Functional Movement Screen (FMS) 

The Functional Movement Screen (FMS) is the product of an exercise philosophy known as Functional Movement Systems. This exercise philosophy and corresponding set of resources is based on sound science, years of innovation, and current research.

How it Works – Simplifying Movement

Put simply, the FMS is a ranking and grading system that documents movement patterns that are key to normal function. By screening these patterns, the FMS readily identifies functional limitations and asymmetries. These are issues that can reduce the effects of functional training and physical conditioning and distort body awareness.

The FMS generates the Functional Movement Screen Score, which is used to target problems and track progress. This scoring system is directly linked to the most beneficial corrective exercises to restore mechanically sound movement patterns.

Exercise professionals monitor the FMS score to track progress and to identify those exercises that will be most effective to restore proper movement and build strength in each individual.

What it Does – Widespread Benefits

The FMS simplifies the concept of movement and its impact on the body. Its streamlined system has benefits for everyone involved – individuals, exercise professionals, and physicians.

Communication - The FMS utilizes simple language, making it easy for individuals, exercise professionals, and physicians to communicate clearly about progress and treatment.

Evaluation - The screen effortlessly identifies asymmetries and limitations, diminishing the need for extensive testing and analysis.

Standardization - The FMS creates a functional baseline to mark progress and provides a means to measure performance.

Safety - The FMS quickly identifies dangerous movement patterns so that they can be addressed. It also indicates an individual’s readiness to perform exercise so that realistic goals can be set and achieved.

Corrective Strategies - The FMS can be applied at any fitness level, simplifying corrective strategies of a wide array of movement issues. It identifies specific exercises based on individual FMS scores to instantly create customized treatment plans.

FOR MORE INFORMATION, CHECK OUT: http://functionalmovement.com/

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The Selective Functional Movement Assessment (SFMA) is a series of 7 full-body movement tests designed to assess fundamental patterns of movement such as bending and squatting in those with known musculoskeletal pain. When the clinical assessment is initiated from the perspective of the movement pattern, the clinician has the opportunity to identify meaningful impairments that may be seemingly unrelated to the main musculoskeletal complaint, but contribute to the associated disability. This concept, known as Regional Interdependence, is the hallmark of the SFMA. 

SFMA offers a unique and efficient approach to the treatment of pain and dysfunction. Our standardized clinical model ensures isolating the cause of injury and efficient care.

FOR MORE INFORMATION, CHECK OUT: http://www.sfma.com

What is a bunion?

A bunion is an abnormal bony bump that forms on the joint at the base of the big toe. The big toe joint becomes enlarged and the big toe points toward the other toes. The medical term for the deformity where the big toe angles toward the other toes is hallux valgus.

People with weak or flat feet and women who wear high heels a lot tend to develop bunions.

How does it occur?

Bunions can result from wearing shoes that don’t fit properly or from wearing high-heeled shoes with narrow, pointed toes. When a shoe rubs against the toe joint it irritates the area and makes it swollen, red, and painful. A tough, calloused covering grows over the site.

The tendency to have bunions may be inherited.

What are the symptoms?

Symptoms include:

•a bony bump at the base of the big toe
•swelling, redness, and soreness of the big toe joint
•thickening of the skin at the base of the big toe
How is it diagnosed?

Your healthcare provider will examine the affected foot. He or she may want to take X-rays of the joint.

How is it treated?

Often nonsurgical treatment is sufficient. You can usually relieve pressure on the big toe by:

•Wearing roomy, comfortable shoes.
•Wearing a corrective device that pushes the big toe back into the right position and holds it in place.
•Placing a pad on the bunion.
In addition, take anti-inflammatory medicine (such as aspirin or ibuprofen) for pain relief. Adults aged 65 years and older should not take non-steroidal anti-inflammatory medicine for more than 7 days without their healthcare provider’s approval. Custom-made arch supports called orthotics may help reduce bunion pain.

