Gray Cook: Movement Screening and Exercise Prescriptions

A lot of people become disillusioned when they learn the Functional Movement Screen . . . Screens tell us when people need more investigation. It isn’t an evaluation or an assessment. For Gray Cook, movement screening is about taking a sample.

It’s just like us to try to standardize a test for our own specific little window on the world and not realize reality. Do we use different blood pressure cuffs for kids or old people? No. We have ranges of normalcy for vision and for blood pressure. Think about it.

When you read an eye chart or get a blood pressure exam, that’s not an evaluation. It’s a screen. An evaluation basically goes in depth and tells you what’s wrong. For example, if one of you came up here, sat on a chair, I put a blood pressure cuff on you and you’re hypertensive. Your numbers are out of range.

I don’t have enough information to diagnose you. You could’ve been late getting here and sprinted up the steps. Your systolic BP is going to be up. You could’ve also had an unbelievably aggressive cell phone fight with a spouse or significant other. That’s going to get the emotional thing going and you’re going to have some vasoconstriction due to that. You could have plaque in your arteries and they’re not extensible. You could be hypertensive because of that.

Screens tell us when people need more investigation. A lot of people become disillusioned when they learn the movement screen. They say:

“Yes, but I need to know if it’s the glute medius.”

Why? Are you going to talk to the glute medius? Do you think your client cares about the glute medius? I work with plenty of athletes. They don’t want to know about their glute medius. They just want to know if I can fix their squat or make them balance on a leg.

It’s a knee-jerk reaction in going through physical therapy school. When you see somebody who has poor single-leg stance, you say, ‘Ah, there’s positive Trendelenburg. That’s a weak glute medius.’

Follow that train of thought. You just limited yourself to a single correction and that’s strengthening of a stabilizer, which doesn’t work.

Stabilization training is not doing three sets of 10 repetitions to a muscle that’s defined as a stabilizer, because that’s called strengthening. Stabilizers don’t do what they do because they’re strong. They do what they do because they’re friggin fast. Three sets of 10 repetitions of abduction will not change the millisecond firing necessary for the glute medius to stabilize the hip so the hip flexor and big glute can drive it forward or backward.

It’s become very vogue for us to do core stabilization, low back stabilization, hip stabilization and shoulder stabilization. However, what we’re really doing is shopping strength training to little muscles, but little muscles aren’t strong. Why should they respond to strength training?

How do babies get their rotator cuffs strong? When you’re not looking at 3 o’clock in the morning, they have a little piece of band? How is it that kids can grow, climb trees, walk into junior high athletics with no weight training at all and can throw a discus or a shot-put, throw a baseball, do push-ups and run hills? Where was their personal trainer? Where was their strength coach?

If they were allowed to be active, if they were encouraged to be active, if they got to run around in the woods, roll their ankles, skin their hands, get blisters and calluses then they had a rich sensory experience.

Their sensory experience was not verbalized. Bad footing, fall out of the tree, land on my butt, it hurts. No words were done in the process of falling. A lot of words happened after.

Here’s my point: Why do we insist on coaching movement with verbal cues when movement was learned the first time before we could follow verbal commands?

Every one of us learned to walk without verbal coaching.

Let’s peel it back. What did you do before you walked? You squatted and crawled. That means the first squat you ever did was not up going down. It was down coming up.

How many of you have decided to teach your clients how to squat in reverse? The first time they ever squatted, they were in a crawling position. They somehow got on one knee, got in the squat position and came up, whereas if you let somebody with faulty posture, faulty alignment and/or faulty neuromuscular activity descend into the squat, they’ve already started wrong.

Let’s say we’re golfing. If I come up right before your back swing and twist the club in your hand so the clubface is facing a different way, no matter what you do, it’s already wrong because you started in the wrong place.

In most people who can’t squat deeply without some type of issue, we’re obsessing on the way they look when they’re down. They can’t go any deeper, but you’re not looking at how they start. Most of them aren’t even starting in full hip extension even if the hip looks straight.

Hip extension is measured on a level pelvis. What if the pelvis isn’t level? What if the pelvis is tilted?

It looks like they’re upright, but they’re not. They’re a negative 10 degrees from hip extension. Thus, the glutes, the hip flexors, the quads, the glute medius, the pelvic floor and the abdominals don’t know what to do.

Movement screening is about taking a sample or a movement profile of what people can and can’t do prior to exercise prescription.

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