Shirley Sahrmann
Shirley Sahrmann
Shirley Sahrmann is a physical therapy scholar at Washington University School of Medicine in the United States who developed the movement system impairment (MSI) syndromes approach, which examines pain in terms of how a person moves rather than where it occurs. Central to this perspective is observing which joint moves first and how much it moves during repeated performance of the same action. She had a major influence on establishing the term 'movement system' in physical therapy.
Who is she?
Shirley A. Sahrmann earned her physical therapy degree at Washington University School of Medicine and completed master's and doctoral degrees in neurobiology. She joined the faculty at the same university in 1961, teaching students and conducting research for many years, and is now a professor emerita. She is also a Fellow of the American Physical Therapy Association (FAPTA).
Her best-known book is *Diagnosis and Treatment of Movement Impairment Syndromes*. Published in the early 2000s, it has been widely read by physical therapists as a framework for observing and classifying movement.
What perspective did she introduce?
Sahrmann viewed muscles and joints as a single system working together throughout the body. She called this the movement system and proposed examining the direction and manner in which a painful region moves, rather than looking only at the region itself.
A key concept is relative flexibility. This concept holds that if one joint or segment among adjacent joints or segments moves more easily, it tends to move first and to a greater extent during the same action. One example is the lower back extending before the shoulder moves when raising an arm overhead. In effect, the lower back takes over for the movement lacking at the shoulder.
These observations lead to directional susceptibility to movement. This perspective considers which directions of movement are uncomfortable and which directions feel more comfortable to practice.
How does assessment lead to practice?
In this approach, everyday movements such as standing, rising from a chair, and raising an arm are observed to identify which joint moves first. The observed movements are organized into defined patterns; movement system impairment syndromes provide the criteria for this classification. This system serves as a common language for describing movement.
After observation, practice focuses on reducing movement in areas where it has been concentrated and helping areas with insufficient movement move better. Another characteristic is the emphasis on correctly repeating movements performed frequently in daily life. A detailed assessment framework is available in Movement system impairment syndromes.
When reading about this perspective
Sahrmann's approach provides a framework for describing movement in detail. However, the classification names are closer to descriptions based on observed movement. Understanding the causes of an individual's pain therefore involves considering not only movement but also contexts such as activity levels, work, overall condition, and changes over time. Principles of testing, assessment and interpretation also explains how to interpret assessments.