Functional Movement and 5 Biomarkers For Assessing Risk of Injury
The fitness world is expanding each and every day. The wellness and well-being aspects of the fitness industry are a major component of that growth as is the human performance area of study. It seems that the United States, and indeed much of the world, has caught the fitness bug. I personally love this but it is not without its challenges. With this surge in interest in having a healthy, beautifully sculpted body comes some built in challenges. You see, not all of us have lived a life that prepares us well for the demands of fitness training, and yet we are motivated to pursue it. People who have spent much of their lives being sedentary or inactive, are now hitting the gym trying to put up big numbers on their lifts or killing themselves in the latest boot camp trend in order to get a million likes on Instragram. Therein lies a problem. What I want to discuss briefly in this article is the concept of movement induced injury and give you some very real factors to look for that could help you avoid injury should you take the right steps up front.
You’ve read about the Functional Movement Screen (FMS) and its inventor Gray Cook in some of my previous articles. The tremendous body of knowledge he has developed over the years also outlines a number of risk indicators that will typically present themselves prior to a person getting injured from performing physical activity. What I want to briefly discuss here are two aspects of his work that are absolutely applicable to every person on the planet regarding their movement whether it be day-to-day movement of athletic movement.
The Pyramid of Function
This simple concept has three (3) main steps:
Movement efficiency is the most foundational and first priority in human movement. Without quality movement, all other aspects are limited. The better or more efficient a body moves, the more performance and skill it may develop over time. If a body has very limited movement capability, and most of us do, then the higher level aspects of human performance and skill cannot be optimized. Trying to develop performance and skill without efficient movement capabilities is where many people begin to injure themselves and “tweak” or “strain” their joints, tendons and muscles. Avoid all of this by prioritizing movement efficiency first.
This is where the Functional Movement Screen comes in. When screened by an FMS practitioner, you can very quickly gain an understanding of how your body is moving and what its limitations or shortcomings are. Without proper screening, you simply cannot accurately know how well, or poorly, your body moves and working to improve in areas of strength, stamina, speed and power are really not intelligent approaches to the process. Screening with a certified FMS practitioner is probably the best way to develop a plan of action to gain efficient movement and mobility, then move on to higher level aspects of performance and skill enhancement. There are certainly other types of screening out there and some practitioners are quite good using those methods, but for our intent and purpose, the FMS is the most comprehensive standardized test out there.
The 5 biomarkers of injury risk
1. Previous Injury
This one seems like a no-brainer, but without being aware of it, people often fall victim to this biomarker of injury. Having a previous injury makes the body more likely to have another injury. If I break my ankle, the likelihood that I will injure that ankle again in the future increases. This is a very important thing to keep in mind when you begin a fitness training program. Whatever injuries you’ve had in the past have left their mark on the body and absolutely will impact it in the present. Perhaps a previously injured joint is less mobile than it was, less stable or has less endurance when being used. Whatever the situation, any previous injury is going to automatically increase your chances of having another injury.
This biomarker of injury can take many forms, but we often see it play out when we look at bilateral symmetry. This means that we often see differences when we look at the left side of the body versus the right side of the body. It plays out in a number of other ways as well, but bilateral asymmetry is the easiest to explain and to conceptualize. We often see asymmetry in body proportion from front to back as well. Picture the guy with the overly developed chest and biceps whose shoulders and arms seem to be in front of his body instead of at the sides. This is seen as a type of asymmetry as well. No matter the type, an asymmetry in your body will increase your risk of injury. In the photo to the right, notice how the knee on the left presents what is called a valgus collapse where the knee on the right looks straighter. Asymmetries like this are usually overlooked by people who are exercising and this will present issues if they remain unaware of their asymmetries and continue training.
3. Motor Control
This one is pretty tough for most people to understand. The take-away message here is that depending on the type of life you live, your body learns to activate muscles in sequences to move around in the world. Unfortunately things like injury, asymmetry and postural shortcomings all create changes in how the body moves from a “motor control” standpoint. When the body is not optimally prepared, it will do the best it can to do what we want it to and this often creates “motor pattern” issues that can lead us to eventual injury. Envision a car engine that doesn’t run smoothly because you haven’t taken good care of it. If all the moving parts are not moving in perfect unison, even if one part is out of sync, the engine still runs and the car still works, but you can tell that something is wrong and the whole system is vulnerable to having problems. The same is true of the human body.
4. BMI (Body Mass Index)
Body Mass Index is a measure of height and weight. When we are taking BMI to determine a person’s body composition, it is not the best measurement tool because it does not take into account muscle, body fat etc. It just uses your weight and your height and produces a score based on those. You can see how this could be problematic for some people. But for injury risk assessment it works great!
A 5’11” man weighing 200 pounds with 35% body fat would have the exact same BMI as a 5’11” man weighing 200 pounds with 5% body fat. Not the best test for body composition. However, BMI is a great test as a biomarker of injury. You see it doesn’t matter if a person has more muscle or fat when it comes to risk of injury from BMI. If their BMI is too high, their body is at risk of injury. You can imagine that a really fat guy could be at similar risk of injury as a really big body builder of the same height and weight because both of them have altered body mass index scores that are beyond optimal.
This sounds silly, but it really is an issue and it’s certainly a biomarker for injury. I’ll explain. I can’t tell you how many people I’ve worked with over the years who have had numerous injuries, body asymmetries, bad motor control and coordination, high BMI and still want to train as hard as possible to get some weight off. It is a very common conversation I have in my line of work. The well known fitness industry professional, Kelly Starrett in the photo at the right is demonstrating one applicable situation. You see, a person cannot typically just start working out and really do it properly. More often than not, this approach begins to reinforce bad motor control and strengthen bad movement patterns. See the “stupid” box jump in the photo to the right? If a person were to do this repeatedly, and they do, this poor technique will be reinforced and the body will begin to view this as normal increasing risk of injury from what was initially a very small risk to one that is much more probable.
For example, I can work with a client who has lower back pain (motor control issues) and is 40 pounds overweight (BMI and asymmetry issues) who wants to jump in on the next boot camp class so they can hurry up and get fit (stupidity issue). Stupidity in this case really means ignoring the signs your body has given you. Some people ignore them on purpose and others ignore them out of ignorance of the situation, but either way it boils down to a really stupid approach to getting fit. Runners are notorious for this. They’ll often “push through” the pain they are feeling in their hips, knees, shins or ankles and just live with it as a necessary part of life. This is probably the most stupid thing one could do because your risk of injury (actually if you’re in pain, you’re already injured) increases with each passing day as these 5 biomarkers of injury get worse and worse as they push through the signals their bodies are giving them to make a change. Don’t let this be you. There are alternatives to this type of reality and they are not only more intelligent, but also longer lasting.
These 5 biomarkers of injury when viewed through the lens of the functional movement pyramid make a ton of sense. Beyond that, they are all very real ways to look at yourself and your body and begin to exercise appropriately. Instead of seeing what someone else is doing and working to mirror that, get on a program designed specifically for you and your body. You are unique and your body is too. What is right for another person cannot be ideal for you. So get fit and live well, but do it through thoughtful, intelligent methods and by all means pay attention to the 5 biomarkers of injury written about here.
Thank you for your attention and all the best to you my friends!