Functional Movement Systems: Where the Gym Meets the Clinic | Dr. Grant Elliot

So what I focus on is I just want you to get up and move as frequently as you can throughout the day. Get in this position, get in this position, stand up, take a walk, get in a hip flexor, stretch, anything you can do to move as frequently as possible throughout the day.

As a chiropractor, what are some of the top things you might be missing with your low back patients? My name is Dr. Jeff Langman with the Evidence Based Chiropractor and I'm fortunate to be here with Grant Elliott of Rehab Fix and he's a certified strength and conditioning specialist and we're going to break down some of what he's seen in the strength and conditioning world and how chiropractic fits in and maybe some areas where as a practicing doc you can improve either your assessments or your back end to make sure that you are helping your patients get the best results possible. Grant, thanks for coming on.

Thank you so much. Happy to be here. It's an honor.

For the docs that are unfamiliar, talk a little bit about Rehab Fix and yourself.

So my name is Grant Elliott, certified strength and conditioning specialist and I'm a trimester 10 student at Logan University and out of St. Louis, although now I'm finishing my rotations here in the lovely city of Tampa. What RehabFix is. RehabFix is a social media account primarily on Instagram that I created around a year ago that I used to both spread educational information, help as many people as I could that I couldn't see in person, as well as build myself as a future provider and help learn more and learn how to teach a little bit better.

What are maybe some of the pitfalls that you've seen in terms of patients that you've seen, people that you've seen in strength and conditioning world who have seen chiropractors concurrently and maybe things that those docs didn't see or didn't have access to that you've seen in their world in the gym.

One of the biggest things is that I'm in on the field or in the gym with these kind of people trying to perform their activities that you're trying to get back to. Very often these patients or athletes, whoever it might be, when they're in the chiropractic clinic, there's not really a gym atmosphere or they're not doing their competitive athletic event there. And so sometimes they're. The carryover isn't exactly concise. So what I have the opportunity of doing is working with them one on one, getting back to their activity. And I Would say one of the most. The initial common miscommunications between the patient and the provider in regards to getting back to their athletic event is should they continue doing it in the first place? I've had some clients who were seeing a great chiropractor, and they came back and they weren't exactly sure if they should continue our sessions because, hey, I have this injury, I have this little back issue, so I'm afraid it might make it worse. So I would say one of the first, most important things is to address with your patient, should they keep exercising and encouraging them to either do so or to not do so, whatever you might see best fit for that individual patient.

Right. Do you think that ties more to, like, maybe a challenge in the functional assessment in the doc's office, maybe history? Taking as far as knowing what their goals and expectations are, I think it.

Would go back to setting goals and expectations. So a lot of people I see, sometimes they don't even really care that much about some specific assessment or even necessarily the pain that much. Sometimes they just want to be able to play basketball again or go kayaking or get back in their CrossFit community, things of that nature. So I would say one of the best ways to establish what the activities are and what you should continue to encourage them to do is first get a baseline of what their goals are and most importantly, what their activity goals are.

Yep. And we were talking a little bit off camera. Sometimes it can be a communication issue. And I guess my question to you would be, how many times as a strength and conditioning specialist for years, how many times has a doc reached out to you and asked you what's going on with a patient?

Almost never. Almost never, unfortunately.

I mean, how do you think that communication could either be enhanced? What do you think the benefits of that would be?

We all know that exercise can be a great thing for a wide array of issues. And I think a phenomenal approach to patient care is collaborating with both your provider and your coach or your personal trainer, whoever might be helping you exercise in the gym and that sort of thing. I think it would be great for more people to reach out and communicate with me and vice versa in the future so that we can both collaborate on the care and I can go, okay, what's your assessment? What did you find? What do you recommend this patient do or don't do? And so then I can incorporate that into the gym or athletic setting to make sure we continue to improve them towards their goal or towards their recovery instead of accidentally making anything worse.

What are some things that you've seen in terms of functional disabilities or dysfunctions that people have come into the gym with that chiropractors can or should keep an eye out for with their patients?

Here could be an example. Someone has some difficulty squatting, maybe they have a pain in their knee or pain in their low back, something of that nature. Well, something I might do is do a few mobility, a couple maybe FMS screens. We might have heard those terms before in regards to, okay, do you have the necessary prerequisites to be able to correctly perform a squat? So I might assess their ankle mobility through some just ankle tests. I might assess some hip mobility, put them through some mobility exercises, see if they can accomplish that or see if they can do it up to standard. Those are probably the most common functional deficits I would see in regards to someone wanting to get back to their squat or back to their heavy squat, whatever it might be. And after we assess those, I might be like, hey, you know what? I'm not telling you to stop squatting, but we might need to address these other areas first to get you back to doing that the best that you can.

Yeah. With FMS screening, talk a little bit about what that is and how it plays directly between what the patient might be doing in a chiropractic clinic and what the client may be doing in the strength and conditioning world.

Yeah. So FMS is functional movement screen, and it's a very, very fast, fast and effective screen that any personal trainer can use during their initial consultation with that individual or any time to just get a really quick blueprint of where their stability is at, where there's. Where their mobility is at, and where they might have some of those deficits. So with that FMS screen, what we can do is we can get those additional findings, we'll call those athletic findings, so to speak, And a good communication with myself and the provider, I can relay that information. Hey, I performed the FMS screen with Suzy, and I found some additional things that might be related to this issue. And I think if we both worked on this together, then we could attack the problem a little bit quicker, and we can make sure she's doing these things on her own and in the gym when she might not be in the office.

Break down the top two things that you've seen in the strength and conditioning world that docs should keep an eye out for in their clinic and if they do concurrently, can help their patients get better results.

I would say one of the first things would be as simple as what Exercises should they keep doing? Because you guys are the ones that are doing the professional assessments, really diving deep. I'm more of the movement guy, looking at exercises and things of that nature. But sometimes, even though someone might be encouraged to continue exercising, they might not know what exercises they should be doing. So maybe there's a runner and they really enjoy running with their community, and they were told, hey, keep running. But they're not sure they how long, or they're not sure if they should be doing other exercises related to that to continue to improve. So I would say one of the most important things would be, one, encouraging them to exercise. But two, determine exactly what exercises they should continue to be doing so that they can be confident in those and they can continue to stay in the activities that they love. On the flip side of that, I would say it would be just as important to determine what exercises they shouldn't be doing. One good example I have is an individual who really, really enjoyed kayaking. And as we all know, when we're in a kayak, we're kind of hunched over for a long period because you don't really have a choice. You're kind of in that tight space. And he really enjoyed kayaking. And typically his ventures would be about four hours straight. I don't know about you, but that's a long time to be sitting down. I personally would be getting stiff. This particular individual was found to have a flexion intolerant, low back complaint. Well, the provider was great in encouraging him to stay active. Keep doing what you love, and that's very, very important. But for that temporary time, these kayak ventures were kind of agitating things and making them a little bit worse. So since I'm in the gym with this individual, we're working on movements, we're working on exercises we went over. Okay, maybe let's just modify your position a little bit. Maybe get a lumbar roll, maybe reduce.