“Back” from Stanford
You may have missed this great joke in the title: I was at Stanford University where Doctor Stu McGill and Gray Cook spent the day discussing the FMS and various back issues. Now, I’m “back.” Get it?
My decision to go to Gray Cook and Stu McGill’s discussion of the FMS was not exactly last minute, but certainly I was up against the clock. I don’t think I make it a secret that I am a fan of both of their work and, frankly, a “debate” between friends is never something I want to see live.
We’ve all been there where two buddies on opposite sides of a political firebomb will quickly go from friends to frenemies to enemies. Gray changed the way I look at mobility; actually, in full candor, Gray made me look at mobility. I had stuck it on the shelf next to flexibility, aerobics, core, and functional as overworked terms for the lazy and trendy fitness trainers. Yes, I am a bad person.
I spent four days at the old CK-FMS with Gray and Brett Jones and learned the deep waters of the FMS. Frankly, my takeaway insights were simply that most people have issues with the Active Straight Leg Raise and Shoulder Mobility test, so I just programmed the basic correctives for those moves into all my training systems. I know that the FMS guys are shuddering when they read that, but I’m both right and wrong on this; I will address this again later.
I use the FMS but I farm it out. Thankfully, I have Mike Brown and Marc Halpern around the facility a lot and they are not only far better than me at doing the screen but they also understand where to go with it.
Stu McGill’s Fourth Edition of his book is in my Master Bathroom. Now, this is important: when I read a book, enjoy it, and then realize that I merely skimmed the surface of understanding it, it moves into my bathroom during “reading time.” I am proud to have learned that my book, “Intervention,” is in honored places near toilets throughout the world. I take honors where I get them.
Stu, without exaggeration, opened my eyes up more concerning elite athletics than probably any person in my life. He is so honest about genetics, genetic mutants, the traits of certain sub groups and how this all impacts sports performance that I rethought how I would push, pull and prod my athletes in the future. God Bless little Billy, but he is simply born to be an Offensive Guard not a Defensive Back. By cueing into his genetic makeup, and we know that I am a monkey in a physics lab when I try to talk about science, I can give little Billy or Sally a chance to succeed not only at a higher level but with an easier path.
Stu’s explanation of a Volleyball jump versus a Slam Dunk jump is something I would like to take every idiot who claims to be able to “add six inches to your Vertical Jump” and say: “Here! See that! It’s not what the best are doing! Cease!”
Thankfully, Laree Draper has enough pull and influence to get me into anything, even at the last minute. A few weeks ago, she arranged an evening for me, Pope Francis and President Obama, but I digress. After we talked, I arranged a flight, a rental car and X’ed out the weekend. The rental car turned out to be a waste of money as the hotel was basically on the Stanford campus and I walked everywhere, but it got me to and from the airport.
Stanford University did a marvelous job. I think their Strength and Conditioning staff is doing literally everything right and they are also simply wonderful people. I got a chance to hang around with their Irish interns and, I have to admit, that was a highlight.
The participants were mostly from the therapy fields. We had lots of Chiropractors, massage therapists and “hands on” people, but there were also all kinds of various coaches, trainers and the like. During the breaks, I was surprised to hear how many people didn’t know what the FMS was when they got there. I wanted to say: “There is this thing called the Intrawebz,” but I held it in. I guess some people expected “fireworks,” as this keeps showing up in reviews, but once you put on your big kid pants in this industry, most of us try to learn from one another, not tear down.
A few years ago, Mike Boyle had just come out with an article on not doing squats and he invited me to speak at this annual gathering. I had several people email me about the “fight” that was going to happen. Mike and I agree on everything: you work with the people you have with the tools you have and the goals of the client.
Stu had a great story about this idea. At another conference, Stu and another guy were both given three patients, BUT they couldn’t watch the other one work with the volunteers. The interesting thing was this: both Stu and the other presenter came to the exact same conclusions, just with different paths. One of the keys to managing people when they ask about diets or exercise programs is to let them list all the options they want to do, then simply insist: Pick one!
Gray’s FMS is a simple tool that starts the conversation. He notes that it is like a blood pressure test: if you have your BP under control, great, we move to the next little assessment. It is simply a baseline. Now, if we add this or that and that pushes the FMS test in a positive way, this is good. A quick point: Gray was very clear about the fact that we need to STOP using the one number, the total (“you have a 16”) and focus on the problem scores on the seven screens. Problem scores would be asymmetries and zero and one scores.
If there was an issue with the day, it was the lack of the follow up tool, the Selective Functional Movement Assessment (SFMA). It was referenced over and over, but there was a lag here: Stu used the morning to assess the science on the FMS that lasted about ten minutes. Then, Stu showed us his method of assessment that clearly was as much about art as it was the science of deduction. It is like watching Sherlock Holmes frankly: yes, I saw that…now that you point it out, yes. We were a roomful of Doctor Watsons marveling at what was obvious to the trained eye.
But, the SFMA would have been an interesting thing to show in the afternoon. Since it is based on a decision tree, much of the work would have been very specific to the person being assessed. The need for a decision ladder, something like an airline checklist, is very important when dealing with injured people. Like motivational expert Tony Robbins explains with Certainty/Uncertainty, we need to dismiss and ignore our first impressions (to a point, of course) and make sure we are making the right conclusions. Stu showed that the FMS needs to be put under load and I think, I’m not an expert on this at all, that the SFMA would have done some of this.
“It depends.” I hope everyone heard this point. In lifting, we argue from the vision of the great quote from Pavel: “If all you have is a hammer, everything you see is a nail.” Stu brought up “it depends” over and often it is going to be your hammer. I’m going make you do the fundamental human movements each and every workout. What tool? “It depends.”
When dealing with someone in pain, “it depends” is not only sound legally, ethically, and morally, but it is probably the best way to save time in the long run. An extra hour of assessing and searching for the root causes of the problem might save a long of time and wasted energy down the line.
Now, this is also my great disconnect. I bored Laree several times with how I assess injuries. I would ask Laree to state this:
I would respond back: “Can you play?”
It’s that simple in much of my life. I have competed with huge black swellings on my knees from a hamstring pull and lower back from a lower back pull. I competed for eight years with five pieces of my left elbow floating around the end of the bone. I Clean and Jerked with a fractured wrist. You might argue: “dumb, dumb, dumb, dumb.” But, when you are a discus thrower on a team (and your education is funded by throwing far), you throw. Also, it was always obvious to me that the ticking time bomb of sports is always getting closer to 0:00 and James Bond isn’t going to cut the right wire with a second left.
The FMS is a tool. If you get a zero for pain, let’s find out why. If you have asymmetries, let’s address them with the lowest hanging fruit. Like Stu told us, he only sees patients after they have gone through ten other professionals. Somewhere between something like a calf stretch and ten doctor visits is where guys like me smile and nod and walk away. You can’t play.
I came away from the day with pages and pages of notes. I also discovered that, once again, the strength coach can be a really important piece of the puzzle in keeping athletes (and everyone is an athlete) on the right path. I give this day TWO thumbs up.
One other thing: I have a new article at t-nation…it’s not bad, it’s real world stuff on fat loss (or metabolic work) that is cheap and easy. Find ithere.