Functional Movement Screening

Rotary Stability

The Functional Movement Screening (FMS) includes flexibility, mobility, balance, stability, and injury screening components through common movement patterns. Subjects are graded on a point system to indicate if a particular movement screen is adequately executed. 

The FMS was intended as a tool of risk management by identifying compensatory movement patterns and asymmetries in the kinetic chain (Cook 2010, Reiman & Manske 2009). Interestingly, the FMS has only been found to be positive in 24% of athletes eventually suffering an injury, using a  composite score of ≤14 (Wright 2016). Attributing performance or potential for injury to any one variable or limited group of variables is difficult because, but its very nature, human movement is multifactorial, involving strength, power, endurance, mobility, and motor skill (NSCA 2012).

However, the FMS was never intended to be an be-all and end-all injury screening test. Furthermore, a composite score had never been a part of the FMS. Instead, the FMS is designed to assess movement competency to determine exercise selection. Indications of significant disfunctions or pain is a clear indication that certain movement patterns should not be loaded until they have been addressed through corrective exercises. (FMS 2018)

The FMS is not intended to determine why a dysfunction or faulty movement pattern exists. Once a asymmetry or deficiency is detected through the FMS, more precise measurements can be used (eg: Selective Functional Movement Assessment [SFMA]). Measuring all the joint's range of motions would be a less efficient alternative to the FMS. Firstly, analyzing individual joints for normal ranges of motion do not effectively assess each joints function within whole body movements. Secondly, joint positions in FMS do not exceed normal range of motion. (Cook 2010)

Individuals aware of acute pain should not go through FMS. Particular tests can be omitted for individuals limited by self-imposed or imposed physical incapacity, disability, or medical restrictions, such as handicapped or morbidly obese. If contraindications do not exist, perform all screen test even if you think one might not be important for client. (Cook 2010)

The FMS was originally developed to rate and rank movement patterns in high school children. Younger children may not score well on a full screen, particularly after periods of rapid growth, but it can still expose deficiency and associated risk. The FMS is prudent and appropriate if children are involved in athletics or formal supervised exercise. (Cook 2010)

Scoring

The FMS requires careful observation by trained clinician and should be critically scored.

3: Completed movement consistent with description
2: Completed movement with faulty form, loss of alignment, or compensation
1: Incomplete movement
0: Any of above with pain or discomfort.

For each screening test with a score of 2 or less on either side remove specified activities noted below until movement pattern can be restored with corrective exercise. If pain (0), refer to health care professional for further evaluation and treatment.

FMS Tests

Inline Lunge

  • Bilateral assessment
  • Score of 2 or less, discontinue activities until corrected:
    • Exercise and loads involving the lunge pattern.
  • Assesses
    • Hip Extension (thigh should be inline with torso)
    • Ankle Dorsal Flexion

Hurdle Step

  • Bilateral assessment
  • Score of 2 or less, discontinue activities until corrected:
    • Exercises and loads involving the single-leg pattern.
  • Assesses
    • Hip Imbalances Internal / External Rotation
      • Weaker muscles should be strengthened and opposite tighter muscle should be stretched.
  • Hip drop on side of lifted leg indicative of weak hip abductors

Deep Overhead Squat

  • Score of 2 or less, discontinue activities until corrected:
    • Exercise involving part or all of squatting pattern.
  • Assesses
    • Shoulder Extension
    • Shoulder Girdle Retraction
    • Spinal Extension
    • Knee Flexion
    • Ankle Dorsiflexion
    • Hip Flexion
      • Note point of hip wink (neutral to flexed spine) . near bottom of squat
    • Low level screening for valgus collapse
      • Ankle Dorsal Flexion inflexibility or Imbalance of hip musculature
        • Hip Imbalances Internal / External Rotation
          • Weaker muscles should be strengthened and opposite tighter muscle should be stretched.
    • Activity restrictions with score of 2 or less
      •  

