Functional screens will not always give you the answer, the screen might only show you another level of compensation. Only the keen at that game will get it right. What do we mean by this ? Well, lets take muscle testing and motor pattern assessments for example.
When we started with muscle testing we used to look for the weakness of the muscle or pattern we were isolating. But now, with more experience and wisdom, our keen eyes are now focused on the clients attempts to “cheat” around the assessment rather than basing our assessment entirely on the isolated tests. Many athletes will quickly figure out how and where to get more strength in a given muscle test, often because they are used to compensating for a weak muscle…..studies even show that clenching your teeth, or squeezing another muscle (often called a Jendrassik Maneuver) can affect the outcome of a muscle test. So, you have to watch for your client’s attempts to “cheat” through your assessments. Just one more thing to think about!
In the screen above, would you know if the person had internal or external tibial torsion? How about femoral retro or ante torsion ? In doing a screen, only the astute assessor will know what the screen is telling them. For example, is the foot turned out because the person has external tibial torsion, or is the knee going inwards because they neutralized the foot progression angle before the test and now the knee is drifting inwards ….. it is still external tibial torsion in both cases. What about internal tibial torsion, where is the foot, where is the knee? (More on Torsions and Versions in Thursday’s post)
The squat can give you information but you might want to think about this. Really how useful is a squat in relation to the most fundamental pattern we use the most, gait ? Well, it is not. 62% of normal gait is stance phase and of that, 51% of that is on one foot (38% of a total gait cycle). We still vividly remember when Professor Janda visited our residency program back in the 90’s for a week. He spoke of many things but one that stuck with us was a discussion about the need for stable single leg stance function, that it was a key motor skill easily cheated. That is not to say that the squat test is not a valuable assessment, there are just better ones in our humble opinion.
You see, a functional screen does give information, but it is only the person who understands the parameters of normal and abnormal function and anatomy who can glean what the screen is telling you. Guys like Gray Cook who are big into this stuff are going to be awesome at this because they have the background to know what the test is telling them and know the anatomical parameters that can skew the test. What we are saying, is that it is not the test that is the gem, it is the knowledge to understand the results of the test that is the key.
Oy vey, why can’t anything be simple, huh ?!
It’s Tuesday, we are The Gait Guys…….. and so much more.
Shawn and Ivo
The Gait Guys
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