Functional Movement Screen (FMS): Understanding Its Purpose, How It's Conducted, and Benefits

What is FMS activity?

The Functional Movement Screen (FMS) is a standardized assessment tool designed to evaluate fundamental movement patterns, identify asymmetries, and pinpoint limitations or pain that may predispose individuals to injury or hinder performance.

Understanding the Functional Movement Screen (FMS)

The Functional Movement Screen (FMS) is a systematic method developed by physical therapist Gray Cook and athletic trainer Lee Burton to identify movement limitations, asymmetries, and potential weaknesses in individuals. It is not a diagnostic tool for specific injuries but rather a screening tool to assess general movement competency. The FMS focuses on the quality of movement, rather than the quantity (e.g., how much weight can be lifted or how fast one can run), providing insight into how well an individual moves through basic, unweighted patterns.

The Purpose of FMS

The primary goals of conducting an FMS assessment are:

• Identify Movement Limitations and Asymmetries: To uncover restrictions in mobility, stability, or motor control that might not be obvious during daily activities or sport-specific movements.
• Establish a Baseline: To create a measurable starting point for an individual's movement quality, allowing for tracking progress over time.
• Predict Injury Risk: While not definitive, lower FMS scores and significant asymmetries have been correlated in some research with an increased likelihood of injury in various populations.
• Guide Corrective Exercise Programming: To provide a clear roadmap for designing individualized exercise programs that address specific movement dysfunctions, rather than generic training.
• Enhance Performance: By addressing fundamental movement deficits, the FMS aims to improve overall movement efficiency, which can translate to better athletic performance and reduced compensatory patterns.

How the FMS is Conducted (Brief Overview)

The FMS is administered by trained and certified professionals, such as physical therapists, athletic trainers, or personal trainers. It consists of seven distinct movement patterns, each designed to challenge different aspects of mobility and stability.

The seven FMS tests are:

• Deep Squat: Assesses bilateral, symmetrical and functional mobility of the hips, knees, and ankles, as well as core stability.
• Hurdle Step: Evaluates unilateral mobility and stability of the hip, knee, and ankle, along with core stability during a stepping motion.
• In-Line Lunge: Challenges hip, ankle, and step stability and mobility, requiring dynamic balance and trunk control.
• Shoulder Mobility: Measures bilateral range of motion in the shoulders and scapular stability, often revealing restrictions in the thoracic spine or glenohumeral joint.
• Active Straight-Leg Raise: Assesses active hip flexion mobility and core stability, indicating hamstring flexibility and pelvic control.
• Trunk Stability Push-up: Evaluates reflexive core stabilization in the sagittal plane, focusing on the ability to maintain spinal alignment during an upper body movement.
• Rotary Stability: Examines multi-planar core stability and neuromuscular coordination between the upper and lower body.

Each movement pattern is scored on a scale from 0 to 3:

• 3: The individual performs the movement correctly without any compensation.
• 2: The individual performs the movement with slight compensation or difficulty.
• 1: The individual is unable to perform the movement correctly or completes it with significant compensation.
• 0: The individual experiences pain during any part of the movement.

A composite score out of 21 is generated, but the individual scores and identification of asymmetries (e.g., scoring differently on left vs. right side for unilateral tests) are often more critical for guiding interventions.

Interpreting FMS Scores

Interpreting FMS scores goes beyond just the total number. The professional administering the screen will look for:

• Scores of 1 or 0: These indicate a significant limitation or the presence of pain, which are prioritized for corrective strategies. Pain (score of 0) always takes precedence.
• Asymmetries: Unequal scores between the left and right sides on unilateral tests (Hurdle Step, In-Line Lunge, Active Straight-Leg Raise) are critical indicators of potential imbalances.
• Specific Patterns: Certain combinations of low scores can point to common movement dysfunctions (e.g., poor ankle mobility affecting the Deep Squat).
• Overall Score Thresholds: While a general guideline, a composite score below 14 has often been cited in research as a potential indicator of increased injury risk in certain populations.

Benefits of FMS

The FMS offers several advantages for individuals and professionals in the health and fitness industry:

• Proactive Injury Prevention: By identifying potential movement flaws before they lead to injury, FMS allows for targeted interventions to mitigate risk.
• Personalized Training Programs: It moves away from generic workout plans, enabling trainers and therapists to design highly specific corrective exercise strategies.
• Objective Measurement: Provides a quantifiable baseline of movement quality, allowing for objective tracking of progress and the effectiveness of interventions.
• Enhanced Performance: Addressing underlying movement dysfunctions can improve overall movement efficiency, leading to better athletic performance and reduced energy expenditure.
• Improved Communication: Offers a common language and framework for communication between fitness professionals, physical therapists, and clients regarding movement health.

Limitations and Considerations

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

• Not a Diagnostic Tool: The FMS screens for movement dysfunction but does not diagnose specific injuries, conditions, or the underlying cause of a movement problem (e.g., is poor squat due to tight ankles or weak glutes?).
• Context-Specific: FMS scores are relative to the individual and their activity level. A score that is concerning for an elite athlete might be acceptable for a sedentary individual.
• Requires Certified Administrator: Accurate administration and interpretation require proper training and certification to ensure reliability and validity of the screen.
• Limited Scope: It assesses fundamental movement patterns and does not evaluate sport-specific skills, strength, power, or endurance directly.
• Research Debate: While widely used, the extent of its predictive validity for injury prevention across all populations remains a topic of ongoing research and discussion in the scientific community.

Who Can Benefit from FMS?

The FMS can be beneficial for a wide range of individuals, including:

• Athletes: From recreational to professional, to identify movement limitations that could hinder performance or increase injury risk during sport-specific activities.
• General Fitness Enthusiasts: To ensure a solid movement foundation before embarking on more intense exercise programs.
• Individuals Returning to Activity: After an injury or period of inactivity, to assess readiness and guide safe progression.
• Anyone Concerned About Movement Quality: Those looking to improve their functional movement, reduce pain, or simply move more efficiently in daily life.

FMS and Corrective Exercise

Once the FMS identifies dysfunctional movement patterns or asymmetries, the information is used to prescribe targeted corrective exercises. The philosophy behind FMS-guided correction often follows a "pain, then dysfunction" hierarchy. Any painful movements are addressed first, often by a healthcare professional. After pain is managed, the focus shifts to addressing the most restrictive or dysfunctional patterns identified by low scores or asymmetries. The goal is typically to restore mobility first, then establish stability, and finally integrate these improvements into more complex movements and strength training.

Conclusion

The Functional Movement Screen (FMS) is a valuable, systematic approach to evaluating fundamental human movement. By providing a clear snapshot of an individual's movement quality, it serves as an excellent tool for fitness professionals and healthcare providers to identify potential areas of concern. While not a diagnostic instrument, the FMS is instrumental in guiding personalized corrective exercise strategies, thereby promoting safer, more effective training, reducing injury risk, and ultimately enhancing an individual's overall movement health and performance.