Okay, thanks to the program committee for asking me to be here. Audiovisual staff, they do a lot of work behind the scenes to make these things go and make our videos play. Jaguars medical staff for letting me be here, and then my PFAS colleagues who are a lot of the thought people in the space we live in today. When I first went to school, the first thing you did when you were doing screening was a postural screening. You looked at people from the back, the front, and then you came across something by yonder called upper and lower cross syndrome, and that's what basically existed. Today, there's so many different options out there for people to look at to decide what it is they need to do for their players. There was a term that came out called regional interdependence. It was coined by a guy named Wainer in 2008, but it dates back to years ago, again, from two people up in Pittsburgh by the name of Dick Earhart, who was a chiropractor and PT, and a guy named Rick Bowling, who was a PT, and they basically showed that something could happen in one part of the body that affects the other part of the body. The injury could have been at that point or somewhere along the chain. We could see when we look at sagittal, frontal, and transverse planes, all the things that could happen, and that's why screening slows everything down, that we could see certain things a little bit better. So when I look at a screen, can it help you identify the path of the target tissue that's affected? If I look at it from the inside out of the body, bone and chondral, is it worn? Is it healthy? Is it congruent? Does it fit the way it's supposed to? Is it inert tissue? Is it loose or tight? Is it contractile? Is it over or underactive? Is it kinematic? Now that's not, it's not misspelled. It's just combining kinematics and kinetics, so you've got forces. And it's movement, linking, and coordination. And then the cognitive piece, that's what everybody's exploring now, is the neuroplasticity. How do you make something go back and be coordinated after it's been injured? We see people in the world that we work with, that a lot of times they have the perfect storm. They have bad bone. They have instability, so they've got inert insufficiency. They've got neuromuscular amnesia. They've got kinematic collapse. And then they've got cognitive uncertainty, that sometimes it looks like it's done pretty well, and then other times it's not done well at all. I broke it down into three different areas. I broke it down into movement. I broke it down in the clinical things that I've seen over my 35 years of doing this, and I broke it down into performance, as Kyle talked about people needing to communicate very well. So here's something called Dory Motion Capture System, sensorless system, where 16 teams in the NFL have been collecting the data. It has algorithms. You do a series of seven to eight tests, and those algorithms help you predict what's going to happen. The one big thing that came from the data capture that occurred during this season is that they were able to see that ankle dorsiflexion was a big thing. So if you want to take something to start working on when you go home, make sure people, their ankles are moving good. I always tell people, you move from the ground up and your strength comes from the core out. So that ankle prediction that they look for injury prevention with the Dory Motion Capture actually was something that they talked about. Functional movement system, that's been around for years. Seven tests, score 21, greater than 14, Greg Cook started that many, many years ago. And then his spinoff from that with Mike Voigt and Greg Rose was the SFMA, which was more clinically based, where you did a top tier system and then broke it down and then you had breakout sections. But these are all available now, depending on what you want to do. NASM screening, Mike Clark, that's been around for years. You look at something as simple as an overhead squat and a single leg squat, and it tells you where the breakdown point is. They do pronation distortion syndromes. And again, it gives you the summary of things that you could actually look at and begin to work on. If we look at kinetic control, a lot of people haven't heard of this. This is from over in Europe, it's the people that designed it was Comerford Mottram and now a guy named Blanford that's been doing it. And this is looking at people that can't control motion, these instability cases that you sometimes see. And they have it for shoulder. Here's just dissociating his hip from his pelvis. All he's doing is doing transverse plane, internal external rotation to make sure that it's occurring in the hip joint. And how many times do we see people when they do hip extension, they go into their back to get the motion. So here's just one simple way of starting to train it, but breaking it down and looking at these screens to say, okay, this person doesn't move right. What do we give them to correct that? Applied functional science, Gary Gray, when the foot hits the ground. How many years ago was that? I think in 1989, I saw him do his first course, okay? And here he's come up with a system called MAPS. And again, it's a series of 12 tests, but it's available to you. True stretch is on the right. And then if you look at the test that he did, you know how he actually came up with the true stretch. But it's right and left crossover, same side rotation, same side lateral movement, and then anterior and posterior chains. Star excursion balance test. That goes back as far as 2000. Again, looking at anterior medial, posterior medial, all of those motions and what it meant to the different sports. If we look at what Plisky tried to do then is he took and instrumented the star excursion balance test. And basically, it's a series of three tests that you could do. You could do it upper and lower, okay? The inter-rater and inter-rater reliability is very high. And again, it can be used. You got those ankle problems and just looking at dorsiflexion and seeing what people get. It gives you a measurement greater than four centimeters to put you at higher risk. Another thing that's been out there a long time is MAT, muscle activation. And that's a comparative assessment mobility. So this is the... I've been doing this a couple of years now too, and it's just part of the toolbox. Basically, you allow people to see that strength can actually be a reason why they have loss of motion. And if you take the classes, it's been pretty effective for us. Again, it doesn't work on everybody. But again, there's so many things out there. If I look at clinically the things that have existed, scan-wise, okay? Upper and lower quarter screening, we're taught that. If you're old enough, you remember the old book by Hoppenfeld that was probably in every athletic training room. It's probably in some libraries now yet. But again, it's what you went by with the upper and lower quarter screens. The one thing you never want to forget is the red flag screens. When you got people that have those referred pains from visceral regions, again, something very important to remember when you're looking at screening. Algorithms that could be based on structure and based on feedback from MRIs or x-rays. This was up at HSS, a girl named Jamie Edelstein, just looking at hip structure and deciding on how to go about treating her patients with osseous overcoverage and inert instability, either positive or negative. And it lets you start shooting when you get these scans and you get good at them. It lets you start shooting with a rifle