dbacks manual therapy approachprobaseballchiros.com/files/2020/01/dbacks-manual... · 2020. 1....

DBACKS MANUAL THERAPY APPROACH: Philosophy and Implementation in the

Professional Baseball Setting

Professional Baseball Chiropractic Society Workshop

January 29th, 2016

Ryan DiPanfilo ATC, CSCS, PRT

Assistant Athletic Trainer

Outline

I. Philosophy & PrinciplesII. Our Keys to SuccessIII. Testing & Treatment

a) Rib Cageb) Upper Extremityc) Lower Extremity

IV. Adjunct Treatmentsa) Recoveryb) Nutritional Supplementationc) Essential Oils

Dbacks Sports Medicine Healthcare Philosophy

Treatment Philosophies (where we draw from)

• PRI (Hruska)• FDM (Typaldos)• Fascial Manipulation (Stecco)• FDM• FRR/FRC (Spina)• ART (Leahy)• Self-Myofascial Release• Lymph Massage (Chikly)• Cupping• IASTM • Trigger Point Therapy (Travell &

Simons) • Dry Needling & Acupuncture• MET (Chaitow)• PRRT (Iams)

• Earthing• Nutrition/Supplementation

– Organic foods– Juicing– Alkaline Water– Nutrient IV’s

• Laser Therapy• Micro-current• Infrared Sauna Therapy• Essential Oils• Hydrotherapy• Compression Therapy (Normatec,

Recovery Pump)• Salt Tank Flotation• Visual Training

Fascial Distoration Model

• Dr. Stephen Typaldos, DO• Treatment model that

views virtually all musculoskeletal complaints as 1 or more of the 6 different types of alterations to the body’s connective tissues

• Each of the 6 alternations are identified through specific verbal and physical descriptions from the patient

Fascial Manipulation

• Luigi Stecco, Italian physiotherapist• “The mainstay of this manual method lies in

the identification of a specific, localized area of the fascia in connection with a specific limited movement. Once a limited or painful movement is identified, then a specific point on the fascia is implicated and, through the appropriate manipulation of this precise part of the fascia, movement can be restored.”

• 14 segments of body each with 6 myofascialunits

• Treatment of fascial densifications identified through palpation of specific fascialcovergence points that act on a joint during specific movements

• Centers of Coordination (CC): deep fascia usually in muscle belly

• Centers of Fusion (CF): septa, retinaculum & ligaments

ART/FRR

Active Release Technique (ART)Dr. Michael Leahy

Functional Range Release (FRR)Dr. Andreo Spina

Self-Myofascial Release

• Athlete-driven daily maintenance

• Warm-ups & cool down

• Empowers athlete for self-care (doesn’t need to rely on therapist)

• Foam rolls, trigger point balls, Tiger Tails, etc

Lymph Massage

• Gentle technique to facilitate natural drainage of lymph/waste post-activity

• Recovery & inflammation control

• Most often used post-game with pitchers

Cupping

• Mobilizes fascia/tissue & facilitates blood flow to localized area to promote healing

• Used in conjunction with movement

• By lifting tissue through suction, it offers alternative to regular downward manual pressure

Manual Therapy Keys to Success

Principles:– Look to identify location of densified, irregular

tissue AND/OR aberrant tissue tension in a specific direction that appears before end range of joint

– Be patient while waiting for release (time varies due to many different variables)

– Don’t look to force release…goal is to influence release (pressure & depth may change person-to-person, day-to-day)

Crucial Non-Manual Treatment Concepts

• Proper breathing (Diaphragm function is KEY!!!)

