General Health Topics

Personally written by Dr. Milan Lassiter, 1303 W. Main St, Richmond, VA 23220.  Contact us at (804) 254-5765 for your FMS assessment.

The FMS (Functional Movement Screen) is a series of 7 screening assessments. It’s efficient and powerful enough that it has been used for years as part of the physical assessment at the NFL scouting combine in order to screen potential players.

The FMS can detect limitations in our ability to perform basic movements, reveal imbalances from side to side, and identify risk for future injury. It is also used to identify areas that can be improved upon for better performance. The test is made up of 7 different movement patterns:  (1) Squatting (2) Stepping (3) Lunging (4) Reaching (5) Leg Raising (6) Push Ups (7) Rotating. Each of these patterns have specific criteria that has to be met and a score is given accordingly. It’s basically a series of tests that you pass or fail.

In real life we move in patterns.  In other words, we don’t just bend the knee…instead we bend the knee while also bending at the hips and ankle, simultaneously moving our torso, balancing with our arms, and shifting our weight with subtle movements made all the way from our neck to our toes. The FMS is a screen for movement patterns, not individual joints or areas.  Instead of assessing parts, the FMS assesses patterns, which is actually the way the body moves in real life.  The FMS leads us to the weakest link in the chain within these patterns.

The FMS is a rating and ranking system, sort of like getting a grade in school (an A or an F). However, with the FMS test, the grade is from a 3 to a 0.  Getting a 3 or 2 is a pass, while a 1 or a 0 is a fail.

3 = Optimal (perfect execution of a movement pattern)

2 = Acceptable (some compensation is occurring)

1 = dysfunctional (unable to perform the movement, which will lead to the clinical assessment called the SFMA)

0 = Pain (a movement pattern produces pain, which will also lead to the SFMA)

When pain is discovered upon an FMS test, it should be assessed by a clinician who can perform something called an SFMA (Selective Functional Movement Assessment).  I will write about this in another blog at a later time, but suffice to say that it’s an amazing tool and, in my opinion, you should look for physical therapists, chiropractors, or even MD’s, who can perform an SFMA if you are injured or have pain upon movement. I am in the process of being certified and will be ready to do the SFMA soon.

There is a standardized screening system for the risk of cardiovascular and heart disease (ie: checking for high blood pressure, cholesterol, and triglycerides and screening for whether or not they smoke, what they eat, whether they exercise or are overweight, etc). It doesn’t matter where you go, these same parameters are going to be screened.  However, we don’t have anything like this standardized screening assessment for exercise, athletic performance, pain upon movement, or musculoskeletal problems. The FMS is a standardized test that is used to quickly assess the way that we move.

When an assessment is performed to screen for cardiovascular disease, a person can have no symptoms or complaints, yet still find out they have high cholesterol or high blood pressure. This puts them at high risk for a potential heart attack or stroke. By intervening and making changes, that person can be saved from something serious or even deadly.

Similarly, the FMS is a risk assessment tool that uses either specific intervention exercises or therapies to save a person from future injury, pain, impaired movement, and performance deterioration. If the assessment comes up decent, but not perfect, it can also be used to enhance the way someone moves…in other words moving them from mediocre, to good, to great. That can only be beneficial for anyone, whether you’re a carpenter who has to do heavy manual labor or a recreational, but competitive tri-athlete.

This is how the pros are being assessed these days.

In our office, you don’t need to be a pro-athlete to be treated like one!

Personally written by Milan Lassiter, DC, 1303 W. Main St, Richmond, VA, Tel #: (804) 254-5765

Continuous passive motion (CPM) is a rehabilitation therapy that’s been around for more than 30 years because it works. The REPEX table in our office is a CPM machine for the low back. It can help when a person has “arthritis,” degenerated/herniated discs in the low back, or just plain stiffness and lack of movement in the low back. It features precise, touch-screen controlled repetitive movements, where exact angles, depth of back and forth movements, speed of treatment, and the total number of repetitions can be controlled.

I was introduced to CPM therapy about 15 years ago without even knowing about it. I was a new chiropractor, just out of school, and I was working for someone. As I remember it, I had an incident of low back pain that was so acute, my boss couldn’t adjust or manipulate my spine. The muscles around the area were locked very tightly. He put me on my back, pulled my knees to my chest, put one hand under my low back and lifted it, and then rocked me back and forth while lifting my low back up and down. After doing that for a while, my muscles were much more relaxed and I felt better with less pain. That is an example of a simple type of CPM. Our REPEX table can do that movement, but do it many more repetitions and also specifically relegate it to the maximum amount of motion that a person’s spine can handle at that given moment in time. It’s all very controllable via a computer interface where you can increase or decrease the range of motion depending on what the person can tolerate.

