Am I Ever Going to Get Them Functional?

Written by Aline Thompson Monday, February 27, 2017 SFMA



The answers to these questions really depends on both the population you are seeing and on the patient you have in front of you. We have to remember that most of the time we are performing an SFMA someone is presenting with pain or other symptoms that are limiting their movement and/or participation in activities.

It is very possible that there are only one or two impairments that are driving all the dysfunctional non-painful patterns. Take a mobility problem in the Thorax as an example. If there is a significant limitation in the thorax either with a Thorax Ext/Rtn mobility problem (found in either UE patterns, MSE or MSR) or with a Spinal Flexion mobility problem (found in MSF with a non-uniform spinal curve), we can say it is highly likely that the patient/client also does not have an optimal breathing pattern. Disordered breathing can lead to a number of different things including maintenance of a high threshold strategy, where the patient is in more of a sympathetic state. In this state muscles develop increased tone then can limit the degrees of movement a person moves thorough. Thorax mobility problems, therefore, can affect all the other movement patterns. This is one of the reasons we emphasize the further assessment and treatment of Thorax mobility problems in the SFMA.

Answering the question of whether you will ever get someone completely functional and painfree in all of their patterns is difficult since there are potentially many extrinsic factors that you can’t control. These factors may include any of the following: insurance visits caps, various orthopedic conditions such as advanced osteoarthritis, and un-modifiable structural limitations of movement like Harrington rods or scoliosis. It is possible to achieve a full SFMA of FNs but the goal is to optimize painfree movement patterns within each patient’s individual capacity to do so.


Aline Thompson obtained her B.A in biology from Kenyon College in 1994 and Masters of Science in Physical Therapy from Arcadia University in 1997. Over the last 17 years, Aline has worked exclusively in outpatient orthopedics seeing a wide variety of patients. She started her professional career in California and has spent the last 8 years working in Denver. Aline is a board certified clinical specialist in orthopedics through the APTA. She blends her knowledge of functional movement with a diverse and contemporary approach to the evaluation and treatment of patients with musculoskeletal dysfunction. She has advanced training in manual therapy, pain science, dry needling, treatment of orthopedic injuries, and breathing pattern disorders.


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