Active Straight-Leg Raise

  • Bilateral assessment
  • Score of 2 or less, discontinue activities until corrected:
    • Heavy closed-chain loaded activities, running and plyometrics.
  • Assesses
    • Hip Flexion with knee straight (Hamstring)
    • Bilateral assessment for asymmetries

Shoulder Mobility

  • Bilateral assessment
  • Score of 2 or less, discontinue activities until corrected:
    • Heavy arm pushing and pulling, overhead pushing and pulling.
  • AKA Active Scapular Stability Test or Impingement Clearing Test
  • Assesses
    • Shoulder extension, flexion, internal rotation, external rotation
    • Shoulder girdle upward and downward rotation, protraction, retraction

Shoulder Clearance

In context of FMS, this bilateral test is not used to test for mobility. Instead it identifies impingement pain in the shoulder. If pain is perceived on either side, a positive (+) is recorded and a score of zero is given to the entire Shoulder Mobility test.

Rotary Stability

  • Sub-Maximum Stabilization Test
  • Score of 2 or less, discontinue activities until corrected:
    • Conventional core training, training that would cause high threshold core control.

Spinal Flexion Clearance

  • In context of FMS, this test is not used to test for mobility. Instead it identifies pain in flexion position. If pain is perceived, a positive (+) is recorded and a score of zero is give to the entire Rotary Stability test.

Trunk Stability Push-up

  • High-threshold stabilization test
    • Tests for ability to handle heavy lifting or high-threshold core activities.
  • Score of 2 or less, discontinue activities until corrected:
    • Conventional Core Training
    • Heavy upper and lower body loads
    • Vigorous plyometric activity.

Spinal Extension Clearance

In context of FMS, this test is not used to test for mobility. Instead it identifies pain in extension as a provocation sign for spinal dysfunction. Refer to medical professional if pain is perceived. If pain is perceived, a positive (+) is  recorded and a score of zero is given to the entire Trunk Stability Push-up test (page 100).

Corrective Exercises

The FMS Corrective Techniques Poster Set and FMS Exercise Database provides corrective exercises for participants who score a 1 or 2 on any given FMS tests. In addition, any joint movement involved in a particular FMS test can be reevaluated in isolation to determine which joints and muscle groups should be stretched when designing the participants customize mobility routine (see Joint Range of Motions and Flexibility and Functional Assessments). However, it should be noted that working on strength and flexibility problems in isolation does not make movement patterns better. 

Faulty movement pattern requires more than performing corrective exercises. It is thought that compensatory movement patterns develop to overcome stability and mobility deficiencies. These poor movement patterns are used subconsciously whenever executing future tasks leading to greater mobility and stability imbalances and deficiencies which increase risk of injury. Movement habits, exercise programs, activities, occupational duties, and athletics can all perpetuate faulty movement patterns. These activities should be discontinued until the participant has established a functional movement platform. (Cook 2010)


Equipment

  • 48” x 2” ×6” wood plank
    • 60" x 1 ⅞” x 5 ⅜’ 
    • 152.4 cm x 4.76 cm x 13.65 cm
    • Marked every inch (0-36), starting 12 inches from one end 
    • Two holes on side ~2″ (5 cm) deep
  • 48.5” dowel x 1.25" diameter
    • 122.5 cm x 3.175 cm diameter
  • Two dowels: 24” x 1.25" diameter
    • 68 cm x 3.175 cm diameter
  • TheraBand or rope/string hurdle
    • Loops at end

References

Cook G (2010) Movement: Functional Movement Systems. Lotus Publishing.

FMS (2018) Injury Prediction And The Origins Of The FMS. YouTube.

Foran B, Chu DA (2001). High-Performance Sports Conditioning, Human Kinetics, 19-48.

NSCA (2012) NSCA's guide to tests and assessments. Human Kinetics, pg 281.

Reiman MP, Manske RC (2009). Functional testing and human performance. Human Kinetics, pg 90.

Wright A, Stern B, Hegedus E, Tarara D, Taylor J, Dischiavi, S (2016). Potential limitations of the Functional Movement Screen: A clinical commentary. British Journal of Sports Medicine; DO 10.1136/bjsports-2015-095796.

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