Sue Falsone and Gray Cook: What is Functional Training?

Sue Falsone and Gray Cook were able to catch up on the lecture circuit. We’re glad that one of them thought it would be a good idea to hit record when they started discussing functional training and all things movement:

Gray: Sue, I really enjoyed Bridging the Gap and have been looking forward to asking you a few questions about what prompted you to write it . . . and why now? One of my takeaways was that, like what Lee (Burton) and I try to do with the Systems (Functional Movement Systems), you’re simply trying to bring the objective appraisal of a reality up against the subjective confidence a person has to find out how far apart they are and in what direction.

Are you over- or under-evaluating the way your brain and body connect and what your greatest movement obstacle is?

If the first thing I need to do is adjust an athlete’s confidence-to-reality ratio, I don’t do that by quoting the rules and regulations of Functional Movement Systems or SFMA. I say, “Touching your toes is not an athletic movement—that’s something that most of the world can do.”

Sue: It’s a human movement.Sue Falsone Bridging the Gap

Gray: And the fact that a person can’t do that means a lot of other things won’t even be possible without significant compensation or unnecessary energy expenditure. That means life is not going to be the same for you from this point on. A movement pattern most people and most training programs assume you have isn’t available to you. Your experience is going to be different.

We’ve been making things harder in fitness when we should set a standard and say, “The minute that gets easier, we will make it harder.” And then the athlete’s job is to make it easier, and our job is to make it harder.

That’s true adaptation.

Sue: Absolutely. It’s amazing how many people don’t know their philosophy or what their gauges are. People mistake their tools for their philosophy. That’s one of the reasons I wanted to create an organizational system for people as I did in Bridging the Gap.

It doesn’t matter what techniques you do. You use an Indian club, a kettlebell or a TRX.

Those are your tools. What’s your philosophy?
What are your professional gauges? What are you always going back to?

If you put me in an empty field with no tools or you give me the most intricate gym that EXOS can create, it doesn’t matter. My philosophy doesn’t change. You can give me a needle, give me an Indian club—it doesn’t matter.

Those are the tools that express my philosophy and I base that on my professional gauges of what I want to see changing. What do I think is important to change? What matters as you change your movement or change your organism? The tool I have on hand to do that with doesn’t matter.

Gray: If we were talking to a lifestyle coach, a nutritionist, a sleep/wake/lifestyle/emotional management person, and asked, “If you’re the best lifestyle management coach on the planet, what metric would you like me to value you by?” If she said something hokey pokey like self-worth or self-esteem, we’d think, well you can probably gauge that.

This is not body comp. I’m not going to tell people to exercise or tell them not to. I’m going to control their lifestyle. I’m going to control their REM cycles, I’m going to give them some breathing information—I’m going to do some stuff just to make daily life easier.

I might insert activity we don’t call exercise, but at the end of 10 weeks of doing what I say, if you’re looking for body comp, it is a great thing to look at to see if we’ve got a system in harmony.

Now, if a nutritionist or lifestyle coach could do that for body comp, what would be the test a movement coach would ask you to do in the mirror?

To me it would look like an overhead deep squat. And if that didn’t work out so well, it would look like half of that. And then an inline lunge. And if that didn’t work, I might ask you to stand on one foot and try not to wobble. And if that didn’t work out so well for you, I’d want to see you in a plank. If that didn’t work out, I’d like to see you in a reciprocal crawl.

If that didn’t work out, I’d like to see if you had tightness in your upper carriage and if that didn’t work out, I’d like to see if you had tightness in your lower carriage. And if your hips and pelvis were restricted, I would not assume anything was wrong with you until I fix that first.

There’s the movement train right there, from the deep squat down and from a leg raise up.

In a fitness environment, if you don’t have pain, I will stabilize your pelvis and give you a base to work from. Not assuming anything’s medically wrong, but in the SFMA, I will check your neck and shoulders first . . . if something’s wrong there, nothing else can work right.

It really locks people up that the FMS is a bottom-up approach and the SFMA is a top-down approach, but medically speaking, top down is a safe play. And if you don’t have pain, bottom up is a safe play.

Sue: That’s one of the best ways I’ve ever heard you describe the Functional Movement Screen.

Gray: It’s a tool to use across a lifespan, just like a blood pressure cuff at the pharmacy.

The movement screen doesn’t predict success; it simply demonstrates that failure’s getting ready to occur. An ‘F’ on the FMS is highly associated with natural consequences you wish you could avoid.

Sue: That’s right. I’m a professor at AT Still . . . I teach a corrective assessment and a corrective movement course in the Doctor of Athletic Training program. In our assessment course, the first week our discussion is how do you assess, what’s your definition of functional movement? Or what does that mean to you?

And it’s so amazing to me how hard that question is for people. I always relate to people that it’s like heart health; we look at blood pressure, we look at heart rate. When your blood pressure is really high, that’s a metric for heart issues.

So what are the things from a health standpoint that say your blood pressure’s too high? Your heart rate’s too high. Your cholesterol’s too high. These things are all not okay, and we need to intervene now because if we don’t, you’re going to have cardiovascular issues later.

What are the things we look at from a movement standpoint that says this is not going to be okay because later you’re going to have these issues? It’s so amazing that people cannot identify these things. No one can agree on them. And yet, when you look at the geriatric population, what do they look at? Timed “get up and goes,” right? How fast can you get up off a chair and walk 10 yards? There’s a huge correlation between people not being able to get up off the floor and their mortality rate.