• Positioning (i.e. neutrality, joint centration)

• Movement quality/awareness

• Recovery

• Reference centers/fixation points

• Treating root cause/patterns (i.e. away from site of pain)

• Assessment: Test…Re-test

Testing the Injured Athlete: RIB CAGE

• Apical Expansion

• Posterior Mediastinum Expansion

• Supine IAP

• Trunk Rotation

Testing: Apical Expansion

Normal Abnormal

Ability to fill opposite chest wall

Inability to fill opposite chest wall due to either rib IR

orientation or hyperinflation

Testing: Posterior MediastinumExpansion

Normal Abnormal

Ability to fill posterior thorax upon inhalation

Inability to fill…descended pelvic floor position & flat

diaphragm positions

Testing: Supine IAP

Normal Abnormal

Proportional activation of all sections of ab wall

RA hyperactivity; inspiratorychest position; hollowing of

ab wall above groin

Testing: Trunk Rotation

Non-Limited Limited

Ability to rotate trunk opposite direction of knees

Indicates inability to rotate trunk opposite direction of

knees

Technique: Rib Cage

• L) AIC

– (+) R Apical Expansion, (+) R HG IR, (+) L Posterior Mediastinum

– Increase ability to fill anterior RIGHT & posterior LEFT chest wall

– Guiding ventilatory system to achieve position (diaphragm domed) to work neurologically as best as possible

Technique: Rib Cage

• Superior T4 – (+) R Apical Expansion, (+)

R HG IR, (+) L Posterior Mediastinum

– Isolate L) triangularis sternion exhalation & inhibit R) triangularis sterni on inhalation

– Isolate R) upper apical chest expansion/fill

– Inhibit neck involvement with accessory respiration

– Integrate diaphragm/abdominals at end of exhalation

Technique: Rib Cage

• Subclavius

– (+) L Apical Expansion following restoration of (-) R Apical Expansion

– R) subclavius restriction & R) neck tension

– Manually restoring rib 1-2 internal rotation ability & separation from clavicle

Technique: Rib Cage

• Infraclavicular Pump

– (+) Bilateral Apical Expansion, (+) B HG IR, (+) B TR,

– Mobilizing rib cage & teaching ribs to reciprocate/alternate with each inhale & exhale

Technique: Rib Cage

• Sibson’s Technique– Fascia from C7-T1 around

1st rib to manubrium to cupula of lung…Comprised of fascia from scalenes & longus colli muscles

– (+) R Apical Expansion, R) neck tension

– Anchoring fascia (not stretching) while allowing breathing & proper rib cage movement to reduce tension

Technique: Rib Cage

• Intercostal

– (+) R Apical Expansion, (+) R Trunk Rotation

– Facilitate rib ER & apical fill following complete exhalation to release intercostals

Testing the Injured Athlete: UPPER EXTREMITY

• HG IR/ER

• HG Horizontal ABD

• Standing and Supine Arm Lift

Testing: HG IR

Normal Abnormal

Full rotation towards table Restriction secondary to scap/rib cage positioning &

breathing

Testing: HG Horizontal ABD

Normal Abnormal

30-60°; ability to rotate trunk contralaterally

Testing: Supine Arm Lift

Normal Abnormal

Lower ribs & T/L junction stabilized

Chest lifted cranially; poor lower rib fixation;

hyperextension

Testing: Standing Arm Lift

Normal Abnormal

Symmetrical cylindrical activation & expansion of ab

wall; scaps stabilized

Poor rib & T/L stabilization; upper trap hyperactivity;

elevation of scaps

Technique: Upper Extremity

• Latissimus Dorsi

– Limited Supine/Standing Arm Lift, (+) Apical Expansion, Increased lumbar lordosis, Flat T-Spine, (+) HG IR/ER

– Can often be implicated with patterned, extension-dominant overhead athlete


• Pectoralis Major– Limited Supine/Standing

Arm Lift, (+) Apical Expansion, (+) HG IR/ER, (+) HG ABD, Flat T-Spine

– Can contribute to protracted, anteriorlytipped & IR scapaccompanied by rib ER

– Leveraged with hyperinflated overhead athlete


• Pectoralis Minor

– (+) Apical Expansion, (+) HG IR/ER

– Can contribute to deflation of upper chest wall limiting air flow

– Implicated in anteriorlytipped, forwardly rotated scap


• Subscapularis

– (+) Apical Expansion, (-) HG IR, Identified overactive lat, pec

– Can often need release due to fascialdensifications as a result of disadvantageous mechanical positioning from larger, dominant lat/pec major

