Course Review: SFMA (Selective Functional Movement Assessment)

We have always thought that it was really helpful when considering courses, to do a bit of research around the internet and see what other participants had thought of the particular course we were interested in. 

Here, one of our physios Budi, writes a review of the SFMA Level 1 & 2 course that he attended in Bondi Junction, Sydney.

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Some of you might have noticed we closed our clinic for a course in Bondi Junction in early August, now’s the time to share what we’ve found! The course we went to was the Selective Functional Movement Assessment (SFMA), with Greg Dea and Rod Harris as our instructors. It was attended by various clinicians – physiotherapists, osteopaths, chiropractors and many more! It was Josh's (Director of our clinic) 3rd time doing and course, and my first time. 

I first heard about SFMA from Josh when I was researching about jobs and explored more into it when I joined the team. He told me about how it was a diagnostic course and how it would be very beneficial. I have heard good things of Functional Movement Systems – the guys who created the SFMA. One of the things I heard a lot in training, especially from very experienced physiotherapists was that I was picking out the right assessment and questions, but I did not have a system to sort it out. Long story short: I did the online course – 5+ hours of videos, but it took weeks to properly take it in. However, this was exactly the system I was looking for.

Here is a reflection of what I felt about the course and what I learnt.

Biomechanical faults – regional interdependence, they both discuss about how a fault or a problem in one area can affect and cause pain in other areas. Greg gave a very good example of a volleyball player who injured her ACL(anterior cruciate ligament) in her knee after landing badly after a jump; the volleyball player had limited shoulder flexion and had to compensate for that lack of movement by bending her body to the side resulting in her only being able to land on 1 foot and injuring that knee. The knee needs treatment, but the shoulder was clearly a contributor in that situation.

The SFMA gives clinicians a diagnostic tool to assess the body as a whole, rather than separate components; it assesses top to bottom and gives a more global outlook to how your body moves and how each component affect each other. Some of you who’ve been to our clinic have noticed that at times we don’t “treat” the painful part; that is because often we find the painful part isn’t always the main problem! It is trying to compensate for the “faulty” part that’s not in pain.

Pros:

Biomechanical diagnosis – it is an amazing tool to give a better biomechanical diagnosis that would benefit most clinicians! I’ve been told as a student that I needed a system that works for me to compile and sort everything that I’ve found in our normal assessments – and that this would come with time and experience. The SFMA almost bypasses this time and experience factor and gives us directly what we need. We’ve found that with many lower back pain problems people tended to have a stiffer mid and upper back and/or hips and the lower back was in pain because it was trying to compensate for that lack of movement

Motor Control – The SFMA also gives us an indication if there is a true mobility restriction (stiffness) or more of a motor control issue – also tells us how to treat it if there is a motor control issue. Some clients come in with a “stiff” back that clicks all the time – despite them doing a lot of stretches! Sometimes we found that these clients do not have a true “stiffness” but lack of control on their back hence they can’t move and felt “stiff”.

Toolbox use! – Every clinician in their respective fields have a set of tools in their toolbox to treat patients and get them better – be it needles, massage, mobilization, taping, or exercise. When we graduate we have a smaller toolbox with less number of tools and as we gain experience this toolbox grows. SFMA finds the areas that needs treating and leaves it up to the clinicians and clients on how to treat them. I have found that there were a lot more things I can do with my toolbox without increasing its size because of the diagnosis given by the SFMA!

Cons:

Local biomechanical testing – The SFMA leads us to every single “imperfection” – or dysfunction. It does not always tell us exactly what is wrong. The system then guides clinicians to perform a local biomechanical exam on the area or component. It is up to every clinician to use what they have learnt in their training and experience to exam the local area. There are other courses and training available for this aspect and SFMA does not replace this by any means. The SFMA guides clinicians around the bigger picture and find which ones require a local biomechanical exam. As such a clinician with an excellent local biomechanical exam technique will not find the SFMA redundant as it would only enhance their expertise by giving it a structure.

Time and practice -  The SFMA is thorough – very thorough. 10 top tier movements and each breakout of the top tier movement has a flowchart if it wasn’t “perfect” to figure out which component was “faulty”. Greg and Rod has demonstrated that with practice and experience they are able to complete a full SFMA in under 30 minutes consistently. This means for others who are less familiar with the system it could take even longer. Some clinicians may find this difficult to adopt early on especially if they have shorter sessions or if they are used to another way of performing assessments. Fortunately for our clients, our clinic has 1-hour initial appointments to ensure we have enough time to perform the SFMA from neck to ankles on every client – literally.

Conclusion:

The course was amazing and full of energy and great discussions across various professions among clinicians, and even shared some treatment techniques that may not be familiar to other professions. It is an amazing tool to diagnose, especially for clients who have been receiving local treatment on their “injured” area, but is not getting much benefit or keeps getting reinjured on the same part – maybe other parts are involved and this is where the SFMA steps in.

Is it easy to pick up? – Short answer: No. It is without a doubt one of the most thorough assessment systems; some would say it is better to pick this up when clinicians have more experience, but I would beg to differ. In my opinion, it is best to start the SFMA early as a possible and start off well - rather than developing an assessment structure that needs to be changed later. This does not stop more experienced clinicians to pick it up, but this does require them to adapt from a structure they’re used to. In saying that, if you’re in a supportive clinic that can provide you with the session times to perform the SFMA, if your clients want to get better to the point they don’t need to keep coming back to you, and if you’re a clinician who wants your clients to get better and stay better – the SFMA is for you – be better.

Thanks for reading!

References:

https://www.functionalmovement.com/system/sfma