Conference Review: Assessing Movement with Stuart McGill and Gray Cook

Yesterday I made the 2 hour trip from Portland down to Stanford University for Assessing Movement: A Contrast in Approaches & Future Directions. The course was set up to be a dialogue and debate between Dr. Stuart McGill and Gray Cook. The event was put on by Craig Liebenson with support from the Stanford Sports Medicine Department. Laree Draper of On Target Publications was there to capture the event for a DVD release at a later date.

Initial Impressions

I have to first thank Dr. Liebenson for putting on the event. It was well run and structured. Also, thanks to Laree Draper for being there to capture it. Laree has done a great job of putting out wonderful educational resources for the profession over the past 4 years or so.

I didn’t know what to expect heading down there. I know these are two passionate individuals, both of whom I have gotten the opportunity to learn a lot from for a number of years, and, based on many of the (foolish) comments on facebook (Ex., “Who won?” or “Did McGill steam roll Gray?” or “Was it a battle?”) I believe this topic is one that people get very emotional about. Truth be told I thought it may turn into a total train wreck with people getting upset, getting loud and uncomfortable, and nothing getting accomplished (IE, no real learning taking place). I was pleasantly surprised. I found both of the presenters to be very complimentary of one another, showing a lot of respect to each other, and maintaining healthy discussion rather than resorting to personal attacks or comments that were not going to lead to further discussion or better learning for the audience.

The Lectures

The morning started out with both speakers giving two lectures in a “you go, I go” type format.

Gray was up first and he presented the basis of the Functional Movement Screen and discussed why we screen, what the FMS is, what it isn’t, and what things the test may be telling you in order to provide you with information to draw up your exercise road map.

Dr. McGill was up next and he presented his review/critique of much of the literature conducted on the FMS. He was very thorough in reading through the literature and I appreciate the time he put into pouring over the research. Throughout this lecture Dr. McGill presented his logic behind what a movement screen looks like to him and some of the issues he takes with the FMS and some of the things he may do differently.  This presentation set up Dr. McGill’s next presentation nicely.

Gray followed up with a short discussion about some directions for the future and addressing some of Dr. McGill’s comments. The nice thing about Gray’s talk was that he got up there and acknowledged that the screen may not be perfect but it may be the best thing we have available to a practitioner “at this time”. Gray isn’t so hell bent on his model that he believes it is the only thing you need to do or that it is perfect. He openly said, “As soon as there is something that we believe is better we will embrace it. Whether it comes from our group or another group of professionals.”

Dr. McGill finished the morning with a talk on “Developing the Ideal Screen/Assessment”. As I said above, this talk expanded on Dr. McGill’s first talk and took his logic and applied it to an approach which is based on understanding the needs/demands of the athlete and coming up with tests that evaluate the athlete in those needs/demands. One of Dr. McGill’s favorite quotes regarding movement is, “Just because an athlete can does not mean they will”. In a nutshell, Dr. McGill is saying that just because they can move well on an FMS does not mean they will move well when placed under load or some sort of metabolic demand. Dr. McGill spends a lot of time with his clients (his assessments are 3hrs long) so that he can poke, prod and push the individual to see where/when they “break”.

Following lunch each presenter was then given the opportunity to do a practical session in front of the crowd to further explain their approach. Gray started and he FMS’d a gentleman from the crowd revealing that the guy had adequate movement and met the baseline criteria of the FMS. Dr. McGill followed with a series of tests that would be specific to sport or task. Dr. McGill took the same guy and had him perform an arm over arm rope pull, similar to something a firefighter might do in training, to evaluate the gentleman’s potential for tolerating load in a rather metabolic situation. Dr. McGill also pulled other people out from the crowd and showed some table tests for the hips, squatting and deadlifting patterns, and a series of box jumps looking at how someone performs the movement, creates power, and creates relaxation.

The day ended with a whole bunch of Q&A from the audience and some closing remarks from both parties.

Some Of My Thoughts

Most people end up agreeing on more things than they disagree on and this was the case on Saturday. There was a lot of agreement between the two presenters and during the Q&A, following Gray’s answer, Dr. McGill would often start his answer off by saying, “I can’t disagree with anything the man said.” (that sentence works really well if you read it in a deep Canadian accent). While there are some disagreements that these two guys have they actually agree on  a lot of things and I believe that both of their approaches have a place in a comprehensive process (more on that in a bit). The cool thing about the areas that they disagree on is that they are both willing to keep pushing the envelope to try and make it better. Both of them agree that movement screening is essential and they both want to do the best they can for their athletes and the general public.