Testing the Injured Athlete: LOWER EXTREMITY

• Adduction Drop Test

• Extension Drop Test

• Passive Adduction Raise Test

• Seated FA IR/ER

Testing: Adduction Drop Test

Normal Abnormal

Neutral hemi-pelvis; ability to extend & adduct

Restriction secondary to anteriorly rotated & forward

hemi-pelvis

Testing: Extension Drop Test

Negative Positive

If (-) ADT = Good, non-pathoIf (+) ADT = Bad, lax anterior

capsule

If (+) ADT = Good, intact capsuleIf (-) ADT = Bad, overactive hip flexors

Testing: Passive Abduction Raise Test

Normal Abnormal

Ability for femur to ABD on pelvis due to positional

clearance

Restriction due to pelvic outlet ABD position,

overactive adductor magnus

Testing: Seated FA IR/ER

IR ER

Integrity of postero-inferior capsule/ischiofemoral

ligament if pelvis is NEUTRAL

Integrity of antero-superior capsule/iliofemoral ligament

if pelvis is NEUTRAL

Technique: Lower Extremity

• Psoas Major

– (+) ADT, (-) PART, Limited FA IR…or (-) ADT with (+) EDT

– Can be overactive as FA flexor/ER in athlete with sagittally compromised abs/hamstrings/glutes


• TFL

– (+) ADT, (-) PART, Limited FA IR

– Can be overactive as IR muscle that is dominating anterior glute medius if pelvis/rib cage in compromised position (especially on left)


• Adductor Magnus

– (-) ADT, (+) PART, Limited FA ER

– Can be overactive as frontal plane adductor (especially on right)


• Posterior Hip Musculature

– (+) ADT, (-) PART, Limited FA IR…can be overworked due to pelvis & femur position secondary to overactive hip flexors/back & lack of FA EXT/IR

– (-) ADT, (+) PART, Limited FA ER…can be overworked as a compensation for lack of proper glute max function


Quadriceps Hamstrings

Adjunct Treatments: Recovery

• Pool options (Hot & Cold)

• REST tank

• Infrared saunas

• Earthing mats

• Pneumatic compression

Adjunct Treatments: Nutrition

• Organic, nutrient dense food options at all times

• Alkaline water units

• Daily post-BP nutritional shakes

• Supplementation options:– Multivitamin

– Fish Oil

– Probiotic

Adjunct Treatments: Essential Oils

• Therapeutic topical applications to aid in relaxation, tissue healing, inflammation control, etc

• Healthier alternative to OTC topical ointments

Take Home Points

1. Prioritize diaphragmatic position & function2. Correct identified thorax deficiencies before

addressing extremities (i.e. rib cage mobility, ability to achieve full exhalation)

3. Athlete body awareness during treatment is a must (i.e. FEELING ribs drop into IR during full exhalation while moving into full ER during inhalation)

4. Think globally (i.e. Is pelvis-on-femur position affecting shoulder function?) & holistically

5. Test…Re-Test

References

About Fascial Manipulation. (n.d.). Retrieved January 26, 2016 from http://www.fascialmanipulation.com/en/about-fascial-manipulation.aspx?lang=enActive Release Techniques. (n.d.). Retrieved January 26, 2016 from http://www.activerelease.com/Anderson, J., & Gruver, L.A. (2014). PRI Integration for Baseball course manual. Lincoln, NE: Postural Restoration Institute.Anderson, J. (2013). PRI Impingement & Instability course manual. Lincoln, NE: Postural Restoration Institute.Anderson, J. (2013). PRI Myokinematic Restoration course manual. Lincoln, NE: Postural Restoration Institute.Functional Range Release. (n.d.). Retrieved January 26, 2016 from https://www.functionalanatomyseminars.com/Getting Started with Essential Oils. (n.d.). Retrieved January 28, 2016 from http://www.honeygheeandme.com/essential-oils/Guest Post! Foam Rolling Techniques for Runners. (2014, August 28). Retrieved January 26, 2016 from http://www.paleorunningmomma.com/guest-post-

