According to the SFMA philosophy you never exercise a painful movement pattern. By exercising a painful movement you foster a compensatory pattern. The same goes for exercising a joint that does not have appropriate mobility. Take the ankle for example, if we start a patient on a wobble board before they have full ankle dorsiflexion they will begin to compensate. Compensation will eventually lead to injury.
The SFMA does a great job of leading you towards a movement diagnosis. At the end of the break out you should be able to decipher whether you have a motor control or tissue extensibility / joint mobility restriction. By doing a few specific joint and/or muscle tests you should be able to determine exactly which joint or tissue needs treatment and which movement pattern / muscle needs greater motor control.
After the treatment, it is imperative to reassess the dysfunctional movement pattern. You must ask yourself, “has it improved?” If it has you are on the right track. If you were treating a mobility issue and you saw a significant improvement it may be time to implement a motor control exercise. Ideally, once mobility has been regained; altering motor control will make the change long lasting. If the movement pattern has not improved, try another tool in the toolbox and reassess. For the SFMA to work properly the therapist must constantly check and re-check the initial indicators to assess the effectiveness of the treatments used.
Next week I will try to break down the 4×4 Matrix of the SFMA.
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