- Upper Extremity Movement Pattern Assessment
- Multi-segmental Flexion Assessment
- Multi-segmental Extension Assessment
- Multi-segmental Rotation Assessment
- Single-Leg Stance (Standing Knee Lift) Assessment
- Deep Squat Assessment
Each of these movements are either performed correctly or not. If the ROM is full and unrestricted, then it is considered to be “functional”. Functional movement means that you are performing this movement with symmetry. A movement can be considered “dysfunctional” if the person has a lack of mobility, stability or symmetry. Dysfunctional movement means that there are asymmetries and you are not performing this movement optimally. Also, the movement will either cause pain or it will not. Pain and asymmetries do not always go together. This means that each of the seven main movements of the SFMA is classified as:
- Functional Non-painful
- Functional Painful
- Dysfunctional Painful
- Dysfunctional Non-Painful
You can either experience pain or be pain free with these movements. However, pain free asymmetry still needs to be treated in order to avoid future pain or injury.
Let’s give you an example
During the SFMA test, if someone reports pain in their mid-back during the deep squat movement assessment, the clinician can further break down the squat into the individual movements that make up the squat.
These individual movements must be symmetrical in order for this person to perform a successful squat. The break down of the squat would look at the mobility and stability of the spine, hips, knees, and ankles. If the left ankle is limited in mobility, this person may shift over to their right at the bottom of the squat, causing abnormal stress through their back and legs.
Treatments based off SFMA Findings
Based off of the findings during the movement breakdowns, the clinician can then instantly start providing the correct treatment. These treatment options can include either chiropractic adjustments, manual therapy (like Graston Technique or massage therapy), functional exercise (corrective exercise), or both, depending on if it is a mobility issue and/or a stability issue.
A mobility issue would mean that you do not have the correct range of motion or flexibility of your muscles and/or joints. A stability issue would mean that you do not have the correct motor control and/or strength of a specific region. The best thing about this test is the clinician can immediately perform treatments and retest the movement, using the SFMA, to see if there are any improvements.
The SFMA allows a quick assessment, quick planning of the best treatment option, and as a result, more successful outcomes.
SFMA versus other assessments
Honestly, most assessment tools really only look at individual body parts or area of pain. This is not ideal because our bodies are complex machines with all types of soft tissues and joints that need to move and work together. But the SFMA was designed with that in mind. It looks at how the whole body moves together. The SFMA allows the clinician to assess your mobility, stability, motor control, asymmetries, and pain, all in one test.
Identifying the most dysfunctional non-painful patterns is the initial focus of the SFMA and not the most painful pattern. When there is pain, the body will try to compensate for pain and any weaknesses by adapting the movements to avoid pain and constraints. These distorted motions result in altered posture, ROM, muscle performance, balance, motor control, and movement patterns.
Low Back Pain Example
Here is another example. This time, you are seeking help for your low back pain. During the single leg balance portion of the SFMA, you may drop your hip without realizing it (meaning your hips do not stay level). Now, you may or may not have pain in your hip and quite frankly, you may not care what your hip is doing because you are coming in for low back pain. But with this test, your clinician notices the drop in your hip and this reveals potential stability issues of the leg you are standing on. This stability issue can lead to low back pain due to having poor hip stability while you are walking, working, exercising, or whatever it is that you love to do.
Poor Movement = Compensation = Pain.
If your clinician did not take you through the SFMA test, they may have missed this dysfunctional, asymmetrical movement. And instead of addressing this issue in your hip, your clinician could have prolonged your recovery with focus on only your low back.
In addition, the SFMA is not only beneficial for the patient, but it is also extremely valuable to the clinician. With the easy to follow guidelines and scoring, a clinician can effectively perform the SFMA test and provide treatment in the same appointment. It takes the guessing game out and allows them to get right into doing what they love, helping you feel better and move better.
Give the SFMA a try!
How many times have you gone for treatment somewhere, had an evaluation or diagnostic test performed, and then had to wait a week for a follow up appointment? Clinicians want you better just as much as you want to feel better. The SFMA literally allows clinicians to cut corners with their treatments. There is no sense in focusing on one specific body part when each body part moves dependently on the others.
So who can benefit from the SFMA? The answer is anyone who is experiencing pain. This could be anyone from elite athletes to weekend warriors. This could be someone who is sedentary with a desk job to someone working in a warehouse. The SFMA can help anyone because we all move our bodies.
If you are tired of having appointment after appointment, with minimal improvements, you need to schedule an appointment to have the SFMA performed. Find out what movements are painful and dysfunctional, figure out your asymmetries, and instantly get to work on correcting these so that you can return to your life without pain slowing you down.