THE MOVEMENT SCREEN
Michelle Wie - Former Women's US open champion going through The Movement Screen at Ace Sports clinic (Our previous practice)
When patterns are well organized, movement is smooth, efficient and undemanding. The Movement Screen is an assessment to identify an individual's movement capabilities, it is composed of a structural assessment and amovement pattern assessment. It aims to collect all relevant information to craft an effective intervention towards movement optimum and into achieving the client's specific goals.
STRUCTURAL ASSESSMENT
An asymmetrical infrasternal angle
Mr. Bannock getting his assessed after four open heart-surgeries
The first step of the structural assessment is to determine the infrasternal angle (ISA) presentation to help identify mechanical compensations. During normal respiratory mechanics, the spine goes through inhalation and exhalation strategies to complete the respiratory cycle. If someone has reduced movement options, they may not be able to move the spine so well in the opposite direction.
These are two most common type of biases:
Inhaled spine = Spinal curves are pushed backward
Exhaled spine = spinal curves are pushed forward
One can have an inhale-biased spine and may not be competent at exhaling the spine - You still have to complete the respiratory cycle so the body compensates at the site of least resistance, the lower ribcage. (These ribs are more flexible due to lacking a sternal attachment). Someone with an inhaled spine will have an exhaled lower ribcage (narrow ISA), and one with an exhaled spine will have an inhaled lower ribcage (wide ISA)
A wide ISA’s structural bias would be of the spine falling forward then. To counteract these forces, a wide may concentrically bias posterior musculature to maintain an upright posture. This would be the body’s primary compensation to your structural bias.
In this particular representation, we would find:
Decreased flexion, abduction, and external rotation measures
Normal extension, adduction, and internal rotation measures
Reverse the above for a narrow ISA.
In addition, suppose that the primary compensation for this wide overcorrects, and this person starts to fall backward. In this scenario the person develops a secondary compensation. This bias counteracts the forces the primary compensation induces on the body. In the case of the wide ISA, the secondary compensation would involve concentrically biasing the frontside of their body
Someone's body structure and compensatory order is essential for an efficient intervention. Taking it into account gives the client the best odds of success. For example, take a narrow ISA with a primary compensation and a wide ISA with a secondary compensation. They both have a concentric anterior thorax but the narrow has this limitation because of their ventral cavity structure, whereas the wide has this limitation to mitigate a posterior concentric bias. Although both archetypes need expansion in the front, one must respect the structural differences between the two. For example, to improve this restriction in the narrow ISA, Franco may choose a move that compresses the body front to back to expand the ventral cavity laterally, making the person’s ventral cavity structure dynamic. Whereas with the wide, the anterior restriction occurs to counteract the posterior restriction. He would not want to choose an activity that compresses the body front to back as that would potentially reinforce the limitations caused by structural bias.
Assessing the individual's body structure and compensatory order first is essential, the intervention can look very different depending on it, even if restrictions are in similar areas.
MOVEMENT PATTERNS ASSESSMENT
Everyone is unique and needs the capacity to meet the demands of their life. The same exercise intervention will not be appropriate for everyone and thus we adapts our recommendations based on the individual’s needs, wants, abilities, and awareness.
The movement pattern assessment helps establish an individual’s current capabilities and allow personalized recommendations to be made. It explores what ranges of motion (RoM) are available within the musculo-skeletal system, the extent of neuromuscular control and the systems capacity over a range of tasks and intensities to determine your level of movement competency.
Assessing Michelle Wie's hip flexion RoM and low back control during the Hinge pattern
Any task we do will be influenced by how much joint range of motion we have (passive) and access (active) through the coordinated contraction of our muscles. Therefore mobility is one of the first pieces of information we gather when assessing a client’s physical needs. Knowing whether they have the ability (passively or actively) to place their body in specific positions will shed light on their available movement options and help to personalize any exercise, education or coaching recommendations. We use a combination of 10 tasks that can be used collectively to ‘rule out’ the presences of ankle, hip and/or shoulder mobility restrictions. The 10 tasks are separated into 3 categories (or grades), each differing in complexity and joint range of motion demands. We categorize performers as having: A) active and passive mobility, B) passive but not active mobility, and C) no active or passive mobility.
After assessing passive and active mobility, we assess the client's movement patterns within the context of any relevant task demands. Knowing whether the client is able to control motion of their knees, back and shoulders, for example, across a range of activities requiring varying degrees of physical fitness will shed light on their movement competency and help to personalize any exercise, education or coaching recommendations. We use a series of 15 tasks that can be used separately or collectively to better understand how an individual moves while performing a series of general movement patterns. The 15 tasks are also separated into 3 categories each differing in the physical demands imposed. We categorize performers as being: A) physical literate (fitness and movement), B) physically fit (fitness only), and C) not physically fit (no fitness of movement).
Examples of common faults during
a shoulder press
The movement pattern assessment can also be highly specific, for example; if a client is interested in increasing their vertical jump, we would break down the task (a vertical jump) to its basic constituents (sacral counternutation and femoral external rotation) and then test the client’s competency under different intensities. In the case of the vertical jump, its basic constituents would be:
Sacral counternutation
Femoral external rotation
We would then would pick different moves that challenge the client’s ability to externally rotate their femur and counternutate their sacrum under different demands (statically, dynamically, during force production, with power and for long periods of time). This will expose areas of improvement and help personalize programming to increase the client’s vertical jump under their current capabilities.
In addition, if the client's goal is to get rid of, for example; foot and ankle pain while walking and squatting, we would take a closer look into the biomechanics of the foot and ankle, testing:
Ankle dorsiflexion
Ankle plantarflexion
Ankle inversion
Ankle eversion
Big toe extension
Big toe extension in dorsiflexion
Midtarsal pronation and supination
Static foot posture
Dynamic foot posture (gait and relevant activities - walking and squatting in this case)
To sum up, The Movement Screen is composed of the Structural Assessment and Movement Pattern Assessment. With their findings, we have all relevant information to craft an effective intervention towards movement optimum.