The Selective Functional Movement Assessment (SFMA) is a whole-body screening assessment. It takes clients through a variety of functional movements involved in sports as well as everyday life. Using a scoring system, the client is assessed whether he/she has any dysfunction or difficulty completing any of the functional movements. Using these results, a therapist can then decide whether to use manual therapy or therapeutic exercises to address any areas of concern.  

A common question I experience in practice is what the SFMA can do for clients and how does it differ from typical musculoskeletal assessment? A good example to explain how the SFMA can be beneficial is to look at back pain. Let’s say we have an issue of low back (lumbar spine) pain with rotation, such as a golf swing. Although pain is described in the low back (source of symptoms), another area in the body could potentially be the source of dysfunction which can lead you down very different roads in terms of treatment. In the case of rotation with a golf swing, rotation not only has to occur at the low back but also at the mid back and hips, the joints above and below the area of pain. If there is a restriction (lack of mobility) in the mid back and/or hips, then the low back will try to over compensate. Anatomically, the hips and mid back are built to be more mobile than the low back during rotation, thus forcing a more stable joint (low back) to be more mobile than usual, resulting in pain.

Anatomically, certain joints should be more mobile, while others should remain more stable. However, in the case of movement dysfunction, decreased mobility in one joint can cause the body to over compensate in other joints.

In some more conventional assessments of the same issue, the low back would be deemed the culprit and treatment would likely involve stretching, strengthening, and some modality of pain control for that area. However, under the SFMA guidelines, more emphasis would be placed on restoring the mobility of the dysfunctional area (mid back) to decrease the excess amount of torque being placed on the low back. In this way, the root cause of dysfunction that created the injury in the first place can be addressed, rather than alleviating symptoms that could potentially be reaggravated in future.

So where does one fit into all this and when would the SFMA be a useful assessment for you? In my clinical experience, assessing and treating movement patterns as opposed to a painful body part is most useful when there is a consistent activity that brings about pain. This could be anything from running to our golf swing example. Pain that has had a gradual onset with no clear mechanism of injury would be another indication. These more vague and obscure patterns of developing pain do tend to be better assessed by looking at a client’s movement a little more globally. Where I would tend to not use the SFMA in clinical practice is with more acute injuries with a clear mechanism of injury, such as a sprained ankle. Although the client in this example may have dysfunctional movement, the actual source of the injury is something they are likely not repeating intentionally on a day to day basis or as part of their sport.

There you have it! The SFMA is a great tool to use if you have a tricky injury that hasn’t fully resolved and are wondering if treating away from the source of pain can help solve the issue. In addition, it is a useful tool in tracking potential areas of future injury if you wanted to know what the best areas would be to address to lower injury risk during sport, the SFMA can highlight areas to work on to keep yourself healthy.  Pinnacle Physiotherapy does offer SFMA assessment for those interested in rehabilitating current injuries or preventing future ones!

All the best!

Jan Lopez M.Sc (PT), Hons B.Sc (Kin), Registered Physiotherapist, Contemporary Medical Acupuncture Provider, SFMA Level 1 Certified