Integrating Movement Screening Tools in your Pilates Practice.

Integrating Movement Screening Tools in your Pilates Practice. By Mathew Grey. B. Phty, M PHTY (Sports), APA Sports Titled Physiotherapist Functional Movement screening has become one of the buzz words in exercise, injury rehabilitation and injury prevention over the last few years. In particular at the elite level of sport, pre-participation screening of athletes has been extremely successful at decreasing rates of preventable soft tissue injuries and non contact injuries. These screens work by systematically screening key movement patterns and flexibility, highlighting faulty movement patterns or at risk flexibility and then implementing an exercise program to address the findings considered a risk for future injury. This has been shown to be very successful in decreasing rates of injuries such as hamstring strains and other soft tissue strains as well as non contact knee injuries. In my opinion Pilates practitioners world wide have been utilising the Pilates assessment as a form of Functional Movement Screening for years, well before the term Functional movement was even coined. On a daily basis in the clinic, we utilise movements in the Pilates repertoire to examine our clients for sub-optimal movement patterns that may be placing them at risk for re-injury or future injury. We then use these findings to as a guide to the most appropriate exercises for that client. We then train and condition that client with an exercise from the APPI Pilates repertoire that corresponds most directly to that clients functional needs i.e Functional Movement Training. Lets look at how we can integrate some of the movement screening tools out there into your daily Pilates practice. Two screens that I like to use are the The Functional Movement Screen (FMS) and the Y Balance test. The FMS is a tool devised in the United States by Physical Therapist Gray Cook. It assesses 7 movement patterns: overhead squat, hurdle step, lunge, upper limb mobility, straight leg raise, push up, and 4 point kneel. Each pattern is scored compare to a baseline requirement. Clinically and in research, asymmetries between left and right have been shown to be predictive of future injury. The “Y Balance test” (also know as the Star Excursion Balance test) is another tool I use regularly in the clinic. The test involves measuring reach distance with the non weight bearing leg in an anterior, postero-medial and postero-lateral direction. A difference of greater than 4 cm between left and right sides has been shown to be a predictor of future lower limb injury on that side in high school basketball players. We can integrate the findings of either of these tests with our Pilates assessment, to establish a retestable baseline for the client and to guide our exercise regime. For example if a client is shown to have a decreased Y balance test while weight bearing on the right side, in conjunction with a poor lunge on the right and a poor hurdle test while weight bearing on the right (from the FMS) we might expect to find some dysfunction in their right lateral sling (gluteus medius) or posterior oblique sling on the right (gluteus maximus) during our Pilates assessment. We can then prescribe Pilates exercises from the APPI repertoire to address these findings (eg clam level 1, shoulder bridge level 2) and retest these findings at the appropriate time frame. We can also use the findings of these tests to guide our return to sport / return to work decision making with the client. Theses are just two examples of movement screening tools available that I have found to be simple easy adjuncts to my examination and Pilates practice. They are by no means the only options available and alternatively you can utilise functional movements from your traditional musculoskeletal assessment in place of the methods I discussed. The key is to make it objective, measurable and repeatable so you can measure the clients progress against a baseline and gauge their readiness for return to their chosen activity. References O’Connor, Francis G., et al. "Functional movement screening: predicting injuries in officer candidates." Med Sci Sports Exerc 43.12 (2011): 2224-30. Plisky, Phillip J., et al. "Star Excursion Balance Test as a predictor of lower extremity injury in high school basketball players." Journal of Orthopaedic & Sports Physical Therapy 36.12 (2006): 911-919.