By Robert “Skip” George, D.C., CCSP, CSCS
On Oct. 26, 2012 I had the pleasure of speaking with the founder of the Functional Movement Screen, Gray Cook, MPT, OCS, CSCS, at the annual Perform Better/FMS Seminar in Los Angeles regarding what the purpose of the FMS is and its potential role in the healing arts especially in chiropractic.
RG-Gray how did you come to settle in Danville, VA?
GC-We moved there in 1975 when my dad became a Methodist minister. We moved from Virginia Beach where my dad was a V.P. of a paint company and was successful. Then he got called into the ministry. Actually we initially moved to a small town called Dryfork in rural Virginia where my dad was minister at a church nearby in Chatham where Lee is from (Lee Burton, Ph.D is the co-founder of the FMS). Lee’s family had been going to that church for two generations and that is how I got to know Lee. Ultimately we became friends and business partners each “team teaching” the FMS.
RG-What motivated you to create the FMS and would you define its purpose ?
GC-I realized early in my career that every big paradigm shift or how we view the human body or big changes in medicine was not because of a treatment protocol or medication. It was because we identified something. We’ve known for some time that we are not functional and especially we have known that from the late eighties and early nineties. We have known that from what we have observed in the military for example regarding lack of fitness and function. We have also known that from guys like Gary Gray, Vern Gambetta and even Janda goes back and talks about what happens when this dynamic wonderful body is made to work in an industrialized office environment. So there has been this cry that we need to make out bodies more functional and move more authentically. Many of the contemporary things we do in fitness have been influenced by body building. Even though body building didn’t try to influence conventional fitness many assumed that if that is the way they train it must be good for us. We have grown dysfunctional because of our culture and we compounded that with a skewed view of training someone away from that process (of being functional). I could see that we had to hold up a mirror to show us how dysfunctional we have become instead of just coming up with new exercises alone that would help somewhat. But we lacked an accurate assessment. So if I didn’t create a “metric” that rates and ranks functions then none of us could really understand what changes function. Without an objective metric, we are just being our own referee. I am not saying that other functional approaches aren’t good. I am saying that if we don’t have a baseline we will never know. So, I had to decide if I wanted to put my effort and energy into creating a good baseline or do I want to just come up with some “neat” exercises. I realized that many of my contemporaries were very innovative in coming up with exercises but my whole thing is when is the exercise applied, what is the progression and where do we go next? Without having a good baseline or metric of what is good function we really don’t know where we are working. So when my original concept of the movement screen was forming in my head I said you know what be a wonderful thing to do? To go to a school in a community in the U.S.A. and run them through a battery of absolutely simple tests to see how well they do. If I went to a martial arts studio or a dance studio in Russia or a gymnastic studio in Brazil and showed the FMS, they would say what do you mean people can’t do these tests because they could do them easily. What I wanted to demonstrate is what we have significant difficulty in doing today that somewhere in a different time zone, or two generations before us, and because of culture they are more mobile, stable and they actually function better.
RG-So, this doesn’t sound like traditional physical therapy .
GC-I think traditional physical therapy literally helped me embody this because the one thing I got from traditional physical therapy was not just my orthopedics background but my neurological background to where I could appreciate the developmental “stuff”. When someone falls victim to a stroke we don’t do bicep curls and triceps presses. We literally have to re-integrate that limb to a part of the brain that is going to have to take over a new role. So, you never really know motor learning until you work with someone who has a truly compromised motor system. And, if you can help someone with small partial brain death to walk again, then helping someone with a bad ankle is no big deal. I went into P.T. school feeling pretty good with a sports medicine background and athletic training background. The thing that knocked my head off was the neurological stuff so my master’s thesis at the University of Miami was on the vertical leap, the leap being the undisputed test for human power. I reference this in my book “Movement”.
RG- I want to ask you about the “ Movement” book in a moment. You have written countless articles, you’ve written “Athletic Body in Balance.” Your latest is the book “Movement” and describe your collaboration with Dr. Greg Rose, a chiropractor. Would you also describe your professional relationship with Greg? (Greg Rose, D.C. is the co-founder and clinical director of Titleist Performance Institute in Carlsbad, CA)
GC-Greg is an “outside-of-the-box” thinker. Greg has not only been looking how to integrate exercise into rehabilitation and especially into golf. Greg is not stuck in one dimensional thinking and it was he who brought me into the world of golf and bio-mechanical analysis. Greg thinks like an engineer and that is a breath of fresh air for us because as we are constructing a thought process and schemes for evaluation, the whole breakouts (algorithm) of the SFMA (Selective Functional Movement Assessment) could not have happened without Greg. We had the breakouts but Greg and Mike Voit took it to the next level and it was an unbelievable contribution.
RG-Speaking of each our professions, chiropractic and physical therapy, our professions continue to have turf wars over competing for patients and scope of practice but you don’t seem to adhere to a specific practice methodology or philosophy that excludes or fights against another profession.
GC-No, I practice very eclectically but I haven’t really left my “tribe”. I got here through physical therapy but I was reading Craig Liebenson’s work(Craig Liebenson, D.C.) the same time I was reading Vern Gambetta, Gary Gray, Cyriax and Janda. So, I dispense with all of that (turf wars, etc.). I think many of the things we do in physical therapy are because we have always done them that way and I have the same criticism for chiropractic. Saying that, I am very blessed to give a workshop where chiropractors and physical therapists are in the same room. The chiropractors are more aggressive with manual therapy and I appreciate that because I think it is a lost art in physical therapy. For a long time there, physical therapists had great hands. In countries where there are less chiropractors on hand, the P.T.’s are doing more joint work and our clinicians here in the states unless they get training out of school don’t get as good of training as they should. Likewise, I don’t think the chiropractors get the motor learning, the developmental model and the exercise stuff. So I see the therapists being creative on the exercise end and the chiropractors very, very creative on the manual end and I don’t see it working without both. I need good manual therapy to “bump” or reset the system but then we need to reload it would some good movement patterns. If I have a therapist that is reluctant to do aggressive manual therapy, I say hey listen find a chiropractor to get that neck moving for you and then get back on your exercise model. Feel free to refer out if you don’t have the skill set. Likewise, if a chiropractor appreciates manual work but doesn’t have the staff or time, make the referral and work together with a physical therapist or adopt the skill set to do both and more.