During Dr. McGill’s talk I found myself nodding along and agreeing with much of what he was saying. In fact, what he was proposing is something that I feel every great strength coach SHOULD be doing – understand the bioenergetic and biomechanical demands of your athletes and test those demands to look for limiting factors that may be holding the athlete back from higher performance. Of course this makes testing difficult because that means you may have to choose different tests for different athletes (and maybe even different tests for athletes in the same sport who play different positions!). It isn’t as algorithmic as people would like it to be. I know people want the easy answer to things but, as Dr. McGill stated many times in his answers during the Q&A, “It depends”. And it does! It always depends! That being said, I believe there is a difference between general screening for risk and specific screening for sport. Which leads me to my question…

My Question

I got up and asked a question during the day (in fact, I was the last question of the day, so thanks for Dr. Liebenson for letting me get it in). My question was directed to Dr. McGill regarding his logic and it went something like this:

“Earlier in the day you provided us with a presentation of your logic around movement screening. I found myself nodding along and agreeing with most of what you said as these are things a great strength coach should be doing anyway – understanding the sport and testing the sport. However, in my logic, I draw a line between testing general movement capacity with a screen of simple body weight movements and testing capacity where we are placing someone under physiological or metabolic load to evaluate when or where they break down. During the practical portion today Gray screened a gentleman that we found to have reasonable movement competency. You then placed this same guy under metabolic load with the arm over arm rope pull and found his form broke down after about 15 seconds, indicating that he either doesn’t understand the technique of the activity or he lacks strength or fitness. In my mind the FMS did what it was supposed to do and your screen did what it was supposed to do. One told us that they guy had adequate movement so we didn’t need to worry about a movement fix and the other told us that he lacked technical ability or strength and fitness. Thus, we could conclude that movement wasn’t a problem but we need to provide this individual with a strength/fitness/technical correction instead. Whether we have 3 hours or 1 hour to assess a client, 10 minutes is a drop in the bucket. Do you ever see these two systems living under the same roof?”

Dr. McGill paused and thought about the question for a second or two and then answered that, “It really just depends. It depends on the situation, the athlete, and the scenario.”

My Own Answer

I believe it doesn’t depend. To me, in my logic, the answer is actually simple. If you have pain doing a basic movement then I don’t need to test you under a metabolic challenge because you need medical intervention and medical screening. If you can’t do the movement with your own body weight then I don’t need to place you under some sort of load or strain to see when you will break down – you already broke down with your own body weight! This is the same discussion I have had with some Crossfit folks in the past:

Them: “The person can do the FMS well but then look like crap when I put a bar in their hand have them overhead squat with 95lbs.”

Me: “The FMS told you that they were allowed to do the overhead squat. It did its job. If they can’t squat with 95lbs overhead then the problem is one of strength or fitness. Train them to perform the lift.”

The application of the FMS is an easy one (in my opinion) and can be represented by this decision tree:

Screen Shot 2014-01-26 at 3.05.07 PM

I think a lot of times people make this more complicated than it is or they don’t fully understand the message and they misrepresent FMS, turning it isn’t some sort of soft “pseudo-physical therapy” system where people don’t really train – they just do “corrective exercise”. As I have said before in previous blog posts, the FMS can help you with the exercise road map and, at times, tell you what not to do, but it can also be very powerful at telling you what you can do and what you can really work at. When you find those things that you can attack in the program, ATTACK THEM! Get after it. Train hard. Get stronger. Get more fit. Being strong, being fit, and being in shape are just as much “corrective” as moving well. I think some of the issues that people take with the FMS is that they don’t really have a system of how to use it with the training programs they write and they think of it more as a “limiter” to what they do than a powerful tool to help enhance what they do.

