John, a 30 year old triathlete, came to the Adelaide Health Clinic with chronic reoccurring low back pain and stiffness after activity. He reported that he has been dealing with this injury for over 3 years. During this time he has tried multiple therapies which have provided temporary relief but no long term success.
John has been competing in triathlons for over 10 years and appeared to be in great physical condition. I reviewed his training regimen, and it was one of the best training programs I’ve seen. There was a good balance between strength, flexibility, cardiovascular training and technique. I thought to myself, what’s causing this reoccurring injury? I performed a Selective Functional Movement Assessment (SFMA) with hopes of determining the root of the problem.
The SFMA is a series of functional movement tests designed to assess fundamental patterns of movement. These tests allow the clinician to determine meaningful impairments which may seem unrelated but contribute to the associated disability. Evaluating the movement globally provides a better picture on the biomechanical flaws that may occur while the athlete is competing, or when a patient performs their activities of daily living.
During the SFMA, John performed all the movement tests without pain or discomfort. However, it was evident his body developed ways to compensate to be able to perform these simple tasks (touch his toes, leaning back, rotating shoulders etc.) Where the movement should be share over multiple joints of the body, he had significant limitations in certain areas which caused other joints of the body to move more and undergo more stress. John had a decreased ability to extend his left hip and rotate his mid back which caused his lower back to suffer increased forces during his workouts.
The treatment for John involved very little focus on his low back symptoms. For the first 2-3 weeks, the treatments included Active Release Techniques (ART®) and joint mobilizations to improve the rotation of his mid back and the extension of the left hip. Due to John’s great physical condition, noticeable changes were observed after every treatment. Once adequate range of motion was obtained, he began corrective exercises with a skilled Functional Movement Screen (FMS) personal trainer who created a tailored program to improve the dysfunctional patterns. The combination of SFMA with the FMS corrective exercises is a great way to improve the patient’s range of motion and develop the strength and control within that range. After 1 month, John no longer reported pain in his low back when training for his triathlons. He reported having a more fluid stroke in the water and an energy efficient running stride. More importantly, he noticed significant improvements with his swim and run times.
If you have any questions about the SFMA and FMS, please contact the Adelaide Health Clinic at firstname.lastname@example.org or 416-367-5200