When I went home recently, my mom got so aggravated at me—she’s 75 and she was sitting on the floor playing with the dog and she had to get up and she seemed like she was not going to be able to get up off the floor. She crawled over the couch. I said, “You need to get up off the floor right now without touching the couch.” I needed to make sure she was able to get up off the floor without using an implement.

Gray: . . . And in reverse, I have been doing some research and discovered the only thing the World Health Organization agrees on with respect to movement is the first 21 months of life and the motor paths.

Sue: The motor development paths.

Gray: Whether you’re getting down and getting up or getting up for the first time, every major posture and pattern that is a vital platform to move from supine or prone to standing is both demonstrated in a geriatric getting up off the floor or a child learning to walk. We enter this platform getting up and we leave this world in a robust way being able to get up, right up until the end.

All the bullshit in between—ultra marathons and glute activation, dorsiflexion mobility, better heel strike, midfoot runner, kettlebell snatch—all that is the result of the developmental progression. And once all that goes away, you’re left with “can I get down and get back up?”

Whatever activity you’re doing, if it’s working for you, it’s fine. But the only thing we’ve ever said about the movement screen is if you can’t pass this test and you call what you’ve been doing “function,” I’d like to question that in a respectful way without undermining your authority.

Sue: And that’s why I tell people, I don’t care what letters you have after your name, I don’t care what certification . . . it doesn’t matter. Your gauge, your metric, end game, pre-game, and how you get there doesn’t matter. That’s the clinical art of what we do based on our science. That’s your clinical art.

Gray: And that’s what we should research. Instead, people think we’re going to research the groundbreaking material that tells you what to do with your knee, hip . . . whatever.

Sue: And we all have to do the exact same thing? No, it’s not going to work.

Gray: What research will do is validate that which we’re already doing with success and if possible, explain why they occur when we have our failures. So, if we’ve got a great protocol for getting the knee that to extend, research can prove why we’ve got an 80/20 play. It’s not going to tell us what to do to get the knee to extend; that’s going to come from on-the-floor clinical innovation and people taking educated guesses.

And that’s clinical innovation. That part doesn’t come out in the lab. It’s coming out in the trenches. It gets confirmed and vetted in the lab 10 years after it’s working for the early adopters.

Sue: And that’s why there is a huge group of rogue PhDs who disagree with med analyses and systematic reviews because the result of all those things is, “More research is needed.”

This is where we need to move the profession forward. Systematic review and med analysis are very interesting, but they don’t agree and the end result is we need more research. These people are in the ivory tower, not in the clinics or on the field.

Case series and case reports are what are going to move this profession forward because we’re a clinical art based on science. If we don’t begin to validate, acknowledge and honor the clinical art, and we act like the science is the most important part of that equation, we’re screwed.

We have to acknowledge, honor and validate the clinical art.

Gray: At the recent World Golf Fitness Sumnit, I presented a case study of an up-and-coming golfer with some of the best rotational speed we’ve ever seen on a K-vest. Because he was skinny, because he was lanky, because he was fast-twitchy and very “basketball” athletic but also golf-gifted, he was reviewed and told, “We need to add 15 pounds to you.”

Now, as a strength coach, I’ve said that a thousand times, but I never meant it that way. What I really meant is that we need to add some strength.

Sue: He needs some strength and he needs some power. He doesn’t really need 15 pounds of mass.

Gray: We add strength and he’s going to have a 15-pound side effect.

Sue: That’s absolutely right. That’s a side effect.

Gray: But, if I just think we have to add 15 pounds, I will arbitrarily do mass lifting on somebody who is already a high precision rotational machine demonstrated by sports specificity.

So what happened? The kid followed all the best advice in the world and jacked up his neck and jacked up his shoulders and jacked up his hip and jacked up his game and lost rotational speed while adding muscle mass. The inherent flaw was we started going for dumb meat instead of intelligent muscle. Intelligent muscle gets stronger before it gets big. Dumb meat gets big before it gets strong.

Sue: We see that all the time in baseball. You might as well have had them eat multiple cheeseburgers a day.

Gray: I have been part of the problem in saying, “I wish I had 15 pounds,” but that’s not what I meant. I wish I had a better deadlift. I wish had a better movement screen. I wish I had a better single-leg stance. I wish I had better posted T-spine mobility. I wish I had better open-chain dorsiflexion.

I wish I had better everything, but what did I say? “I wish this kid were a little bit thicker.”

When movement is symmetrical, when movement is available, when movement is represented, then we know we’re making progress.

Sue: That’s the key right there: Movement is available. Our job is to give the organism as many degrees of freedom as possible to perform the task in any given environment. That’s functional training.

If we do not increase movement availability so the nervous system can select the movement pattern it needs in the given environment, then we haven’t done our job.

That is our job: to give the organism as many degrees of freedom as possible so the nervous system can select its appropriate movement pattern given the task and the environment.

That’s functional training. Boom.


Sue Falsone Bridging the Gap from Rehab to Performance

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In Bridging the Gap from Rehab to Performance, physical therapist Sue Falsone walks the reader through the thought process and physical practice of guiding an injured athlete from injury through rehab and back to the field of play. To both health care professionals and strength and conditioning experts alike, she describes the path as her athletes move through pain and healing toward optimal function and advanced performance.

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Gray Cook Movement Book

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Screening, assessing and improving movement can reduce injury risk and help people unlock their performance potential. In Movement, Gray Cook outlines his systematic approach for evaluating and improving movement quality so you can create better exercise and rehabilitation programs.

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