I agree with both Gray and Dr. McGill. Rather than focus on the differences between their two messages I embrace them. I believe that we should screen for general/basic movement competency to ensure the individual doesn’t have pain when performing a body weight task and to ensure they can even perform the task with their own body weight in the first place! I also believe that we should be testing individuals under metabolic challenges and not just be focused on the numbers of their output (how much, how high, how fast) but also watching their movement to understand what their strategy is for dealing with load in a fatigued state. Both of these approaches attack different parts of the paradigm and answer different questions about the athlete. They are both necessary. If they weren’t, then I wouldn’t have both “movement” and “fitness” as two of the three key pieces in my Physiological Buffer Zone training philosophy:

Screen Shot 2014-01-20 at 7.34.38 AM

 Movement is life! If we stop moving we die. I believe Gray said it best, “Move well, then move often.”

If there is one thing that people take away from Saturday’s event (or the DVD when it comes out) it should be that we need a comprehensive evaluation process that starts general and then digs deeper into the specifics, based on athlete/client’s needs. No one ever said the FMS provided all the answers. In fact, if you go back and read Gray’s first book, Athletic Body in Balance, there are chapters in there on strength and power testing and on training endurance capacity. If you go back and even read the chapter Gray wrote in Bill Foran’s High Performance Sports Conditioning Book, the FMS served as one chapter of many in the assessment of the athlete. In fact, the FMS was the broad/general assessment and then each chapter was written by a different coach who specializes each sports (soccer, baseball, football, endurance running, etc). Each sport had its own unique set of tests used to evaluate different physiological capacities necessary for success in that sport. That isn’t much different from what Dr. McGill is proposing with his movement screen approach, which is asking us to put the person under load and see what happens.

Both approaches are necessary and, in my mind, they both live under the same roof.

25 thoughts on “Conference Review: Assessing Movement with Stuart McGill and Gray Cook

  1. Andrew schmitt

    Well said Patrick.As Gray has said over and over.The screen is blood pressure and was meant for large groups. IF you have an athlete one on one ,every set, every warmup becomes the screen/assessment. I used the screen with 50 football players for three years and it absolutely worked.

    Reply
  2. Jason Williams

    Very interesting article, glad to see two movement specialist collaborating for the betterment of sport science. Well done Gray and Stuart!

    Reply
  3. Brent

    Awesome write-up. I too don’t really think it has to be as complicated as it is made out to be. What I’m confused about is what movement screens does Dr. McGill use and how do they differ from the FMS? In the presentation it sounds like he screened for movement under physiological stress only. I assume he also screens movement NOT under stress? I see no reason to test someone under stress if that can’t demonstrate a test under little to no stress. Doesn’t make much sense to me. Good stuff. Looking forward to the DVD.

    Reply
  4. Josh Landis

    Great write up Patrick! I agree with you wholeheartedly. Neither of their approaches are wrong, just context specific. I think McGill dodged your question a bit at the end. Perhaps he needed more time to formulate a proper response. Your assertion that both systems can be married and should be is correct. The FMS has it’s own soecific use, and is most powerful when used in conjunction with deeper, specific testing. Thank you for this review. I was there as well, and you wrapped it up nicely.

    -Josh

    Reply
  5. Michael Roberts

    Patrick, thank you for the summary and thoughts. While each scenario has a “best” approach, both approaches need to be considered in every scenario. A wise intern once taught me, and I agree….every exercise is a test. While the fms has holes, it is a valuable tool. Thanks again for the post! Mike

    Reply
  6. Bob Schroedter

    I concur that most of those who lob criticisms at the FMS don’t understand the FMS. And if they are lost with how to use the FMS results to help them build a program and design a training philosophy that incorporates correctives as a piece of the puzzle but not the whole puzzle, then they should take the FMS 2 course and pay attention.

    Reply
  7. Joshua Zavertnik

    Excellent post Patrick. I appreciate you taking the time to summarize the day but then to expand on it further. As coaches and clinicians such as yourself and those that were present continue to push the envelope we will develop greater methods of testing our athletes.

    Reply
  8. Eric Dixon

    Very nice work Patrick. I was just explaining this to some training clients this morning. I explained that I try to take both philosophies (which are very similar) and mold them into one. Two different types of testing that I think you did a phenomenal job explaining. Both are (in my mind) mandatory under the same roof!!

