Assessing and correcting movement in a performance setting with limited time.
By Dan Liburd, MS, CSCS, USAW, FMS
I would like to preface this presentation with the following statement. This article is an invitation for discussion and an opportunity to provide movement specialists (athletic trainers, physical therapists, and strength and conditioning coaches) with a potential valuable resource for assisting members of the fitness and performance community.
This proposal is especially pertinent to movement specialists and performance coaches who work with a large number of athletes and/or clients within a limited amount of time. It is for those individuals who are seeking to understand more about their clients’ potential without infringing on the time needed to develop that potential.
We are at an age now where we have innovative tools that can track useful information about an athlete’s speed, distance, strength and power without disrupting their field practice and performance. We can assess often valuable information about athletes or clients while they focus on their objectives without interruption within their activity such as sport. These advances have come in the shape of GPS units, Keiser machines, force plates and even recently the Nordbord. However, when it comes to assessing a standard of movement with efficiency, ease, and without interruption to an athletes performance, we are still in need of improvement.
There are limitations in our current model for assessment. We approach assessment as the activity we do before correction and ultimately before performance. While the movement assessment model correctly explains that we should not build performance over movement dysfunction it does not offer a practical strategy on how we should accomplish this goal. As performance coaches in a time limited setting we cannot afford the time to assess and then correct before we focus on improving factors related to performance. Unfortunately, this is where the appeal for establishing or respecting an assessment or standard of movement begins to dwindle. When pressed for time, coaches will incorrectly focus all their attention on strength exercise (a measure of performance) rather than be relegated to a model that proposes an assessment first, correction second, and performance last.
It is important that we as performance coaches respect our role as movement specialists and continue to establish an effective standard for movement, assessment and correction. The development of the Functional Movement System (FMS) provided the opportunity and set the stage for understanding and evaluating movement. While this concept is brilliant, its application to team sports is less than ideal.
This FMS Screen creates a limitation due to the fact that it takes away from the valuable time that athletes need to spend focusing on developing strength and improving performance. As team performance coaches we are often tasked with the responsibility of developing large groups of athletes (upwards of 100) within a short period of time. We simply do not have the time to effectively assess large groups of athletes in a short period of time without diminishing time dedicated to improving strength and performance skills for those same athletes.
An example of these time limitations can be reflected in the rules instituted by the National Football League (NFL) under the Collective Bargaining Agreement set forth in 2011. The Collective Bargaining Agreement states under Article 21 section 5 B:
“During the offseason program period, except for the ten days of organized team practice activity and minicamps, players may be (1) at the Club facility no more than four hours per day, no more than four days per week, and not during weekends; and (2) on the field no more than ninety minutes per day. In addition, the Club may not specify to any player more than two specific hours a day during which it suggests that the player be at club facilities.”
Four hours a day for four days may appear to be a great deal of time needed to accomplish the task of appropriately developing ninety or more athletes for the many challenges of a football season. However, when we consider commitments such as film study and position meetings (which can often take two hours per day) we immediately begin to see the time needed for appropriate movement and performance development of ninety or more athletes diminish. Consider again the many physical stressors of a football season. They include, but are not limited to, sprinting at high velocities, aggressive change of direction movements, physical strength and integrity needed to sustain forceful movements, and hits and/or activities.
It is no surprise that when performance coaches are presented with a scenario to spend valuable time assessing athletes, as opposed to developing athletes in the form of strength training and the various factors related to performance, coaches will choose the latter, without spending much time evaluating and providing a standard of movement for their athletes. Who can blame them; our standards of measure when it comes to the evaluation of athletes are biased towards performance rather than movement. Despite this bias, we should be concerned with movement as much if not more than we are with factors related to performance. The questions is how can we do both efficiently and effectively with regard to time and with respect to a large numbers of athletes.
The answer to this question is to provide a system and/or resource that allows for assessment, movement correction and the opportunity to improving factors related to performance all at the same time. As performance coaches for large groups of athletes, we should no longer approach assessment as a task we perform prior to performance. Instead, we should focus on including assessments within our performance training programs. Movement assessments should occur as we focus on improving all of the factors related to performance as well as movement. By including assessments within our performance training setting we can do the following:
- Effectively appraise an athlete’s movement potential while also focusing on developing factors such as strength and speed.
- Take measurements against an objective standard providing us with a better understanding of the athlete’s needs and/or limitations.
- Provide assessment tests that challenge our athletes to move while also serving as exercises for improving movement.
- Change the perspective of movement assessment from the task you complete before you perform activities such as strength training to the task you complete while you focus on strength training, skill building and performance.
In order to understand the multiple benefits of this model let’s examine the football athlete as a training client. We know that in the course of a football season the athlete will go through multiple stressors that can potentially change their quality of movement. The athlete can regularly experience mental and physical stress, pain, and may develop various other biomechanical restrictions. These are the factors that will have an impact on their fundamental way of moving. For example, Joe athlete’s movement spectrum can differ day to day so it is important to provide him an assessment tool that measures his ability to move against an objective standard. In addition, it is important to provide him with a solution to his movement limitation(s) on a consistent basis. Let’s take for instance an athlete who has gone through the stressors of a normal football practice session. By the time the football athlete has gone through several days or weeks of practice and competition, they may experience fundamental changes to their movement range which in turn will have an impact on their ability to perform and to execute certain skills.