foam-rolling-techniques-for-runners/Hruska, R. (2014). PRI Cranio-Cervical-Mandibular Restoration course manual. Lincoln, NE: Postural Restoration Institute.Hruska, R. (2013). PRI Postural Respiration course manual. Lincoln, NE. Postural Restoration Institute.Kangzhu 12 Cup Chinese Cupping Therapy Set. (n.d.). Retrieved January 26, 2016 from

http://www.chinesecupping.com/kang_zhu_12cup_cupping_set.htmlKolar, P., & Kobesova, A. (2012). Dynamic Neuromuscular Stabilization According to Kolar Standardized “Advanced Skills” course manual. Prague, Czech

Republic: Rehabilitation Prague School.Kolar, P., & Kobesova, A. (2011). Dynamic Neuromuscular Stabilization According to Kolar Standardized “C” course manual. Prague, Czech Republic:

Rehabilitation Prague School.Kolar, P., & Kobesova, A. (2010). Dynamic Neuromuscular Stabilization According to Kolar Standardized “B” course manual. Prague, Czech Republic:

Rehabilitation Prague School.Kolar, P., & Kobesova, A. (2010). Dynamic Neuromuscular Stabilization According to Kolar Standardized “A” course manual. Prague, Czech Republic:

Rehabilitation Prague School.Silent Waves: Theory and Practice of Lymph Drainage Therapy. (n.d.). Retrieved January 26, 2016 from https://chiklyinstitute.com/Products/Silent-WavesThomsen, L. (2014). PRI Pelvis Restoration – Home Study course manual. Lincoln, NE: Postural Restoration Institute.What is FDM? (n.d.). Retrieved January 26, 2016 from https://www.fascialdistortion.com/what-is-fdm/

http://www.fascialmanipulation.com/en/about-fascial-manipulation.aspx?lang=enhttp://www.activerelease.com/https://www.functionalanatomyseminars.com/http://www.honeygheeandme.com/essential-oils/http://www.paleorunningmomma.com/guest-post-foam-rolling-techniques-for-runners/http://www.chinesecupping.com/kang_zhu_12cup_cupping_set.htmlhttps://chiklyinstitute.com/Products/Silent-Waveshttps://www.fascialdistortion.com/what-is-fdm/

THANK YOU!

The Functional Movement Screen as used and implemented by the

Arizona Diamondbacks

Professional Baseball Chiropractic Society Workshop

January 29th, 2016

Paul Porter MS, ATC, PES

Assistant Minor League Medical Coordinator

Functional Movement Screen

• “A ranking and grading system that documents movement patterns that are key to normal function”.

• Tool used to identify “functional limitations and asymmetries”

Limitations and Asymmetries

• What are they?

– Issues that can reduce the effects of:

• Functional Training

• Physical Conditioning

• Lead to distorted body awareness

• Why do we want to address these?

– Restore mechanically sound movement patterns to enhance training and reduce the risk of injury

Functional Movement Screen:What it is

• A functional evaluation, leading to the prescription of corrective exercises

• Test of how the “software” operates

– How the person uses their body

• Stems from a DNS background

– Developmental kinesiology

• 7 Tests

– Ranging from mobility and stability tests

Functional Movement Screen:Tests

• Deep Squat

• Hurdle Step

• Inline Lunge

• Active Straight Leg Raise

• Shoulder Mobility

• Trunk Stability Push Up

• Rotary Stability

Functional Movement Screen:Scoring Sheet

• Identifying (in order of priority)– Pain with movement

(Scored as a 0)

– Inability to perform a simple movement pattern, even with compensation (Scored as a 1)

– Major asymmetry with movement (e.g. 3 on L, 1 on R)

Functional Movement Screen

• What it does:– Simplifies the concept of movement and its impact on the body

by providing:– Communication

• Simple language

– Evaluation• Quick; approx 5-8 mins

– Standardization• Functional baseline

– Safety• Identifies dangerous movement patterns• Participant readiness for exercise

