Can You Handle the Steps at Stanford?

nytI was unbelievably proud and surprised to see the New York Times article on New Year’s Day about Stanford’s football success, and some of the strength and conditioning innovation behind it.

Coincidentally, next week I head to Stanford for a talk with Stuart McGill. It’s an event arranged by Craig Liebenson, where we’ll discuss the implications of movement screening and assessment, and look at some future trends.

The Stanford steps I’m referring to in the title aren’t a set of stadium stairs or concrete steps anywhere on the campus. I’m referring to the organized and systematic approach the Stanford Sports Medicine, Rehabilitation and Performance teams use to manage athletes, and to communicate among themselves, the coaches and athletes.

One element of their system is our Functional Movement Screen. The Functional Movement Screen often gets associated with injury prevention or injury risk, but that’s shortsighted.  Even as a young physical therapist and strength coach, when we created the FMS I knew it needed to be a management tool. I envisioned movement as a biomarker, a biological indicator we weren’t already using.

By that point, we’d done a pretty good job mapping anatomy, and an equally good job developing both general and sport-specific performance measures. One place where we needed improvement was in looking at movement patterns—the behavior that connects the parts and the performance.

Here are the criteria I put forth for the screen.

  • It has to be a simple and reproducible test.
  • It can’t have significant expense dedicated to equipment or data collection.
  • It must not be an isolated assessment.
  • It must not involve physical capacity.
  • It must target movement competency.
  • Can the parts work together in fundamental movement patterns at one bodyweight load?

I knew if we could identify a movement biomarker and make it work, it would definitely enhance the injury-management model. I speculated that it would also give insight into systems and practices that might help reduce the effect of an injury.

It could easily be said that the NFL has a 100% injury rate. Is the issue the prevention of injuries in situations where we know they’re going to occur, like in tactical maneuvers and collision sports? Or is it to minimize the effect of an injury by having an otherwise healthy body?

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An injury rarely occurs in isolation, but when it does, the rehabilitation process is smooth, efficient and effective. It’s when something like an ACL injury is complicated by a stiff hip, a weak core and poor ankle mobility that rehabilitation becomes more complex.

The first rule in orthopedics is to always clear the joints above and below the problem area. If you follow this tenet, you’ll often discover why the area is problematic in the first place. The movement screen is simply a constriction that compresses movement quality into an acceptable range and captures it when it’s outside of that range.

The overlying theme is that our methods should be determined by our measurements. By measuring things, we gain perspective. That perspective can be used to create a systematic approach. The systematic approach can be tested against the current program to gauge whether better decisions can be made with the available information.

Stanford is a shining example of information utilization. I’m absolutely sure that people will look at what Stanford is doing and try to copy the programming. If they have a different population, a different environment, a different competitive season and a different type of athletic recruiting situation, Stanford’s system may not work. My prediction? They’ll try anyway.

stadium stairsPeople won’t go through the steps Stanford did to develop their program. They’ll just copy. Copying alone may offer some degree of improvement, but Stanford is the leader because of their measurements, because of their metrics, and because of the insight they gain by quantifying the effect of the decisions they make.

The first and most important issue is the creation of clear, consistent and honest communication in regard to movement. It’s easy for an athletic trainer or a physical therapist to say someone has completed rehabilitation. It becomes harder to make that statement when the pain-free athlete still can’t pass a Functional Movement Screen.

It’s also extremely easy for strength and conditioning professionals to assume they’ve improved a situation. We often see speed increases in one or two drills, where a strength coach has made an improvement in one area at the expense of movement—losing fundamental mobility and stability. How much of the strength is really actionable and how much of the strength is functional?

A baseline is the starting point—one that holds rehabilitation professionals accountable for function in the rehabilitation process, and holds strength and conditioning professionals accountable for maintaining an appreciable level of function throughout the performance enhancement process. From here, metrics and measurement can make the difference.

Organizations that use the Functional Movement Screen in both athletics and rehabilitation are instantly better—not because the movement screen is so good, but because it creates clear, consistent communication with actionable results.  I’m proud of the work Stanford is doing in both rehabilitation and performance enhancement—and not just in football but across the board.

It’s as simple as this: Find the right things to measure and measure them consistently. Measure them often. Develop programming that improves them. Create a program without negative side effects that manages minimums, and you’ll have a feedback loop that will help you refine your decisions for the rest of your career.

The results are in the steps. Don’t copy Stanford’s methods without also copying their measurements and metrics. You can handle those steps—it’s as easy as remembering the old carpenter’s rule: Measure twice, cut once. 

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