It has now been exactly a month since I took the Selective Functional Movement Assessment certification course in St. Louis, MO. You can read my initial course review here. I have been trying to incorporate the SFMA into my clinical practice as much and as often as possible since then. I wanted to take the time to highlight some thoughts and self-reflections from this process so far.
- Incorporating the SFMA into practice definitely takes time and dedication.
- Right now I can easily do the top tier tests very quickly but the breakouts are still taking me anywhere from 10-40 minutes depending upon the amount of dysfunction.
- To decrease the current time sink I think I am going to have to take more time and really master and "own" the system. It isn't about memorizing the breakouts but more so internalizing the philosophy of the breakouts.
- However, I love the treatment road map that the system provides me and my patients.
- I am definitely finding dysfunction in patients and sometimes A LOT of dysfunction.
- Sometimes this makes me feel bad when assessing a patient because it high lights a lot of issues.
- But it also gives them a reason for their pain and can help assure some people that their injury or poor performance isn't all psychological.
- Test - Treat - Retest
- I love that the system works as a baseline to measure the efficacy of my interventions. I have more confidence in my selected interventions if I am finding a measurable difference, especially if I make a FP turn into an FN as a result.
- This also helps to prevent me from wasting time trying to use an ineffective intervention.
- Documentation
- It can be a lot to write out and list the findings from all of the top-tier tests and all the potential findings from the related break-outs.
- To combat this issue I have been utilizing the PDF files of the breakouts, my iPad, and a note-taking application (Notability) to streamline my evaluation and documentation of the SFMA.
- I use my finger or stylus within the note taking app to highlight or document my findings during/after the assessment.
- Later on I can upload the .pdf to the patient's online file or print them out for their paper files as well. This is nice addendum to a traditional SOAP note evaluation sheet instead of trying to make it all fit.
- Integration and Education
- I love that using this system allows me to utilize my old "toolbox" but helps me do so with a clear and defined purpose.
- The SFMA combines well with my previous experience using the Functional Movement Screen (FMS). They compliment each other nicely to help form a more complete system (I guess this is a "duh" fact, considering they are made by the same people?)
- Nevertheless, there is a struggle when trying to communicate and share findings with other professionals that are not trained in the SFMA/FMS.
- Some people scoff at the idea of regional interdependence
- Some people are interested but just don't know enough...but may want to know more
- Some people just don't care and don't want to know
- I love the fact that I can audit the course again at no additional charge in the future to help me learn the system better/for a refresher.
- They have also been good at responding to my emails when I have questions regarding the SFMA.
- Lastly, I find myself worried sometimes that I am imagining dysfunction where it does not truly exist. I don't want inexperience to leave me missing a piece of the puzzle.
- This may be a good thing!
- The breakouts can be used as a system of checks and balance to decide if dysfunction truly exists
- It is better to assume dysfunction when in doubt
- The repercussion is that I will only make an iffy movement pattern just a little bit better.
- It would be far worse to rule something to be functional when true dysfunction existed.
- Fortunately, the system has built in checks and balances to help prevent a clinician from over-looking dysfunction that might have initially gone unnoticed.
In conclusion, I need to put in more work to master the SFMA. I want to own this system eventually. I am curious to see how FMS level 2 and SFMA level 2 would change my viewpoint regarding all of this. I love that this system takes out a lot of guess work and enhances my clinical reasoning. However, you must remember to combine the approach with your other various clinical skills, the rest of your evaluation beyond the SFMA (its not a replacement), and then try to incorporate all of it together to form the big picture. Allow all of this to work together to guide you, advance your clinical reasoning, and improve your efficacy as a clinician.
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