– Corrective Strategies• Can be applied at any level

Functional Movement Screen:Why the Diamondbacks like it

• Insight into a player’s motor recruitment/ movement pattern

• Simplicity– Exam is easy and convenient to

implement

• Effectiveness of corrective exercise

• Common language between athletic trainers and strength and conditioning coaches

• Backed by research• Provides quantitative data to

flag at risk individuals

Functional Movement Screen:How we implement it

• Pre-participation Physical Exams– Screens performed during spring Training, mid season, end of season, and

during rehab– Spreadsheet; asymmetries, asymmetries with a 0 or a 1, scores below 14, 3 or

more asymmetries

• Test/ Retest– Short term and long term– Does what we prescribe make a change on the person’s ability to move

• Exercise selection– Why we select what we select– Is it a mobility or a motor control issue?

• Exercise prescription– Quality over quantity– Regress to most basic movement before progressing

Test Results during the Season

FMS Screen Report

Functional Movement Screen:In rehab setting

• Supplement their Postural Restoration Institute exercise prescription

• Build strength

– Body Weight

– Chops/ Lifts

– Kettle Bells

• Prevention of future injuries

– Better movement patterns; stability

Functional Movement Screen:In strength and conditioning/ prevention setting

• Supplement their Postural Restoration Institute exercise prescription

• Incorporate FMS into their warm up in the weight room prior to baseball activities

– Enhance mobility

– Correct movement dysfunctions

– Prepare body to perform baseball activities

• Create better static stability, dynamic stability

Player 1

• No asymmetry

• 3’s on four tests

• 2’s on three tests

• Focus on priority tests/ movements first

– TSPU, ASLR, SM

L

R

L

R

L

R

L

R

L

R

L

R

Total 18

2 2

Press-Up Clearing Test Negative

Rotary Stability2

2

Inline Lunge 3

Shoulder Mobility 3

Impingement Clearing Test Negative

Test Raw Score Final Score

Deep Squat 3 3

2

Posterior Rocking Clearing Test Negative

3Active Straight Leg Raise 3

Trunk Stability Push Up

3Negative

Negative

3

2

3

3

3

Hurdle Step2

2

Player 1exercise selection

• Power Push Ups

• Push Up Drive to Elbows

• Tall Kneeling Activity –TSPU

• Bear Crawl

• Bottom’s Up March

• Bottom’s Up Lunge

Player 2

• One asymmetry (Shoulder mobility)

• All final scores are 2’s.

• Address asymmetry first

• Unilateral activity before bilateral

– Half kneeling

– Rotary stability

L

R

L

R

L

R

L

R

L

R

L

R

2

Negative

Negative

2

2

2

2

Negative

2

2

2

2

2

14

2

2

2

3Negative

Negative

2

2

2

2

Hurdle Step

Shoulder Mobility

Impingement Clearing Test

Active Straight Leg Raise

Rotary Stability

Trunk Stability Push Up

Press-Up Clearing Test

Posterior Rocking Clearing Test

Total

Raw ScoreTest Final Score

Inline Lunge2

Deep Squat

Player 2 exercise selection

• Reverse bretzel

• Wall Sweep

• Trunk Stability Rotation

• Half kneeling Chops –Core stability

• Half kneeling deadlift

• Bottom’s Up March

Player 3

• One asymmetry (Rotary Stability)

• Mixture of 3’s and 2’s

• Address asymmetry first

• Focus on pelvic control/ Active straight leg raise

L

R

L

R

L

R

L

R

L

R

L

R


Total 15


Rotary Stability1

12

Active Straight Leg Raise2

22

Trunk Stability Push Up 2 2

Shoulder Mobility3

33

Impingement Clearing TestNegative

NegativeNegative

Hurdle Step2

22

Inline Lunge2

22


Deep Squat 3 3


• Leg lowering w/ kettlebell – ASLR/ pelvic stability

• Supine diagonals

• Hard roll

• Physioball Stability Rock

• Bear Crawl March

Player 4

• One asymmetry (ASLR)

