Video Analysis Questionarre and Functional Movement Screen Instructions

Skater Video Analysis Questionnaire

Please fill out all information to the best of your ability to help us design the most beneficial off-ice program for you.

Name: Age:

Phone number: Email Address:

Address:

Parents’ names (if applicable):

Years skating: Coach:

Tests passed:

Highest level consistent jumps:

Moves that are difficult to complete:

Other sports/activities:

What are your short and long term goals for skating?

Hours skated per week and days skated:

Describe you current off-ice training program:

What are you looking for in an off-ice program?

Describe any injuries you have had: when and for how long? Did you have treatment?

Functional Movement Screen Instructions

1) Go to http://www.youtube.com/watch?v=j1ZrPqxoHUg for demonstration of each test of the FMS.

2) Video the following movement tests:

* Deep Squat (at least 5 repetitions, side and front view)

* Hurdle Step (at least 5 repetitions, side, back, and front view)

* In-Line Lunge (at least 5 repetitions, side, back and front view)

* Shoulder Mobility (twice each side)

* Active Straight Leg Raise ( 5 repetitions each side)

* Trunk Stability Push-Up (at least 5 repetitions)

* Rotational Stability (5 repetitions each side

Sk8Strong Inc. 2008