GRAY COOK

Assessing Movement: A Contrast in Approaches, Part Two of Three

I want you to feel absolutely comfortable with everything that’s happening today. The deep interest that drove Dr.
McGill to raise questions and suggest that we not assumptions is the same force that inspired me when I was 32 years old
and felt like I didn’t have the tools to do my job.
At that time, I was a strength coach and a physical therapist. I felt like the movement-pattern issue wasn’t actionable
for athletes, adults and elderly people.
In PT school I was taught movement-pattern observation is absolutely vital in developmental milestones. Why does
a model that works so well in the first 24 to 36 months of life all of a sudden get trashed?
If we’re going to look at movement, we’ve got to throw a measuring stick in the ring. If that metric gets broken,
adjusted or modified over time, at least we’re looking at movement. We can’t continue what we did in the past and try to
predict what the patient’s Selective Functional Movement Assessment (SFMA) or athlete’s Functional Movement Screen
(FMS) is going to look like. We’re not that good.
I always learn something by watching movement patterns. If we look at somebody’s parts or performance and are
unable to predict the one-bodyweight movement behavior, we should observe that movement. What do we do with the
information we learn? The behavior could be an important piece of information.

1—Gray Cook—Assessing Movement: A Contrast in Approaches DVD transcript, Part Two of Three
For more information on this workshop DVD, please visit movementlectures.com, functionalmovement.com or otpbooks.com.
 I felt forced to make assumptions early in my
career. I didn’t have a metric, tool or gauge to look at
movement-pattern behavior. I didn’t want to assume
anything on something that important—one of the
number one entry points in the first two to three years
of life. We look at patterns before we look at parts
or performance. I didn’t want to make assumptions
about movement if we could get a metric based on
movement patterns.
I believe Dr. McGill was also saying to not place
too many assumptions on that measuring stick now
that we’ve thrown it into the ring. If it gives you a
piece of information we didn’t previously have, intel-
ligently and effectively use that piece of information.
Don’t use it in opposition of what the science
says, but if it adds practical value, all it’s costing us is
two minutes on the SFMA Top Tier and 10 minutes
on the FMS. There is no real need to upgrade equipment. It either provides a vital piece of information or you already
know how people move without ever looking at it.
We have a standard operating procedure in the clinic. We set a baseline. Most of the scrutiny and debate on the
FMS is on a its scoring system; we convert a movement pattern to a number because it allows us to cleanly talk about it.
If we take away the scoring, what do we have?
We have people who pass a pre-participation physical who still have pain with movement. We have people assuming
they can use a fitness solution on a medical problem. Take away all of the numbers associated with the FMS, simply say
“People getting ready to move should move here before they move over there,” and we’re going to find that many of these
people are actually in pain.
That pain is going to either cause them to compensate, avoid a pattern or have inappropriate motor control. The
exercise you’re getting ready to dump on that pain-based pattern is probably going to be a risk factor in itself. If you do
more on a painful pattern, I don’t know if it’s going to get better.
People have debated the numbers of the FMS considerably more than they have its utility. If we disregard the scoring
criteria, what two things happen with the movement screen?
• We identify pain with movement before we introduce loads.
• We set a baseline in time.
The NFL currently has a problem with concus-
sions that touches on the value of baselines. A lot of
people have tried to build a better helmet that won’t
allow players to get a concussion. They made a lot
of money doing it, but players still get concussions.
What has modern science given us on concussion
management?
Here’s the real science that helps us manage
a concussion or even multiple micro-traumas that
don’t result in a concussion: We set a processing and
cognition baseline before players get into a situa-
tion where a concussion could happen. If we want
to know whether that concussion changed or altered
him in any way, we’ve got a pre-concussion baseline
to revisit. It’s that simple.