If the bunion gets worse and causes too much discomfort, your healthcare provider may suggest surgery (called bunionectomy) to:

•Straighten the toe by taking out part of the bone.
•Permanently join the bones of the affected joint.
How long will the effects last?

A bunion is a permanent problem. You’ll continue to have it unless you have surgery to remove it. Recovery from bunion surgery may take 2 months or more.

How can I take care of myself?

If you have swelling, redness, or pain in the big toe joint:

•Keep pressure off the affected toe.
•Wear comfortable shoes that fit well and allow enough room for your toes.
•See your healthcare provider or a foot specialist if your condition doesn’t improve or if new symptoms develop.
•Follow your healthcare provider’s instructions for taking prescribed medicine.
What can be done to help prevent bunions?

You can help prevent bunions from developing by wearing comfortable shoes that fit well. Be sure your shoes don’t cramp or irritate your toes. This is especially important if your family has a history of weak or flat feet, conditions that may be inherited.

Written by Pierre Rouzier, MD” and “Permission to copy for patient education” and “www.sportsmedpress.com

•Toe passive range of motion: Use your hand to gently bend the injured toe joint. Then gently try to straighten out the toe with your hand. Repeat slowly, holding for 5 seconds at the end of each motion. Do this 10 times. Do these exercises 3 times per day.
•Towel pickup: With your heel on the ground, pick up a towel with your toes. Release. Repeat 10 to 20 times. When this gets easy, add more resistance by placing a book or small weight on the towel.
•Standing toe raise: Stand with your feet flat on the floor, rock back onto your heels and lift your toes off the floor. Hold this for 5 seconds. Do 3 sets of 10.
•Heel raise: Balance yourself while standing behind a chair or counter. Using the chair to help you, raise your body up onto your toes and hold for 5 seconds. Then slowly lower yourself down without holding onto the chair. Hold onto the chair or counter if you need to. When this exercise becomes less painful, try lowering on one leg only. Repeat 10 times. Do 3 sets of 10.
•Towel stretch: Sit on a hard surface with one leg stretched out in front of you. Loop a towel around your toes and the ball of your foot and pull the towel toward your body keeping your knee straight. Hold this position for 15 to 30 seconds then relax. Repeat 3 times.

Written by Pierre Rouzier, MD” and “Permission to copy for patient education” and “www.sportsmedpress.com

What is a broken toe?

A broken toe is a break in a toe bone. A broken bone is also called a fracture. The break can occur in any of the toe bones. You may have a break in several places or the break may be in the joint between toe bones.

How does it occur?

A broken toe can occur several ways. Broken toes are commonly caused by a direct hit (such as kicking a hard object or something landing on the toe). A toe can also break from a twisting type injury.

If you play a sport where you don’t wear shoes (such as martial arts, ballet, gymnastics) you are at an increased risk for a toe injury.

What are the symptoms?

You will have pain, swelling, and tenderness in the toe. It will be difficult to walk or run.

Your toe may turn black and blue. You may get bleeding or discoloration underneath your toenail. Your toenail may eventually come off.

How is it diagnosed?

Your provider will review your symptoms, ask about how the injury occurred, and examine you. A toe fracture is diagnosed by an X-ray showing a break in the bone.

How is it treated?

The treatment depends on the type of fracture you have. Usually the broken toe is taped to the toe directly next to it. In rare cases surgery must be done to fix the broken bone.

Treatment will also include:

•Putting ice packs on your toe for 20 to 30 minutes every 3 to 4 hours for the first 2 to 3 days or until the pain goes away. Thereafter ice your toe at least once a day until the other symptoms are gone.
•Elevating your foot by placing a pillow underneath it to keep the swelling down. Try to keep your foot above the level of your heart.
•Taking an anti-inflammatory or pain medicine as prescribed by your provider. Adults aged 65 years and older should not take non-steroidal anti-inflammatory medicine for more than 7 days without their healthcare provider’s approval.
Your provider may advise you to wear stiff-soled shoes. You may also be given crutches until you can walk without pain.