As performance coaches we understand that It is imperative to the success of the athlete to consistently measure performance factors such as speed, sets, reps, and resistance weight and to modify them based on impactful elements such as stress, fatigue and the various occurrences of life. By the same token, we should aim to consistently assess movement ability and make immediate modifications to issues that can manifest themselves as tissue restriction based on elements such as stress, fatigue and the natural occurrences of life.
As we approach this offseason I have spent time evaluating our current approach to movement assessment and correction. Taking into consideration our schedule and the limitations of time spent with large groups of athletes I have proposed a strategy that combines assessment with movement corrections in an effort to understand and improve the athlete’s movement potential while also respecting our responsibility as performance coaches.
This proposal comes in the form of a series of various tools and tests that can be easily implemented in a performance setting within a short period of time. Over the next few presentations I will detail how these tests and tools can play a role in movement assessment and also help your athletes and/or clients to improve movement without disrupting the time spent to improve performance. I will start by explaining this assessment and movement correction model for ankle dorsiflexion.
It is commonly understood that ankle dorsiflexion (flexion of the foot) is integral to functional movements such as walking, running and also an important factor for lower body force production. Restricted dorsiflexion can cause limitations to athletic performance and can be also be a factor for increase susceptibility for lower body dysfunction that can result in pain injury. Movement authors note that normal dorsiflexion can range from approximately 20 to 30 degrees. However, some researchers suggests that ankle dorsiflexion range of up to 38 degrees may diminish the susceptibility of individuals to pain and/or injury risk. Researchers in Sweden published a study in the American journal of sports medicine evaluating ankle dorsi flexion range in over ninety junior elite basketball players and their predisposition to a form of sports induced knee pain. The results of their study demonstrated that individuals with a dorsiflexion range of less than 36.5 degrees had a significant risk ( up to 29% greater chance) of developing knee pain as compared to players who had a dorsiflexion range of more than36.5 degrees. When mobility is limited in areas such as the ankle, it can negatively affect the function of other areas up the kinetic chain such as the knee or the hip.
This occurrence can result in limitations in mobility at certain joints and can negatively affect movement in the form of compensation, substitution, asymmetry, loss of efficiency and ultimately injury. This biomechanical relationship between joints is often referred to as the joint by joint approach and explains that particular joints such as the ankle, hip and thoracic spine are intended to be biased towards mobility while joint regions such as the knee and lumbar areas are intended to be stable. Limitations to the normal function of these joints can potentially lead to movement dysfunction or injury.
Despite this common knowledge among movement specialists, performance coaches are sometimes unaware of the potential stiffness that may negatively impact an athlete’s ability to move at the ankle. For those of you who work with large numbers of athletes in a limited time setting, when is the last time you took the time to assess your athlete’s range of motion at the ankle joint?
The first test of the eight part assessment/movement correction model measures an athlete’s dorsiflexion and stiffness in the posterior chain at the lower leg (gastroc, soleus). The test includes a measured slant board attached to series of marking poles which are in succession and evenly spaced apart.
To perform the test simply have the athlete start from a standing position and place one foot over the slant board with their toes pressed firmly against the edge of the wall placed at the end of the gradient (or end of the slant). We want to measure the athlete in a standing and body weight loaded position because we want to understand the mechanisms that take place at the ankle joint in this functional position. The angle of the assessment slant board is measured at 10 degrees. As a result of this design, by simply placing your foot on the board (with the knee perpendicular or directly over the ankle at 90 degrees) with the heel placed firmly to the ground will result in 10 degrees of dorsiflexion. From this position the athlete should be instructed to drive the knee as far forward as possible without elevating the heel from the board. Coach the athlete to perform 8 – 9 reps on each side.
It is important to take this time to clarify that we are treating this activity as both assessment and also an opportunity to improve mobility (if needed). We are looking to improve mobility at the ankle by challenging any restrictions on the extensibility of the posterior chain in the form of stretching.
Along the board are four indicators or markers placed at various angles. As the athlete drives the knee forward (with the ankle placed firmly to the ground) they can potentially pass these set of markers at the knee. These differently angled indicators reflect varying degrees of range of motion at the ankle. They are expressed as follows:
- Marker 1 – reflects a range of motion of up to 10 degrees at the ankle joint.
- Marker 2 – reflects a range of motion of up to 20 degrees at the ankle joint.
- Marker 3 – reflects a range of motion of up to 30 degrees at the ankle joint.
- Marker 4 – reflects a range of motion of up to 40 degrees at the ankle joint.
From this test we can categorize dorsiflexion of our athlete while also providing them a means to improve dorsiflexion. This strategy can provide the coaches with knowledge of their athlete’s ability to move by understanding potential limitations of movement characteristics
Consider implementing this assessment or mobility exercise as a paired activity with a complex movement or coaching intensive exercise such as a clean or front squat where a certain degree of ankle mobility and/or dorsiflexion is needed for good movement. This can give a coach the freedom to make quick inferences on potential movement while also spending time coaching performance.
We should look at this assessment tool with the same perspective we place on performance factor assessments such as weight lifted and reps. As performance coaches we do not make any inferences on potential injury risk based on weight lifted and reps without understanding all other factors. This perspective should also be applied to this assessment strategy. We are simply taking note of any movement restriction using a tool that provides a standard of measurement while also providing a resource to improve movement (if there needs to be improvement). Finally and most importantly this strategy can be performed anytime without disruption to the time needed for performance.