Functional Movement Screen (FMS): What It Assesses, Benefits, and Limitations

What Does FMS Test For?

The Functional Movement Screen (FMS) assesses seven fundamental movement patterns to identify limitations, asymmetries, and pain, providing insights into an individual's movement quality, injury risk, and guiding the development of targeted corrective exercise strategies.

Understanding the Functional Movement Screen (FMS)

The Functional Movement Screen (FMS) is a standardized, systematic tool used by fitness and healthcare professionals to evaluate an individual's foundational movement patterns. Developed by physical therapist Gray Cook and athletic trainer Lee Burton, the FMS is rooted in the philosophy that quality of movement is paramount for both performance and injury prevention. It shifts the focus from how much one can lift or how far one can run, to how well one moves.

The FMS does not diagnose specific injuries or conditions. Instead, it identifies general movement limitations, muscular imbalances, and asymmetries that can predispose individuals to injury or hinder their physical performance. By observing how an individual performs a series of basic movements, the screen reveals areas of weakness, lack of mobility, or poor motor control.

The Seven Fundamental Movement Patterns Assessed by FMS

The FMS consists of seven distinct movement tests, each designed to challenge different aspects of mobility, stability, and neuromuscular control. Each test is scored on a scale from 0 to 3, with a score of 0 indicating pain during the movement, and a score of 3 representing optimal, effortless execution.

1. Deep Squat: This test evaluates bilateral, symmetrical, and functional mobility of the hips, knees, and ankles, as well as coordinated spinal stability. It requires the entire body to work in unison.
2. Hurdle Step: This assesses unilateral mobility and stability of the hip, knee, and ankle, along with stride mechanics and balance. It challenges the body's ability to maintain stability in one leg while the other moves dynamically.
3. In-Line Lunge: This test evaluates stride mechanics, hip and ankle mobility and stability, and dynamic balance. It assesses the body's ability to decelerate and control movement in a staggered stance.
4. Shoulder Mobility: This screen assesses bilateral shoulder range of motion, scapular stability, and thoracic spine extension. It looks for limitations in the combined movement of the shoulder complex and upper back.
5. Active Straight-Leg Raise: This test primarily evaluates hamstring and gastrocnemius-soleus flexibility while simultaneously assessing pelvic control and core stability. It determines the ability to disassociate hip flexion from pelvic anterior tilt.
6. Trunk Stability Push-up: This screen assesses the ability to maintain reflexive core stability and spinal alignment during an upper body pushing movement. It's not about strength, but about the body's capacity to prevent unwanted spinal motion.
7. Rotary Stability: This test evaluates multi-planar core stability, neuromuscular coordination, and the ability to perform contralateral limb movement without compensation. It challenges the body's capacity to resist rotation and maintain alignment.

What FMS Scores Indicate

Each of the seven movements is scored from 0 to 3:

• Score of 3: The individual performs the movement perfectly, meeting all criteria without compensation. This indicates optimal mobility and stability in that pattern.
• Score of 2: The individual performs the movement with slight compensation or difficulty, or requires a modification to complete it. This suggests a functional limitation.
• Score of 1: The individual is unable to perform the movement pattern or cannot meet the basic criteria. This indicates a significant limitation or dysfunction.
• Score of 0: Any pain experienced during the movement, regardless of the quality of execution, results in a score of 0. This is the most critical score, as pain is a contraindication to loading that movement pattern.

Beyond individual scores, the FMS also highlights asymmetries (different scores on left vs. right sides for unilateral tests) and the presence of pain. These are critical indicators that guide subsequent corrective strategies. A composite score (out of 21) can also be used, with lower scores generally correlating with a higher risk of injury.

The Primary Objectives and Benefits of FMS

The insights gained from the FMS serve several key objectives:

• Identify Movement Dysfunctions: Pinpoint specific limitations in mobility, stability, or motor control across fundamental patterns.
• Predict Injury Risk: Research has shown a correlation between low FMS scores (especially below 14) and an increased risk of musculoskeletal injuries in various populations, particularly athletes.
• Establish a Baseline: Provides a measurable starting point to track progress over time, especially after implementing corrective exercise programs.
• Guide Corrective Exercise Programming: The FMS results directly inform the creation of individualized, targeted exercise interventions designed to address identified weaknesses and restore optimal movement.
• Improve Performance: By addressing foundational movement deficiencies, individuals can move more efficiently, leading to enhanced athletic performance and everyday functional capacity.
• Promote Safe Training: Ensures that individuals are not progressing to more complex or heavily loaded exercises before they have established the necessary foundational movement quality, thereby reducing the risk of injury during training.

Limitations and Considerations

While a valuable tool, it's important to understand the FMS's limitations:

• Not a Diagnostic Tool: The FMS identifies dysfunction within movement patterns; it does not diagnose the cause of the dysfunction (e.g., it will show limited ankle dorsiflexion but won't tell you if it's due to tight gastrocnemius, joint capsule restriction, or nerve impingement). Further orthopedic or medical assessment may be required.
• Context Specificity: The FMS assesses general movement patterns, not sport-specific or highly complex movements. An athlete may score well on the FMS but still have specific movement issues related to their sport.
• Inter-Rater Reliability: While standardized, there can be some variability in scoring between different assessors, emphasizing the importance of trained and certified professionals.
• Part of a Broader Assessment: The FMS should ideally be integrated into a comprehensive assessment alongside other tools, such as performance tests, medical history, and specific diagnostic evaluations.

Who Can Benefit from FMS?

The FMS is a versatile tool applicable to a wide range of individuals:

• Athletes of all levels: From recreational to professional, to identify areas that could hinder performance or lead to injury.
• General fitness enthusiasts: To establish a safe and effective starting point for their exercise journey.
• Individuals with a history of recurrent injuries: To uncover underlying movement dysfunctions that may be contributing factors.
• Those starting a new exercise program: To ensure they have the foundational movement quality to safely progress.
• Anyone seeking to optimize their movement patterns: To improve overall physical literacy and reduce the risk of future pain or injury.

By understanding what the FMS tests for, individuals and professionals can leverage its insights to build more resilient bodies, enhance performance, and move with greater freedom and less pain.