2—Gray Cook—Assessing Movement: A Contrast in Approaches DVD transcript, Part Two of Three
For more information on this workshop DVD, please visit movementlectures.com, functionalmovement.com or otpbooks.com.
 Baselines are how we manage concussions. If the player isn’t where he was before, he’s not ready to go out and do it
again.
Strip away all of the things we want science to flush out and simply think about the action point this forces us to
take—we take pain off the table before we train it. We make an appropriate referral and set a baseline in time. This is
especially important in the most active populations.
If we have a baseline for cognition and concussions, why don’t we have a baseline for movement? From there, can
we get a better, more efficient or more effective baseline? I hope so, but at least get a baseline. At the beginning, I did the
best I could with the available information. Almost everything told me to look at parts or gauge performance, or it sent
me down a rabbit hole of impairments that may or may not be actionable because they could be medical false-positives.
The FMS began on seven napkins during a flight home from a university where I had been performing evaluations. I
questioned myself: If I could have seen these movement patterns, could I have taken better action? I was 32 years old and
naïve enough to think I could change the world. I don’t know if I did, but some very important minds are now looking at
movement-pattern behavior because we threw a measuring stick in the ring.
I’m not offended by anything Dr. McGill said this
morning. The fact he’s talking about something I devel-
oped is an honor. If we make it better because of his
input, it’s an honor. If we stick fast and say, “At the mo-
ment, there is nothing better,” it’s still an honor.
We’re not offended by scientific scrutiny. Our mea-
suring stick works in the clinic. The way we explain why
we do what we do in the clinic may very often be ‘wrong’
or inconsistent, but we’re getting results. We’re going to
continue what we’re doing until we understand a little
bit clearer why we do it or even become more efficient
and effective at it.
In the mid-1990s, we didn’t have a movement met-
ric. We now have a movement metric. It doesn’t discount
the fact we need to do an assessment and it doesn’t guar-
antee performance. The FMS doesn’t give you a license
not to do those tests. If there are other responsible measures we need to take, the FMS doesn’t give us a reason to skip those
steps.
The way a person moves with bodyweight doesn’t tell us what that person is going to do with loads. This is why we
like to impose loads. But testing with loads is a risk factor in itself. If the person can’t move without load, I don’t know if
loaded test is a prudent thing to do. I don’t want anyone to get injured on my watch. Exercise should be an opportunity
to perform better, but over the last 10 or 15 years, it has become a risk factor because of how we measure it.
We can blame that on poor coaching, gym
design, programs and other challenges. We need
good, clean information. Some magazines look
at imposing a functional metric before they offer
functional exercise.
For 10 years, I’ve been reading magazines es-
pousing functional exercise. What’s the definition
of function? To me, function is a state where we
pursue physical excellence without an inappropri-
ate side effect. If a person specializes in a particular
endeavor, there’s greater potential for side effects.
But if that’s the plan, we can manage it.
It’s really hard to define function, so we usu-
ally invert it and try to define dysfunction.

3—Gray Cook—Assessing Movement: A Contrast in Approaches DVD transcript, Part Two of Three
For more information on this workshop DVD, please visit movementlectures.com, functionalmovement.com or otpbooks.com.
 We’re not trying to predict function. We’re trying to catch dysfunction in a bottleneck that may or may not add un-
necessary risk or poor adaptability.
When you can’t move well, how much can you learn about movement? It’s my opinion there’s a point at which great
coaching cues don’t matter.
Coach up a frozen shoulder and see how that
works. Coach up a scoliosis and see what happens. If
movement quality is so diminished that we can or can
almost call it dysfunction, adaptability is going to be
compromised. Even if the person isn’t at risk due to self-
regulation and avoiding positions likely to cause injury,
adaptability will be compromised.
What is the point of exercise if we’re not going to
become adaptable from it? What’s the point of investing
your time in a movement endeavor if some capacity or
competency isn’t going to improve?
How frustrating would it be if I took you to the
rifle range and you didn’t have your glasses? How are
you going to feel among your peers? Disconnected? In-
timidated? Probably, and it’s only because I didn’t do the
right thing before taking you to the range.
How many kids in physical education class are looking for a sick note so they don’t have to participate? Physical
education is not about athletics. I love athletics, but we shouldn’t simply roll out the ball and let kids play in physical edu-
cation. Use the time to develop opportunities to teach them life lessons. Time in the weight room, the physical therapy or
chiropractic clinic are wonderful opportunities to teach life lessons.
The first book I wrote was Athletic Body in Balance—I believe in maintaining balance. Focus too much on strength
and sacrifice flexibility, and you’re breaking a philosophical rule that has withstood the test of time. Try to give up sleep
and live on energy drinks and you’re not balanced. Pursue yoga perfection and never do a push-up, a pull-up or run, and
that mobility may not benefit you.
If what we’re doing now is a little bit better than we were doing—if we’re looking at movement patterns a little more,
we’re good. If there’s an improved or different movement screen one day, I’m going to embrace it whether it or not it comes
out of our camp. I hope it does.
In the future, I think there’s going to be a GPS we can look at to navigate us through the murky waters of movement
pain and movement dysfunction. But for now, we’ve got a compass that can get us pointed in the right direction and keep
us from making an assumption about movement. Use that compass until we have the GPS.
Use something. It doesn’t have to be branded FMS. Consistently and reliably use something as you look at a move-
ment patterns. Don’t just assume parts and performance are going to get you there.
Embrace everything Dr. McGill is saying. I invite the scrutiny and criticism. If we as professionals can’t handle a
debate in an auditorium of our peers, how can we take action for people who are dependent on us? They’re going to do
what you say. Make sure what you’re saying is as good as it can be with the evidence you have.

4—Gray Cook—Assessing Movement: A Contrast in Approaches DVD transcript, Part Two of Three
For more information on this workshop DVD, please visit movementlectures.com, functionalmovement.com or otpbooks.com.