• Raw score of 1 on DS and SM

• 2 on IL and HS –unilateral mover

L

R

L

R

L

R

L

R

L

R

L

R


Total 13


Rotary Stability2

22


23


Shoulder Mobility1

11


NegativeNegative

Hurdle Step2

22

Inline Lunge2

22


Deep Squat 1 1


• Toe Touch Progression – Hip hinge

• Leg Lowering w/ KB

• Turkish Get Up Figure 8’s

• Reverse bretzel

• Reverse bretzel w/ reach

• Physioball Stability Rock

Player 5

• 2 scores of zero due to pain in shoulder (SLAP repair Oct/15)

• One asymmetry (SM)

L

R

L

R

L

R

L

R

L

R

L

R


Total 11


Rotary Stability0

00


33


Shoulder Mobility1

13


NegativeNegative

Hurdle Step2

22

Inline Lunge3

33


Deep Squat 2 2

Player 5 exercise selection

• Reverse bretzel –Thoracic mobility

• Wall Sweep

• Trunk Stability Rotation

• Half Kneeling Dorsiflexion Stretch

• High Step w/ KB

• Bottom’s Up Lunge

References

• What is FMS? (n.d.). Retrieved December 22, 2015, from http://www.functionalmovement.com/fms

• Schwartzkopf-Phifer, K., & Kiesel, K. (2014, July). Functional movement tests and injury risk in athletes. Retrieved December 28, 2015, from http://lermagazine.com/article/functional-movement-tests-and-injury-risk-in-athletes\

• Burton, L. (2010, December 20). Tips on Using and Documenting the Scores on the Functional Movement Screen Score Sheet. Retrieved December 29, 2015, from http://functionalmovement.com/articles/Screening/2010-12-20_tips_on_using_and_documenting_the_scores_on_the_functional_movement_screen_score_sheet

• Plisky, P. (2015, December 9). The Relationship Between the FMS and Injury Risk. Retrieved December 29, 2015, from http://functionalmovement.com/articles/Research/649/the_relationship_between_the_fms_and_injury_risk

http://lermagazine.com/article/functional-movement-tests-and-injury-risk-in-athletes/

Pre-Season Assessments: What are they telling us?

Kyle Torgerson, MS, ATC, CSCS

Minor League Medical Coordinator

Arizona Diamondbacks

Overview of Material• Part I – Pre-Season Screens

– General Physician Orthopedic Evaluation– DBacks postural screen– FMS screen

• Part II – Screen Evaluations– Short Term Goals :

• Evaluating “At-Risk” individuals & Team Deficiencies

– Long Term Goals:• Collecting data throughout the season to determine:

– Low/Medium/High Risk Players

• Part III – Transforming to the Field– On Field Application– Re-Evaluating/Improving Assessment

Minor League Baseball Factors and Variables

• 200+ players during spring training

– 3 different physical dates

– Determine orthopedic “At-Risk”

– PRI Postural exam

• Sports Medicine Team = 18-24 members

– Spring Training FMS screens

What information do we expect to receive from the different screens?

ScreenWhat we are looking for?

PRIAsymmetries

(Normal, but not optimal)

FMSAsymmetries and

Total Score

OrthopedicEvaluation

Pain & Obvious abnormalities

Physician Orthopedic Evaluation

• Total Body Evaluation– Foot/Ankle

– Hand/Wrist

– Spine/Head/Neck

– Shoulder/Elbow

• Special Tests per Region

• Manual Muscles Test per Region

• Diagnostic recommendations– MRI / X-ray / CT Scan

DBacks Postural Screen

• Modified Postural Respiration Institute Eval

PRI Position FA IR FA ERStraight Leg

RaiseShld Hz ABD

Shoulder Flexion

HG IR HG ERHG

Total ArcIce Picks

Pelvic Tilt

UB LB L R L R L R L R L R L R L R L R L R Diff

R) BC / T4

L AIC / PEC

33 32 32 34 87 87 42 42 167 166 75 65 99 104 138 140 10 9 1

• Team Averages –

– Hip Averages WNL

– R) Glenohumeral Internal Rotation

– Anterior Pelvic Tilt

Functional Movement Screen Evaluation

SQUAT HURDLE STEP INLINE LUNGESHOULDER MOBILITY

ACTIVE STRAIGHT LEG RAISE

TRUNK STABILITY PUSH UP ROTARY STABILITY TOTAL ASYM.