If your toenail is loose and has not yet fallen off, keep a Band-Aid around it.

How long do the effects last?

It usually takes 4 to 6 weeks for a broken toe to heal. If the fracture goes into a joint your toe may continue to feel stiff and can lose some range of motion. You may develop arthritis over time. Sometimes a toe may become shorter after a fracture.

When can I return to my normal activities?

Everyone recovers from an injury at a different rate. Return to your activities will be determined by how soon your toe recovers, not by how many days or weeks it has been since your injury has occurred. The goal of rehabilitation is to return you to your normal activities as soon as is safely possible. If you return too soon you may worsen your injury.

You may safely return to your normal activity when you can walk straight ahead without pain or limping.

How can I prevent a toe fracture?

Most toe fractures are caused by accidents that cannot be prevented. However it is important to wear proper fitting footwear and avoid playing or running on surfaces that are uneven.

Written by Pierre Rouzier, MD” and “Permission to copy for patient education” and “www.sportsmedpress.com

•Wand exercise: Flexion: Stand upright and hold a stick in both hands, palms down. Stretch your arms by lifting them over your head, keeping your elbows straight. Hold for 5 seconds and return to the starting position. Repeat 10 times.
•Wand exercise: Extension: Stand upright and hold a stick in both hands behind your back. Move the stick away from your back. Hold the end position for 5 seconds. Relax and return to the starting position. Repeat 10 times.
•Wand exercise: External rotation: Lie on your back and hold a stick in both hands, palms up. Your upper arms should be resting on the floor, your elbows at your sides and bent 90°. Using one arm, push your other arm out away from your body while keeping the elbow of the arm being pushed at your side. Hold the stretch for 5 seconds. Repeat 10 times.
•Wand exercise: Internal rotation: Stand with one arm behind your head holding the end of a stick. Put your other arm behind your back at waist level and grab the stick. Move the stick up and down your back by bending your elbows. Hold the bent position for 5 seconds and then return to the starting position. Repeat 10 times.
•Wand exercise: Shoulder abduction and adduction: Stand upright and hold a stick with both hands, palms facing away from your body. Rest the stick against the front of your thighs. While keeping your elbows straight, use one arm to push your other arm out to the side and up as high as possible. Hold for 5 seconds. Repeat 10 times.
•Wand exercise: Horizontal abduction and adduction: Stand upright and hold a stick in both hands. Place your arms straight out in front of you at shoulder level. Keep your arms straight and swing the stick to one side, feel the stretch, and hold for 5 seconds. Then swing the stick to the other side, feel the stretch, and hold for 5 seconds. Repeat 10 times.
•Shoulder flexion: Stand with your arms hanging down at your side. Keep your elbow straight and lift your arms up over your head as far as you can reach. Hold the end position for 5 seconds. Do 3 sets of 10.
•Shoulder abduction: Stand with your arms at your sides. Bring your arms up, out to the side, and toward the ceiling. Hold for 5 seconds. Return to the starting position. Repeat 10 times.
•Horizontal shoulder abduction: Stand with your arms held straight out in front of you at shoulder level. Pull your arms apart and out to the sides as far as possible. Hold them back for 5 seconds, then bring them back together in front of you. Repeat 10 times. Remember to keep your arms at shoulder level throughout this exercise.
•Shoulder extension: Stand with your arms at your sides. Move the arm on one side back, keeping your elbow straight. Hold this position for 5 seconds. Return to the starting position and repeat 10 times.
•Scapular active range of motion: Stand and shrug your shoulders up and hold for 5 seconds. Then squeeze your shoulder blades back and together and hold 5 seconds. Next, pull your shoulder blades downward as if putting them in your back pocket. Relax. Repeat this sequence 10 times.
•Side-lying horizontal abduction: Lie on your side with your top arm relaxed across your chest. Slowly bring your top arm up off the floor, elbow straight, so that your hand is pointing toward the ceiling. Do 3 sets of 10. Hold a weight in your hand as the exercise becomes easier.
•Prone shoulder extension: Lie on your stomach on a table or a bed with one arm hanging down over the edge. With your elbow straight, slowly lift your arm straight back and toward the ceiling. Return to the starting position. Do 3 sets of 10. As this becomes easier, hold a weight in your hand.
•Single-arm shoulder abduction: Stand with your arms at your sides with your palms resting against your sides. With your elbow straight, lift one arm out to the side and toward the ceiling. Hold the position for 5 seconds. Repeat 10 times. Add a weight to your hand as this exercise becomes easier.
•Resisted shoulder internal rotation: Holding tubing connected to a door knob at waist level, keep your elbow in at your side and rotate your arm inward across your body. Make sure you keep your forearm parallel to the floor. Do 3 sets of 10.
•Resisted shoulder adduction: Stand sideways next to a door. With the hand closest to the door, hold tubing connected to a door knob at waist level. Stand away from the door approximately 8 to 10 inches. Slowly bring your arm with tubing next to your body. Do 3 sets of 10.
•Resisted shoulder flexion: Holding tubing connected to a door knob at waist level, face away from the door, keep your elbow straight and pull your arm forward. Do 3 sets of 10.
•Resisted shoulder extension: Face a door holding tubing connected to the door knob at waist level, pull your arm back. Be sure to keep your elbow straight. Do 3 sets of 10.
•Resisted shoulder external rotation: Stand sideways next to a door. Rest the hand farthest away from the door across your stomach. With that hand grasp tubing that is connected to a doorknob at waist level. Keeping your elbow in at your side, rotate your arm outward and away from your waist. Make sure you keep your elbow bent 90 degrees and your forearm parallel to the floor. Repeat 10 times. Build up to 3 sets of 10.