Passive range of motion moves an area gradually and slowly, without the use of the patient’s muscles. CPM produces a stressless motion by controlling motion in the affected area and moving it passively, without causing additional strain or inflammation.  A common way to produce CPM is to have a machine do all the work and force the area to move within that persons limitations. During rehabilitation, these joints may be too sore or weak to bend on their own. CPM machines are commonly used in the knee, ankle, elbow, or shoulders. Our office has the only machine that specifically produces continuous passive motion in full range of motion (flexion and extension) for the lumbar spine.

CPM has been clinically proven to:

Reduce pain and swelling

Prevent joint stiffness

Promote blood and oxygen to a damaged area

Increase range of motion

Prevent scar tissue formation and muscle contractures

Activate muscles so they don’t weaken

How does the REPEX treatment work?

The REPEX machine was developed by Robin McKenzie, one of the forefront specialists on spinal conditions in the world. He even has an entire institute named after him, which trains physical therapists and rehab specialists. The exclusive, trade-marked design of the REPEX table was developed by him to address low back disorders using his McKenzie Technique.

Because of pain, fatigue, and other limitations, patients are sometimes unable (or very limited) to repeat exercises to maximum benefit. The REPEX table automatically and passively exercises a patient’s lower back to its full available range of motion (the table does all the work for you until you’re able to do it on your own). The REPEX table can exercise a patients low back with a greater number of repetitions than what is possible using exercises that someone could perform on their own.

Personally written by Milan Lassiter, DC, 1303 W. Main St, Richmond, VA (804) 254-5765

I had a patient who came in last Friday and told me a crazy story about her husband who had a seizure that was so bad, he actually bit his tongue half way off. Right before he had the seizure, he called his wife (my patient) and she detected that something wasn’t right, so she called his father and told him to get over there ASAP. Long story short, if his father hadn’t gone, she said that her husband very well may be dead.

You won’t believe why he had the seizure…from dehydration! She said that he doesn’t drink water…ever. The seizure was so bad that he actually caused a few compression fractures to his spine. She also said that their place looked like a murder scene because there was blood all over the place from the tongue.

Drinking water is one of the most powerful health improvements that most people can make. Water makes up more than 70% of the body’s tissues and plays key roles in nearly every body function. Drinking water is one of the most important health habits that you can establish and if you don’t get enough, you’ll suffer with bad health consequences.

The basic rules are:

• Most of what you drink should be water.

• If you drink alcohol, space out drinks by drinking water in-between drinks and drink water before going to bed.

• Avoid drinking tap water because of chemicals.

• Brita filtered water will cost maybe $0.20 per gallon and is well worth the investment.  Filtered tap water is great because there are a lot of minerals in there, but you can still filter out bad things like lead, chlorine, flouride, arsenic, etc.  (One of the problems with bottled water is that minerals have been taken out)

• Don’t buy the one-gallon jugs of water from the grocery store that are in the cloudy or bumpy plastic containers because of PVC plastic, which will transfer chemicals  into the water.

• Never drink water bottles that have been out in the sun, especially bottles that have been left in the car for the same reason.

Also important is to avoid ALL sodas and juices.  That includes diet and “zero calorie” sodas, orange juice, and sports and energy drinks.  Coffee and most sodas are loaded with caffeine, which is a diuretic that will dehydrate you even more. Add in all the sugar or high-fructose corn syrup and you have a recipe for worse health and the number one source of calories for all the overweight people in our nation (almost 70% are overweight).

You can use 2 things to determine when to drink water:  thirst and color of your urine.  When thirsty, drink filtered water, not Gatorade, lemonade, or iced tea. If it’s hot or dry outside, or if you exercise a lot, you’ll need more water.  As for the color of your urine, it should be a very light pale yellow. A deep, dark yellow means you’re dehydrated, even if you’re not thirsty.

As far as sports drinks go, your most healthy choices for replacing electrolytes are (1) fresh coconut water or (2) simply adding a pinch of natural, unprocessed salt to a glass of water and stirring it very fast to create a vortex (like a tornado).  I like sea salt or Himalayan salt as natural salt options. Sodium is the most important electrolyte that you need to replenish after exercise, so I like adding salt to filtered water, but I know that many people won’t be able to handle the taste.