Functional Movement Screen (FMS): Scoring, Interpretation, and Injury Risk

What is the Average FMS Score?

While there isn't a universally defined "average" FMS score that indicates optimal function, research consistently shows that a composite score below 14 out of a possible 21 points is often associated with an increased risk of injury in various populations.

Understanding the Functional Movement Screen (FMS)

The Functional Movement Screen (FMS) is a systematic tool designed to evaluate seven fundamental movement patterns in individuals. Developed by physical therapist Gray Cook and athletic trainer Lee Burton, its primary purpose is not to diagnose specific conditions, but rather to identify asymmetries, limitations, and pain within these basic movements. By uncovering these dysfunctions, the FMS aims to:

• Identify movement inefficiencies: Pinpoint areas where an individual lacks proper mobility, stability, or motor control.
• Predict injury risk: Research suggests a correlation between certain FMS scores and the likelihood of future non-contact injuries.
• Guide corrective exercise strategies: Provide a roadmap for fitness professionals and clinicians to develop targeted interventions that address identified limitations, thereby improving movement quality and reducing injury potential.

The seven movement patterns assessed are:

• Deep Squat
• Hurdle Step
• In-Line Lunge
• Shoulder Mobility
• Active Straight-Leg Raise
• Trunk Stability Push-up
• Rotary Stability

How the FMS is Scored

Each of the seven movement patterns is scored on a scale of 0 to 3, yielding a maximum possible composite score of 21.

• Score of 3: The individual performs the movement perfectly, meeting all established criteria. This indicates no apparent limitation.
• Score of 2: The individual performs the movement with some compensation or minor deviation, indicating a slight limitation or inefficiency.
• Score of 1: The individual is unable to perform the movement correctly or complete the pattern, highlighting a significant limitation.
• Score of 0: Pain is experienced during any part of the movement pattern. This is the most critical score, immediately indicating a need for clinical evaluation rather than just corrective exercise.

Beyond the numerical score, the FMS also notes asymmetries. If a bilateral movement (like the Hurdle Step or In-Line Lunge) is performed differently on each side, the lower score for that pattern is recorded, and the asymmetry is highlighted as a critical area for intervention.

Is There an "Average" FMS Score?

While studies often report mean FMS scores for specific populations (e.g., collegiate athletes, military personnel, general fitness enthusiasts), it's crucial to understand that the FMS is not designed to establish a population "average" as a benchmark for optimal function. Instead, its utility lies in identifying individual deviations from ideal movement patterns.

However, in the context of injury prediction, a widely recognized threshold has emerged:

• The "Cutoff Score" of 14: Numerous research studies, particularly those involving athletic populations, have identified a composite FMS score of 14 or less as a significant indicator of increased injury risk. Individuals scoring 14 or below are often found to be at a higher statistical likelihood of sustaining a non-contact musculoskeletal injury compared to those scoring above 14.

It's important to note that this "average" in research refers to statistical means, which can vary widely depending on the population tested (age, activity level, sport). For example:

• Athletic Populations: May have higher average scores due to their training, but still exhibit the "below 14" injury risk.
• General Populations: Might have lower average scores due to sedentary lifestyles or existing musculoskeletal issues.

Therefore, rather than focusing on hitting a specific "average" number, the FMS emphasizes identifying and addressing dysfunctions and asymmetries regardless of the total score.

Interpreting Your FMS Score

Understanding what your FMS score means is more nuanced than simply looking at the total.

• Scores of 0: Any movement pattern that elicits pain (a score of 0) immediately signals a need for a referral to a healthcare professional (e.g., physical therapist, physician) for further evaluation. Pain is a red flag that supersedes all other scores.
• Asymmetries (e.g., 1 on one side, 2 on the other): These are critical findings. Even with a high total score, significant differences between sides indicate potential imbalances that can lead to compensatory movements and increased injury risk.
• Scores of 1 on Individual Patterns: A score of 1 indicates a significant limitation in that specific movement. These are primary targets for corrective exercises.
• Composite Score Below 14: As discussed, this strongly suggests a higher likelihood of future injury and indicates a need for a comprehensive corrective exercise program focusing on addressing the underlying movement dysfunctions.
• Composite Score of 14-17: While potentially indicating moderate movement quality, there may still be specific patterns with scores of 1 or 2 that warrant attention.
• Composite Score Above 17: Generally indicates good fundamental movement patterns, though specific patterns might still benefit from refinement.

The Purpose of the FMS: Beyond the Score

The true value of the FMS is not just the number, but what that number helps you understand and what actions it prompts. It serves as:

• A Screening Tool: It's a quick, efficient way to screen for fundamental movement competency, not a diagnostic tool for specific injuries or conditions.
• A Baseline Measure: It provides a snapshot of an individual's movement quality at a given time, allowing for re-evaluation to track progress after corrective interventions.
• A Guide for Programming: The specific patterns that score low or show asymmetry directly inform the design of personalized exercise programs. For example, a low score on the Deep Squat might indicate a need for ankle mobility or hip stability work.
• A Risk Management Tool: By identifying those at higher risk of injury, it allows for proactive intervention, potentially preventing injuries before they occur.

Limitations and Considerations

While valuable, it's important to recognize the FMS's limitations:

• Not Diagnostic: The FMS does not tell you why a movement is limited (e.g., muscle weakness, joint restriction, neurological issue). It only tells you that it is limited.
• Requires Trained Professionals: Accurate administration and interpretation of the FMS require specific training and certification.
• Context Matters: An FMS score should always be considered within the broader context of an individual's health history, activity level, and specific goals.

Conclusion: Actionable Insights from Your FMS

In summary, while there isn't a single "average" FMS score to strive for, the research-backed threshold of 14 serves as a critical indicator for injury risk. The true power of the FMS lies in its ability to systematically identify individual movement dysfunctions, asymmetries, and pain points. For fitness enthusiasts, athletes, and trainers alike, understanding your FMS score, especially individual pattern scores and the presence of asymmetries, provides invaluable data to tailor exercise programs, enhance movement quality, and ultimately, build a more resilient and injury-resistant body. Always consult with a certified FMS professional for accurate screening and personalized guidance.