Written by Pierre Rouzier, MD” and “Permission to copy for patient education” and “www.sportsmedpress.com

What is a broken collarbone?

A broken collarbone is a break in the clavicle, the bone in your upper chest that connects your breastbone (sternum) to part of your shoulder blade (scapula). A broken collarbone is also known as a fractured clavicle.

How does it occur?

A broken collarbone can occur in several ways. You may fall on your outstretched arm and hand, you may fall on your shoulder, or you may be hit directly in the collarbone.

What are the symptoms?

You have pain and swelling at the area of the break. It is difficult to move your arm or shoulder. You may have heard a crack at the time of the injury.

How is it diagnosed?

Your healthcare provider will examine your collarbone and find tenderness and swelling. An X-ray will show a fracture.

How is it treated?

To ease your discomfort, your collarbone may be immobilized in a “figure of 8″ splint or brace that holds your shoulders back (as if you were standing at attention). Your arm may be placed in a sling. Very rarely a broken collarbone needs to be surgically repaired.

Your provider will prescribe a pain medicine. Broken collarbones are very painful in the first few days. You should place an ice pack over the fracture for 20 to 30 minutes every 3 to 4 hours for the first few days.

How long will the effects last?

Most broken collarbones are healed within 6 to 8 weeks. Your healthcare provider may take another X-ray to be sure that the bone has healed. You must be able to move your clavicle, shoulder, and arm without pain before you can return to your activities or sports. You can begin rehabilitation exercises after your broken collarbone has healed and after you have seen your provider.

How can I prevent a broken clavicle?

Clavicle fractures are usually the result of accidents that cannot be prevented.

Written by Pierre Rouzier, MD” and “Permission to copy for patient education” and “www.sportsmedpress.com

What is body fat?

Your total body weight is made up of lean weight and fat weight, or body fat. Lean weight includes the muscles, bones, tendons, ligaments, and water in the body. Body fat includes the fat stored in the fat cells and the organs of the body.