RAW FINAL L R FINAL L R FINAL L R FINAL L R FINAL RAW FINAL L R FINAL

1.83 1.83 2.00 2.07 2.00 2.76 2.76 2.76 2.83 2.79 2.69 2.14 2.10 2.03 1.97 1.97 1.93 1.90 1.90 15.17 0.48

• Team Averages –

– Split stance and shoulder mobility

– Single leg stance

– Core integration

So What does this all mean?

• ?????

• The PRI and Orthopedic evaluation gives us an idea of:– Joint capsule integrity

– Ligamentous integrity

– Joint-by-Joint integrity

• FMS evaluation gives us an idea of:– How well does the athlete move

– How well does the athlete compensate

Categories for Individual deficiencies and goals for intervention

ScreenWhat we are looking for?

Goal

PRIAsymmetries

(Normal, but not optimal)

Reciprocate & Integrate Body

AwarenessSystems

FMSAsymmetries and

Total Score

Core Control & Symmetrical

Patterns

OrthopedicEvaluation

Pain & Obvious abnormalities

Rule if player if ABLE or UNABLE

to participate

Short Terms Goals from screens:Identifying “At-Risk” Athletes

• What numbers identify athletes as at risk?

– FMS articles identifying 14 and under for an overall total are athletes who are at a higher risk for injury

– Currently, there are over 14 reliability studies on the Functional Movement Screen that indicate that it has good to excellent reliability.

http://www.functionalmovement.com/files/Articles/538a_FMS_RA_Table_01_v2.jpg

Short Terms Goals from screens:Identifying “At-Risk” Team Deficiencies• Overall team numbers can point us in a

direction to assist universal warm-up

– Not perfect for each individual, but with the overall numbers in MiLB, helps overall prevention

• FA IR deficiencies (PRI Screen)

– Unable to get into the front hip

– Weak Back side (i.e. Glute Max)

Long Terms Goals from screens:

• Collecting data throughout seasons

• Comparing data– Pre-Season

– Mid-Season

– End of Season

• Attempting to make an educated guesson who are the athletes at a higher risk of injury from the data collected

Long Terms Goals from screens:

• When an athlete is injured

– Look at previous/most recent screen

• Chronic or acute injury

• What was their deficiency

• Due to injury or post-surgical

– Unable to complete a full PRI/FMS screen

– Use previous screen to address what the

player lacks

On-Field Application

• How do these evals correlate to on field performance

• Best example I can give is Femoral-Acetabular Internal Rotation

– Applies to Hitting and Pitching Mechanics

– Righties vs. Lefties

FA IR FA ER

Last First Hand L R L R

R 22 25 48 43

Right Handed Hitters

FA IR FA ER


R 52 41 33 31

R 35 33 42 31

Right Handed Hitters

Left Handed Hitters

FA IR FA ER


R 46 43 45 47

Left Handed Pitcher

FA IR FA ER

Last First L R L R

LHP (pre TJ) 33 40 35 33

LHP 50 51 34 34

Right Handed PitcherFA IR FA ER

Last First L R L R

RHP 33 30 34 43

• Right hander unable to get into L FA IR

Re-Evaluating Our Process

• End of season process

– Evaluate screens from beginning/middle/end

• Individual Changes?

– Assess “High Risk” guys

– Evaluate the screen

• What should we add or subtract to our screening process

• Always looking into improve

References

• Arnsberg, B. (2016, January 21). Personal Interview

• Pilsky, P. (2015, December 9). The Relationship Between the FMS and Injury Riskhttp://www.functionalmovement.com/articles/Research/649/the_relationship_between_the_fms_and_injury_risk

• Masek, J. (2015, March 15). Femoroacetabular impingement: mechanisms, diagnosis and treatment options using Postural Restoration Part 1https://co-kinetic.com/content/femoroacetabular-impingement-mechanisms-diagnosis-and-treatment-options-using-postural-restoration-part-1

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