    Reply
  9. Kevin Mao

    One of the points I wish prof. McGill would have elaborated on further was his dissection of the criteria needed for a “3″ on the deep squat. I recalll him including a spine where someone who passes as a “3″ would have been a “1″ under his criteria. Based on McGill’s research one of the most important components of a deep squat, or any squat for that matter, is to maintain natural lumbar lordosis throughout the range of motion, because although someone may pass with a “3″ based on FMS criteria, if more attention isn’t paid to collapse of the spine or posterior pelvic tilting of the pelvis, then that person may be “blowing out their spine” because of of inability to control that forward flexing motion. Maybe those cross-fitters cannot place load on their “3″ because someone with a better trained eye would call it a “1″. I think its great that having the FMS in the first place would actually force a person to be assessed in that position, but I agree with McGill that much more further attention to detail is absolutely needed in order to make both systems work better. The take-home message for me was that Cook has established “movement baselines” for others to speak common language to one another so people like McGill can take those baselines and expand on them further.

    Reply
  10. Jared

    Wow what an event that would have been. The biggest limiting factor from facility to facility is amount of time set aside for an assessment. In one hour we have a lot we need to cover. However I think developing a comprehensive list of possible performance tests to use with each athlete starts that process of situational assessment. If the coach can pull out a reasonable amount of viable performance tests, those tests can be revisited frequently.

    I will be on the lookout for that DVD, would be an excellent one for the collection!
    Thanks for the write up Patrick.
    Jared

    Reply
  11. Dr. Robert Newhalfen

    There is a better system out there and it’s called DNS (Dynamic Neuromuscular Stabilization). Lots of people, including Dr. Liebenson, continue to delve into the depths of DNS even after all the McGill and Cook education. I was a previous Mag 7, FMS and McGill user who now uses DNS simply because it works better, makes more sense and involves a much truer progression of complexity.

    Reply
    1. Patrick Post author

      Dr. Robert Newhalfen,

      Thank you for your reply. I am sorry but I disagree. DNS is a system established to treat pain. There are main principles from DNS that apply to training (and actually find their way into the FMS or even McGill’s approach) but as an assessment process it does not provide an exercise road map for the intense training that is needed for sport. I have taken and used many of the principles and Dr. Charlie Weingroff has done a fantastic job of teaching these concepts/principles in a manner that shows how they can be used for hard training. However, as a stand alone system for training non-pathalogical individuals I don’t find DNS to be complete with regard to providing us better decision making for higher level exercise/activities.

      Kevin Mao,

      There is a difference between screening and testing. The “3″ in the deep squat allows for pelvic/lumbar movement because those regions of the body should be able to flex and extend (not just stay stuck in extension the entire time >> joints should be able to produce their requisite mobility in order to display their optimal stability). There is a different between testing/screening and training. In a training environment, with load, that would be totally unacceptable (I agree with you and Dr. McGill) but when testing body weight I am less finicky about it.

      patrick

      Reply
  12. Mark Bubeck

    Patrick,

    Excellent write up of what was probably a fantastic seminar. I think the question you asked Dr. McGill was perfect and showed how both systems can work together. The FMS has to come first, without competency how can we know if we can be adding capacity to a pattern. Why people can not see the difference between what the FMS shows and what fitness/conditioning/strength testing shows is perplexing to me. You need both and both matter, but competency comes first. I love Dr. McGill’s work, but I would have liked a more in depth response to your question from him. Saying “it depends” is sort of side stepping the question.

    Mark

    Reply
  13. Max Prokopy

    Way to go, Patrick. Oh, to be a fly on the wall…but you really set the tone and encapsulated the key bits. I couldn’t agree more and couldn’t thank you enough for posting.

    Best wishes,
    Max

    Reply
  14. ian rubin

    I agree with you Patrick. I shouldn’t be so complicated. It seems like a step 1 FMS, step 2, add load and reassess. I work with general populations and the first 4-6 weeks of their workouts are really just opportunities to reassess movement under different loads, speeds, conditions using basic movement patterns. Then things can ramp up or regress along the way as necessitated by what I see in their movement each workout. So, it depends makes perfect sense to me. It’s the Personal part of Personal training. Keep up the good work. I hope your influence as well as all the others involved can permeate the mainstream personal training industry. They need it!!

    Reply
  15. Keats Snideman

    I finally got around to reading this blog post and it was well written. I think your conclusion of starting general (FMS) and then going to more specific physiological testing (McGill) if movement was clean enough (2′s and no pain) makes most sense. Neither program is right or wrong..its all in the perspective and a big picture (global) approach of checking for basic/fundamental movement makes sense. The FMS is not the be-all end-all of movement screening, its just the best thing we have out there right now to use as a starting point for any movement oriented profession.

    Reply

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