For good health, it is important to have a high proportion of lean weight compared to fat weight. The muscle part of lean weight produces work and burns food calories. When there is too much body fat, it acts as excess baggage for the body and can be a detriment to your health. People with a higher fat content, especially around the waist, are at a higher risk of heart disease.

How much body fat should I have?

The percentage of body weight that is normal depends on your gender and your fitness level.

Men Women

Body Fat % Body Fat %

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Normal

Range 10 to 20% 15 to 25%

Athlete 6 to 10% 10 to 15%

The fat percentage for women is normally higher because of breast tissue and a larger layer of fat under the skin. Athletes have lower percentages of body fat compared to the average man or woman because they burn the fat calories for energy and store less fat in their fat cells. Also, young adults typically have a lower normal body fat percentage than older adults.

Obese people, on the other hand, often have more than 30% body fat. This can be a risk factor for various health problems. Exercise and proper nutrition can help lower the fat content of the body.

How do I measure my body fat?

The most accurate way to measure body fat is to use a DEXA scan. This is a special X-ray device that can measure body fat. Another accurate way to measure body fat is to be weighed underwater. Athletes sometimes have these procedures done, but they are expensive and not practical for everyday use.

The most practical way to measure body fat is with a skinfold measurement. Skinfold measurements are done using special calipers. Calipers are pincher-like devices that are used to pinch your skin in specific locations on your body, such as your waist. It can measure how much fat you have under your skin. Skinfold measurements are available at most gyms or health clubs that have certified fitness instructors. Skinfold measurements are only reliable if they are done correctly by experienced people.

There are other ways of measuring body fat that are not as accurate. Some health centers provide circumference measurements of the arms, legs, and waist. These measurements are not as accurate as the skinfold test because the measurements are not sensitive to normal changes that take place in the lean and fat parts of your body. For example, if you have not been exercising for several months, the fat in your leg may increase and the lean muscle decrease without any change taking place in your leg circumference.

Another method used by some health clubs is called bioelectric impedance. This method measures your body’s resistance to a small electrical current. The problem with this method is that it is sensitive to the water content in your body. Because your body’s water content may change a lot, the measurements are not always accurate.

Call your local recreation center, health club, or gym for more information about getting your body fat measured.

Written by Pierre Rouzier, MD” and “Permission to copy for patient education” and “www.sportsmedpress.com

What are blisters?

A blister is a bubble of fluid under the outer layer of skin. The fluid may be clear or filled with blood or pus. There are many possible causes of blisters including a burn, disease, an allergic reaction, or from your skin rubbing against something. Blisters caused by your skin rubbing against something are called friction blisters and most commonly occur on feet or hands. This topic is about the treatment and prevention of friction blisters.

How do they occur?

You may get blisters on your feet if your shoes or socks don’t fit well and rub uncomfortably. Athletes and hikers often get foot blisters. You may also get blisters on your hands when you work with tools for a long time (such as digging or raking). Gymnasts and baseball players often get blisters on their hands or fingers.

Blisters usually occur at the start of a new sports season or exercise program, after wearing new shoes, or when the weather is hot and humid.

What are the symptoms?

When the skin becomes irritated, fluid collects underneath the outer layer of skin. This can be quite painful. The surrounding area may be red, sore, or swollen. Blisters can be very small or quite large.

Most blisters are filled with clear fluid. If the fluid is bloody it usually means that a lot of force caused the blister. If the blister is filled with pus it is probably infected. The blister as well as the tissue around the blister can get infected. Infected blisters are very painful, they may be swollen and hot and you may even have a fever.

How are they treated?

It is best to leave most small blisters alone. They should be kept clean and covered with an antibiotic ointment and a bandage. Putting a little petroleum jelly around the blister or the part of a shoe that causes the irritation may reduce friction.

