Movement Screening Explained (part 2)- what the FMS is not

My last post outlined the basics of the Functional Movement Screen (FMS), why it’s important and what it tells us.  Today, I want to clear up some common misunderstandings that I see around the internet in regards to the FMS and explain what the FMS does not do.

FMS Deep Squat

The FMS is NOT:

-A test of strength, endurance, body composition, cardiovascular fitness, etc. All of these qualities may or may not be important to find out depending on who you are and what your goals are, but they should come after you find out how well you move. Remember, move well first, then move often.

-A predictor of performance. Scoring high on the FMS does not mean you’re a better athlete than somebody with a lower FMS score, nor does it mean you’ll lose weight quicker, or achieve any of your other fitness goals any faster than somebody else.

-A judgement of your character. People with little to no exercise experience tend to develop all kinds of anxiety about the FMS until I explain this point to them. “I’m so out of shape, I’m going to do terribly!” is something that I hear very often prior to a movement screening. The FMS is not meant to award the high achievers and punish those who are out of shape. I explain the FMS as more of a pass-fail test than a graded exam.

  • Did you score a 2 or a 3 on all of the movements in the screen? Great, you passed. Now get to work. There are no bonus points awarded for making a 2 into a 3 and I wont spend a great deal of time trying to do so. If one of your life goals is to get a 3 on the Active Straight Leg Raise and right now all you have is a 2, by all means I’m not going to stop you from trying to improve it, but just know that there’s no reason to think that getting that 3 will make you a stronger deadlifter, make you less prone to athletic injuries, or make you less likely to slip on that patch of ice on your steps.
  • Did you score a 1? You fall under the line of passing the test, and that means that putting you into this pattern is going to exacerbate your dysfunction and perhaps lead to injury. Now let’s make an intervention to clean that movement pattern up. This intervention could come from an endless array of possibilities- mobility, motor control, soft tissue, etc. This is where your coach is invaluable. How do you get from dysfunctional to functional to training as quick as possible? And remember, passing the screen isn’t the end goal, it’s more of a starting point. We just need you to be a 2 or better to be able to safely say “okay- now let’s get to work on your goals.”
  • Did you score a 0? That’s okay. There are still things we can do to help improve your fitness, we just aren’t going to use that particular movement pattern. Let’s get you set up with a really good medical professional and see what exactly is going on. People hate this result, but it’s incredibly necessary and incredibly powerful. Going to see your doctor or physical therapist is not a death sentence to your fitness and in this case it’s actually the fastest and safest way to achieve your goals. Whenever trainers/coaches/instructors act resistant to refer a client with pain to the appropriate medical professional for fear of losing a client, my response is always: “You can’t guarantee that that lower back pain isn’t cancer.” While this may seem like an extreme reach when we’re talking about a very common complaint (back pain), the fact is that pain can often be the only present symptom for a number of very serious diseases, including cancer.

One more thing to add about the FMS: There is a total score which can be generated by adding the scores from each individual test. This total score is where much of the debate exists as to whether the FMS is an accurate predictor of future injury. Several studies have examined the correlation between total score on the FMS and future injury incidence in certain athletic populations, and I’ve cited some such studies at the end of this article. I’ve used the FMS for several years now, and have never paid any particular attention to the total score on the screen. In my opinion, the movements are so different from each other, and athletic injuries vary so widely in nature, that simply combining the scores together and running some statistical analysis of injury incident vs. total score does not seem to make much sense. Due to the way the test is scored, high scores in a few movements can overshadow dysfunctions or asymmetries on other patterns.

For example, a male football player may score as such:

Deep Squat- 2

Hurdle Step- 1 left, 2 right

Inline Lunge- 1 left , 2 right

Shoulder Mobility- 3 left, 3 right

Active Straight Leg Raise- 3 left, 3 right

Trunk Stability Push-Up- 3

Rotary Stability 2 left, 2 right

When totaling score, you take the lowest score per test so, this person with a 1 left, 2 right Hurdle Step would score a 1 for that test. The total score of this screen comes out to 15, a relatively high score and usually the cut-off point for “high” vs. “low” scores in research. This person creates their high score by nailing shoulder mobility, active straight leg raise, and the push up, but I have some serious questions about their hurdle step and inline lunge, two tests which create a functional, on-your-feet demand for both mobility and stability. I would be much more concerned about this individual from an injury standpoint than somebody who had nothing but 2’s across the board with no 3’s.

I believe that an athlete playing with movement pain or severe movement dysfunction probably puts that athlete at a higher risk of athletic injury, I just don’t think a sum total of scores in the FMS is the way we should be looking at injury risk. I focus entirely on individual movement results and look at each movement as it’s own small piece to the injury risk puzzle.

The FMS is a wonderfully simple and valuable tool that can be administered in under 15 minutes and is quite reliable from test to test (see citations 2 and 3 at the end of the article). It can and should be used as a pre-participation screening prior to engaging in sport or exercise and can also be used to monitor movement progress over time, especially if dysfunctions show up at that first visit. If your trainer doesn’t use the FMS, fire him…just kidding. If he or she doesn’t use the FMS just make sure they’re doing SOMETHING to assess your movement quality the first time you meet them. Remember, that doesn’t mean “how many push-ups can you do in a minute?” Quality, not quantity. If you’re not assessing you’re just guessing, and movement is far too important to guess on.

In my next post I’ll go into greater detail on the individual tests and what they mean.

Thanks for reading!

Adam Reeder

Scholarly articles reviewing the FMS:

1) Chorba, R. S., Chorba, D. J., Bouillon, L. E., Overmyer, C. A., & Landis, J. A. (2010). Use of a functional movement screening tool to determine injury risk in female collegiate athletes. North American journal of sports physical therapy: NAJSPT, 5(2), 47.

2) J Orthop Sports Phys Ther. 2012 Jun;42(6):530-40. doi: 10.2519/jospt.2012.3838. Epub 2012 May 14.

3) J Strength Cond Res. 2013 Apr;27(4):982-7. doi: 10.1519/JSC.0b013e3182606df2.

3) Kiesel, K., Plisky, P. J., & Voight, M. L. (2007). Can serious injury in professional football be predicted by a preseason functional movement screen?. North American journal of sports physical therapy: NAJSPT, 2(3), 147.

4) Lisman, P., O’Connor, F. G., Deuster, P. A., & Knapik, J. J. (2013). Functional movement screen and aerobic fitness predict injuries in military training. Med Sci Sports Exerc, 45(4), 636-643.

5) Parchmann, C. J., & McBride, J. M. (2011). Relationship between functional movement screen and athletic performance. The Journal of Strength & Conditioning Research, 25(12), 3378-3384.

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