Posted on

A Comparison of Different Commercial Models of Movement Assessment: Part III

In part I and part II, we covered the Selective Functional Movement Assessment (SFMA) and Postural Restoration Institute® (PRI) respectively. Here, we’ll cover Functional Range Conditioning (FRC). FRC is taught in conjunction with Functional Release (FR), a series of manual therapy courses that also include more in depth joint and soft tissue assessments. FR is supposed to be completed by medical providers while FRC is open to all fitness professionals. The inclusion of fitness professionals in the FRC course, however, does not render its content any less relevant to medical professionals. In fact, the principles espoused in the FRC course apply to the entire rehabilitation-fitness continuum. While I have yet to complete any of the FR courses, I suspect there is some degree of overlap with FRC.

The FRC course is philosophical without being overly abstract. It begins with a four-hour discussion about the cellular mechanisms of tissue adaptation. This lecture alone justifies the price of the course. Dr. Spina does a remarkable job of presenting very dense histology research in a clinically relevant way. Anatomical structures delineated by a scalpel in a cadaver lab miss something, mainly the “bioflow” or continuity of the connective tissue system. At what point, for example, does the biceps muscle become the biceps tendon? Under a microscope, there is no distinct point at which the connective tissue composition in the muscle and the tendon noticeably differs. The relative contribution of various connective tissue components gradually changes or flows to produce what we ultimately characterize as distinct structures to facilitate a framework for discussion. Distinguishing between muscular attachment sites, tendons, joint capsules, and ligaments makes more sense for surgical decisions than it does for movement practice. The forces we impose on connective tissue cells through deliberate movement practice are the “language” that elicits an adaptive response.

Using this analogy, it takes a very serious conversation to influence movement at the histological level. This is why the suggestion that things like foam rolling and manual therapy can improve tissue quality in a matter of seconds is misguided. It takes a lot of time and force to change tissues. If laying on a piece of Styrofoam for a few seconds could break up scar tissue, imagine what would happen to our muscles and joints when we sprinted, jumped, or lifted heavy weights. We’d tear ourselves apart. The forces involved in sport for exceed anything one encounters on a treatment table. This is not to say that manual therapy and foam rolling lack therapeutic value. They just don’t “work” for the reasons often ascribed to them. Adaptation should be difficult. If the nervous system drastically reprioritized biological resources in response to transient changes in homeostasis, we would be too unstable to survive.
Many movement systems differentiate between mobility and stability to help dictate therapeutic interventions. Philosophically, FRC makes no such distinction. FRC defines mobility as the ability to control a joint throughout its range of motion. By this definition, one can never have too much mobility. People who achieve extreme joint angles by hanging out on connective tissue (impingement strategy) are traditionally classified as hypermobile. The concept of hypermobility is not compatible with FRC thinking. This distinction is not semantical; range of motion without motor control puts joints at risk, especially at end ranges.

While FRC is often associated with “flows” that integrate a large number of joints, its emphasis on clearing individual joints that comprise a gross movement allows for effective clinical triage. In other words, the “software” won’t work without the right “hardware”. Like SFMA and PRI, FRC cautions us that technique cueing during a complex movement may not be effective without first clearing the requisite joints. Neurocentric (software) approaches to movement are popular these days because they elicit observable changes very quickly, albeit transiently. People are often quick to dismiss jointcentric (hardware) thinking as overly reductionist.

FRC brings this false dichotomy back to the center where it belongs because it recognizes force (via neural drive) as the driver for tissue adaptation. Just as intelligently training joints at end ranges can produce capsular alterations that improve mobility, neglecting to consistently “speak” to those connective tissue cells through a full range of motion provides no impetus for capsular extensibility. Going above and beyond is biologically wasteful when it comes to adaptation. Our tissues do what we ask of them. Consequently, normative range of motion data should be applied with restraint. The current snapshot of our collective movement ability is likely not reflective of what is optimal or even normal from an evolutionary perspective. “Normal” mobility by today’s standards likely has consequences for our orthopedic and general health.

While many of the positions and methods utilized in FRC may be familiar to movement professionals, the details (duration and strength of contraction) are more compatible with current histological research.  Remember, significant forces must be continually applied to modify tissues.  During the course, Dr. Spina was very clear about differentiating between what the research says and what he thinks.  FRC is his sincere effort to reconcile research with clinical practice and the experiences of martial artists, dancers, gymnasts, and other impressive “movers”.  When combined with movement assessment and orthopedic testing, FRC principles can be applied along any point in physical preparation spectrum to improve joint function and prepare tissues for sport.

Stay tuned for part IV where we tie all three of these systems together.