You can also use moleskin to protect a blister. You can buy moleskin at a drug store. Use the moleskin to make a “blister donut” to put over the blister. Do this by cutting a hole in a piece of moleskin that is bigger than the blister. Then put the moleskin on your skin with the “donut hole” over the blister. Cover the moleskin with a bandage.

Blisters usually drain by themselves. The overlying skin is a natural protective layer. It should be left in place until it is very dry and the underlying skin has become tough and painless. Then you can trim off the layer of dry skin.

Large blisters may need to be drained. It is important to do this in a way that does NOT cause an infection. Always use a sterilized needle to drain a blister. The needle should be sterilized by heating it with a flame until it is red hot and then allowed to cool. You can also sterilize a needle with rubbing alcohol. Use the needle to puncture the edge of the blister in several places. Make the punctures wide enough so they do not reseal. Cover the area with antibiotic ointment and a bandage.

If you have a blister that becomes infected, you need to see your healthcare provider. Your provider may want to prescribe you an antibiotic.

How long will they last?

Most blisters last about 3 to 7 days. You can continue with your activities (such as hiking or landscaping), as long as you can tolerate the discomfort of the blisters and they are well protected. If your blisters are infected, you should stop your activities until the infection is gone.

How do I prevent blisters?

Try to minimize rubbing against your skin using the following guidelines.

•Make sure that your shoes fit well.
•Don’t wear wet shoes.
•Wear two pairs of socks.
•Put petroleum jelly (Vaseline) on spots that tend to rub or use a foot powder.
•Put athletic tape or a bandage over sore spots.
•Wear gloves to protect your hands.

Written by Pierre Rouzier, MD” and “Permission to copy for patient education” and “www.sportsmedpress.com

What is bicycle, rollerblading, and skateboarding safety?

People of all ages enjoy rollerblading, skateboarding, and bike riding. These activities are great forms of exercise, but they are not without the risk of injury. In order to prevent injury in these recreational activities there are some important rules that one must follow.

What are some common injuries?

Common injuries from bike riding, rollerblading, and skateboarding are:

•concussions
•broken collarbones (clavicle)
•wrist fracture
•leg fracture
•arm fracture
•cuts and scrapes
•sprained ankles
What are some common safety equipment you should use?

For all three activities you should always wear a helmet. Helmets are the most important safety precaution for biking, rollerblading, and skateboarding. Make sure it fits correctly,

To help reduce cuts and scrapes from falls while rollerblading and skateboarding you should also wear knee pads, elbow pads, and hand guards.

What are common safety rules to observe?

For biking:

•If you are riding on the road or highway, always ride on the same side of the road as traffic.
For rollerblading:

•Watch out for pedestrians on walking paths and trails.
•Use caution if the path is wet or if it is raining. Slick trails make it easy for a skate to slide out and cause a fall.
•Be careful if there is dirt or gravel on the trail. It can cause you to slip.
For skateboarding:

•If you are skateboarding in a terrain park make sure to inspect the all the jumps and other equipment before you do any stunts.
What can I do to prevent an injury?

•Always wear a helmet. It is the best way to prevent injuries.
•Follow the rules of the road. Obey traffic lights and signs. Stay on the correct side of the road.
•Avoid pedestrians.
•Never bike, rollerblade, or skateboard out of control. Stay within your comfort level.
•Don’t take unnecessary risks.
What happens if I get injured?

When an injury happens you should:

•Clean any cut right away to cut down risk of infection.
•Put ice on bumps or bruises to limit swelling.
Minor injuries may only need rest, ice, and anti-inflammatories such as ibuprofen. If it is a serious injury, you may need to go to the emergency room. You may need x-rays to see if a bone is broken.

When can I return to biking, rollerblading, and skateboarding after an injury?

How soon you can return to your activity depends on how severe the injury is. For serious injuries, you should never return to activity until your healthcare provider says it is OK. If you return too soon you may worsen your injury.

Written by Pierre Rouzier, MD” and “Permission to copy for patient education” and “www.sportsmedpress.com