Functional Movement Screen: Understanding Scoring, Patterns, and Max Score

What is the highest score one can obtain when performing the functional movement screen?

The highest score an individual can obtain when performing the Functional Movement Screen (FMS) is 21. This is achieved by scoring a perfect '3' on each of the seven distinct movement patterns assessed.

Understanding the Functional Movement Screen (FMS)

The Functional Movement Screen (FMS) is a pre-participation screening tool designed to identify an individual's fundamental movement patterns, limitations, and asymmetries. Developed by physical therapist Gray Cook and athletic trainer Lee Burton, the FMS is not a diagnostic tool but rather a system to assess movement quality and highlight areas of potential dysfunction that could contribute to injury risk or limit performance. It provides a standardized way for fitness professionals, coaches, and clinicians to observe how an individual moves through basic patterns that mimic everyday activities and athletic movements.

The FMS Scoring System Explained

The FMS consists of seven fundamental movement patterns, each scored on an ordinal scale from 0 to 3. The scoring criteria are consistent across all movements:

• Score of 3: The individual performs the movement pattern correctly, demonstrating optimal mobility, stability, and control without any compensations. This indicates an efficient and biomechanically sound movement.
• Score of 2: The individual performs the movement pattern with some compensation. This means they are able to complete the movement, but with noticeable deviations from the ideal form, suggesting mild limitations in mobility or stability.
• Score of 1: The individual is unable to perform the movement pattern, or performs it with significant compensation. This indicates a substantial limitation in mobility or stability, making the movement highly inefficient or potentially risky.
• Score of 0: Pain is experienced during any part of the movement pattern. Any report of pain, regardless of the quality of the movement, immediately results in a score of 0 for that specific movement, indicating the need for further clinical evaluation before proceeding with corrective exercises for that pattern.

The seven movement patterns assessed are:

• Deep Squat
• Hurdle Step (Left and Right)
• In-Line Lunge (Left and Right)
• Shoulder Mobility (Left and Right)
• Active Straight-Leg Raise (Left and Right)
• Trunk Stability Push-Up
• Rotary Stability (Left and Right)

It's important to note that while some movements are scored bilaterally (left and right), only the lower of the two scores for a bilateral movement contributes to the total score. For instance, if an individual scores a 3 on the left Hurdle Step and a 2 on the right, their score for the Hurdle Step movement pattern is recorded as a 2.

Calculating the Maximum Score

Given that there are seven distinct movement patterns, and the highest score achievable for each pattern is 3, the maximum total score for the Functional Movement Screen is calculated as follows:

7 Movement Patterns x 3 Points/Pattern = 21 Points

Therefore, a score of 21 signifies that an individual has demonstrated optimal movement quality across all seven fundamental patterns without any compensations or pain.

Is a Perfect Score (21) Always the Goal?

While a score of 21 indicates excellent fundamental movement quality, the primary goal of the FMS is not simply to achieve the highest possible score. Instead, the FMS aims to:

• Identify Dysfunctions: Pinpoint specific movement limitations, asymmetries, or pain that could predispose an individual to injury.
• Guide Intervention: Provide data-driven insights to develop individualized exercise programs that address identified weaknesses and improve movement patterns.
• Establish a Baseline: Offer a measurable starting point to track progress as corrective strategies are implemented.

For example, an individual might score a 21, but if they have a history of certain injuries or specific sport demands, further, more specific assessments might still be warranted. Conversely, someone with a lower score might have a greater need for targeted corrective exercises to improve their foundational movement.

The Significance of Individual Movement Scores

The true value of the FMS lies not just in the total score, but in the detailed breakdown of scores for each individual movement pattern.

• Asymmetries: Discrepancies between left and right sides (e.g., a 3 on one side for the Hurdle Step and a 1 on the other) are particularly important. These asymmetries can indicate imbalances that may lead to overuse injuries or affect athletic performance.
• Lowest Scores: Movement patterns with scores of 1 or 0 are considered "red flags." These are the areas that require immediate attention and targeted corrective strategies before progressing to more complex or loaded exercises.
• Pain (Score of 0): Any movement that elicits pain (a score of 0) overrides all other considerations and indicates that the individual should be referred to a healthcare professional for further evaluation before any exercise intervention is prescribed for that specific movement.

Beyond the Score: Corrective Strategies

The FMS is designed to be actionable. Once scores are obtained, they inform the development of a progressive exercise plan. The FMS philosophy emphasizes addressing the most dysfunctional patterns first, following a "correct, then train" principle. Corrective exercises are prescribed to improve mobility, stability, and motor control in the areas where limitations were identified, ultimately aiming to improve overall movement quality and reduce injury risk.

Limitations and Considerations of the FMS

It's crucial to understand that the FMS is a screening tool, not a diagnostic one. It does not diagnose specific injuries or medical conditions. It should be used as part of a comprehensive assessment and interpreted by trained professionals. Factors such as fatigue, acute injury, or neurological conditions can influence scores and should be considered during interpretation. The FMS is most effective when used consistently over time to track an individual's movement health and guide intelligent exercise programming.