instead of a shotgun. Something so simple, Shaytao, from England, a DO, basically just sits people down. Years ago, they used to do a test where it was a sit and reach test and there was a box that you got measured on that was objective. But basically, if you just look at this, he's looking to see if your hamstrings are tight, your calf is tight, your low back's tight, thoracic is moving too much. But these are all things that are available for you to examine people. And then, again, table pelvis and ankle check. We do this so much every day on players that come in, especially players that might have tissue breakdown during camp. And we're just going to check to make sure the pelvis is level, make sure the ankles are moving correctly, make sure that they're in alignment at the medial malleolus. Have them do a bridge, check the pelvis again, have them sit up. A nice rule is if you load it, you check it again. The reason I did this slide before was because what does the Trendelenburg tell us? When I went to school many years ago, it told me that you had a weak gluteus medius, right? But just think about what that means. When your pelvis drops on the opposite side, it means everything on the stance leg to the outside is stretching. We deal with the holy grail of the hamstring. So let's say I lay the person on the table and I see they're anteriorly rotated. So now they've got an anteriorly rotated pelvis, so it's going to cause the hamstring to stretch. It's going to lengthen posteriorly up near the glute. Now they stand up and they do this, and they're weak in the gluteus medius. What does that mean? It means that the hamstring is stressed laterally because the pelvis is going up. It means it's going to be stressed in the sagittal plane because it's rotating anterior, and just pronation and supination means that it has the potential, if you over-pronate, that you're going to be moving it in a longer excursion by going into pronation, not coming out of it. So when we look at some of these things, it may give us a reason why a person is getting some of the injuries that they do. Simple little task, single leg squat by Crossley and Skeish. We've all seen this, performance rating good, poor trunk, poor pelvis, poor hip and knee. So you could see the kinetic collapse of the knee. You could see the adduction of the femur. You could see the lateral tilt of the pelvis, and you could see when somebody's doing it pretty well. And then those results basically demonstrated what we would expect to see. The bungee test that was used mainly for runners, but it's the fascia lines, and they do a series of five tests. And again, it's just another way of looking at how you might evaluate a core in a scan. Sports specific screening. I was in hockey a lot before I came to football a couple years ago, but we always saw adductor injuries and Tim Tyler up in New York, he was able to do a study that showed that if the adductors weren't at least 80% as strong as the adductors in professional hockey players, basically your chance of injuring the groin was 17 times greater. That's a good screen to do when you got sports specificity and you got results like that. One of the things that we see in the clinical world today is what they call clinical prediction roles. That's something to the left there called low back classifications. So if you have those symptoms, you're going to manipulate. If you have the other symptoms, you might stabilize. Maybe that's something we should be looking at when we start looking at testing clusters, when we're looking at movement. Maybe two or three of the different types of movements would be a better indicator for us than just picking one thing, just like it would be for core strength, power fitness or load management. From a performance standpoint, the Nord board, that's the big thing you've heard people talk about this morning. And again, this was a study that, again, looking at structure, that this was a poster put out by Mike Voigt and Chris Wolf and basically the effect of the pelvic tilt and weight bearing of hamstring on force production. And it showed that if you were in an anteriorly rotated position or a posteriorly rotated position, your strength levels were less. So again, the application of that is, do we actually go and correct the pelvis before we do the Nord board or do we just interpret it to make sure that we check the pelvis and say, okay, this is why this might've occurred. Couple things in there for you just with hamstring training so that you can take something away. I'm not big about raising a problem and not giving a little bit of a solution, but these are some good articles that you could actually look based on fascicle length, based on structure of the hamstring and then running as well. The vault force frame, again, we could look at so many different things to test, but we have abduction, adduction, and some of the things that we've seen in abduction, everybody uses bands, band around the forefoot recruited gluteal group better than TFL. Something to take with you. Mean normalized EMG signal amplitude, that it was better to start the affected side as the stance leg as opposed to the moving leg. But again, the NFL, the vault company, they collect the data and it tells us where everybody is from a percentile standpoint and how you compare against people in your position and people around the league. So that's pretty valuable for us when we look at that. From an adductor standpoint, the best exercises were to Copenhagen, which was the bottom exercise, and then just squeezing a ball. If we look at velocity-based training that we see in the performance centers now, there's some normative values for what happens when you're working at different strength levels. There's a ground reaction force and meters per second squared, how fast he's moving. So these are things that are scans that allow you to take and evaluate your players on a day-to-day basis very quickly. Lastly, force plates, something else that we're really big into, and we'll do jumps probably at least once a week now in the weight room just to identify people. And the things to the right there tell you the breaking position of the person. Are they going equal on both sides? How's their push-off? You can see how when he lands, he's rotated a little bit to the right, lands on the right foot faster. So again, now we've got ways of qualifying this like Joe talked, or quantifying this like Joe talked about. More times than not, it's still, it confirms what my eye test does, but it's really a good way of identifying numbers for people. And the athlete, sorry, how do I go back to that? Basically the conclusion then is you have all these different types of scans. Get good at one or two of them, but remember that the big part of it is you're going to have people that are tight. You're going to have people that have too much motion. You got to know what to do for them afterwards. And the big part of the, let's see, the conclusion screening can be done with movement, clinical eval, or performance. Screening can be used to identify deficiencies, movement compensations. They can help direct treatment and establish baselines. They can lead to the development of correctives or buckets for groups of players who may be experiencing the same problem. Screenings can help to identify a weak link or escape route as part of the chain kinematics. And then activation can increase mobility just as easily as flexibility can increase strength. Thank you.

screening individuals

regional interdependence

screening options

individual needs

deficiencies