The point of functional movement screening, or testing, is to establish if any of these discrepancies are present. While the general population may get away with having mobility inadequacies, more active, and especially athletic, populations will almost definitely find themselves on the injured list if they are not addressed.
One of the most common, and simplest, tests for functional mobility is the overhead squat test:
- Have the client place their feet shoulder-width apart with their arms straight up over head, elbows extended. They can hold something over their head such as a dowel rod, tubing or even a towel.
- Instruct the patient to slowly squat down to a position that is comfortable for them, cueing them to go slow and controlled, squatting as deep as they can without letting the heels leave the ground. If they are unfamiliar with the squatting motion, use the analogy of sitting down in a chair.
- Instruct them to squat under control for 2-3 repetitions. If the patient experiences too much pain, discontinue the evaluation and document location and intensity.
- Do not let the client know what you are specifically looking for, as they will tend to try and “correct” themselves as they perform the desired repetitions. Do not coach the movement; simply repeat the instructions if needed.
- View the motion from all different angles: anterior, lateral and posterior.
Ideally the client should wear shorts and a T-shirt and be in bare feet so you can get unobstructed views of the movement.
Normal Assessment Criteria
- Heels remain on the ground
- Feet do not externally rotate
- No lateral shifting
- Knees track over the toes
- Hands remain behind knees
- Hips break parallel
- Head remains level
- No pain
Scoring
Deep Squat Scoring Criteria (Score = 3)
- Upper torso is parallel with tibia or toward vertical
- Femur below horizontal
- Knees are aligned over feet
- Hands aligned over feet
Deep Squat Scoring Criteria (Score = 2)
- Upper torso is parallel with tibia or toward vertical
- Femur is below horizontal
- Knees are aligned over feet
- Hands are aligned over feet
- Heels are elevated
Deep Squat Scoring Criteria (Score = 1)
- Tibia and upper torso are not parallel
- Femur is not below horizontal
- Knees are not aligned over feet
- Lumbar flexion is noted
If pain is noted, score is 0
While this scoring template is considered standard, an observation of each joint should be made, from all angles possible. Any deviations should be noted, as they may point towards mobility issues.
Exercises and the Body
With the understanding that we do exercise in order to improve some aspect of fitness; be it strength, endurance, aerobic capacity, or even flexibility, and also understanding that to affect these improvements, the exercises will need to be designed to stress the particular aspect of fitness we are trying to improve, it is reasonable to think we need to understand how the body will overcome these stresses.
Overcoming forces
We already know that our bodies consist of a system of levers. And, in order to produce movement, these levers must overcome resistive forces. We also know that in all cases, the force arms of these levers are shorter than the resistive arms. This is because the distance from the joints to the point of contact with the resistance, is greater than that of the distance from the joint to the insertions of the muscles generating the forces to overcome this resistance. And, as was discussed earlier, this means the force generated must be greater than the resistive force.
To enable ourselves to overcome even greater forces, we turn to exercise. Here, training of the muscles to either generate more force, or increase endurance in order to repeatedly overcome a force, can be done. Muscles must increase in strength, and endurance, in order to keep up with the demands placed on them.
An important effect to take note of is something referred to as a length-tension relationship. Simply put, when a muscle is stretched, the tension within that muscle increases (as a result of the stretch reflex). The greater this pre-stretch, the greater the tension built up. And, as a result of this, the greater the amount of force the muscle can produce.