Functional Movement Screen (FMS): Purpose, Components, Scoring, and Benefits

What is the FMS test?

The Functional Movement Screen (FMS) is a standardized, seven-part screening tool designed to identify movement asymmetries and limitations in individuals, highlighting potential risks for injury and areas for targeted improvement in physical performance.

Introduction to the Functional Movement Screen (FMS)

Developed by physical therapists Gray Cook and Lee Burton, the Functional Movement Screen (FMS) is an innovative system widely adopted in fitness, rehabilitation, and sports performance. It is not a diagnostic tool for specific injuries or conditions, but rather a screening tool that assesses fundamental movement patterns. The primary purpose of the FMS is to identify dysfunctional movements, asymmetries, and limitations that could predispose an individual to injury or hinder optimal physical performance. By highlighting these "weak links" in the kinetic chain, the FMS provides valuable insights for creating personalized, corrective exercise strategies.

The Philosophy Behind FMS

The core philosophy of the FMS is encapsulated in the mantra, "Move well, then move often." This emphasizes the importance of movement quality over quantity. Before attempting to build strength, power, or endurance, individuals should possess a foundational level of mobility and stability. The FMS operates on the principle that the body functions as an integrated system, and a limitation in one area can compromise the entire kinetic chain. By identifying and addressing these limitations, the FMS aims to:

• Reduce Injury Risk: Correcting dysfunctional movement patterns can decrease the likelihood of musculoskeletal injuries.
• Improve Performance: Efficient movement is the cornerstone of athletic performance and daily functional tasks.
• Guide Exercise Prescription: The screen provides objective data to inform individualized exercise programs, focusing on corrective strategies before progressing to more intense training.
• Establish a Baseline: Offers a measurable baseline for tracking progress over time.

Components of the FMS Test

The FMS consists of seven fundamental movement patterns, each designed to challenge different aspects of mobility, stability, and neuromuscular control. These tests are performed without a warm-up, as the goal is to observe natural, uncoached movement.

1. Deep Squat: Assesses bilateral, symmetrical, and functional mobility of the hips, knees, and ankles, as well as bilateral and symmetrical shoulder mobility. It requires proper coordinated movement of the torso and extremities.
2. Hurdle Step: Evaluates unilateral mobility and stability of the hip, knee, and ankle. It identifies compensatory patterns during stepping, which are crucial for gait and locomotion.
3. In-Line Lunge: Measures staggered-stance stability and mobility, hip and ankle mobility, and knee stability. It assesses the ability to maintain balance and control in a reciprocal movement pattern.
4. Shoulder Mobility: Assesses bilateral shoulder range of motion, scapular stability, and thoracic spine extension. It looks for limitations in internal and external rotation, and the ability to approximate the hands behind the back.
5. Active Straight-Leg Raise: Evaluates the flexibility of the hamstrings and calves while maintaining pelvic stability. It assesses the ability to disassociate the lower limb from the pelvis.
6. Trunk Stability Push-up: Assesses reflexive core stability in the sagittal plane. It requires the ability to stabilize the spine during an upper body movement.
7. Rotary Stability: Measures multi-planar core stability and upper and lower extremity coordination. It assesses the ability to stabilize the spine while performing a contralateral limb movement.

Additionally, three "clearing tests" (shoulder impingement, spinal extension, and spinal flexion) are performed to rule out pain during movement, which would result in a score of 0 for the relevant pattern and necessitate a referral to a healthcare professional.

How the FMS is Scored

Each of the seven FMS tests is scored on a scale of 0 to 3:

• 3: The individual performs the movement perfectly, meeting all established criteria without compensation.
• 2: The individual performs the movement with slight compensation or difficulty, or fails to meet one of the established criteria.
• 1: The individual is unable to perform the movement pattern or performs it with significant compensation.
• 0: The individual experiences pain during any part of the movement pattern. A score of 0 indicates the need for immediate referral to a medical professional for further evaluation.

The maximum possible score for the FMS is 21 (7 tests x 3 points). Crucially, the FMS also notes any asymmetries between the left and right sides for tests like the Hurdle Step, In-Line Lunge, Shoulder Mobility, and Active Straight-Leg Raise. An asymmetry (e.g., scoring a 2 on one side and a 1 on the other) is considered a significant finding, even if the total score is relatively high.

Interpreting FMS Scores

While a total score provides a general overview, the FMS emphasizes the lowest individual scores and any asymmetries as the most critical findings. These low scores pinpoint the specific movement patterns that require the most attention.

• Score of 0: Indicates pain, requiring immediate referral to a healthcare provider.
• Score of 1: Represents significant dysfunction or inability to perform the movement, indicating a high priority for corrective strategies.
• Asymmetry: Even if both sides score 2, an asymmetry (e.g., 2 on left, 1 on right) is prioritized for correction, as it can lead to compensatory patterns and potential injury.
• Overall Score: While debated, a composite score of 14 or lower is often cited in research as being associated with an increased risk of injury in athletic populations. However, the true value lies in the qualitative assessment of each movement and the identification of specific dysfunctions, rather than just the sum.

Benefits of Using the FMS

The FMS offers several advantages for fitness professionals, athletes, and the general population:

• Injury Risk Screening: It helps identify individuals who may be at a higher risk of injury due to poor movement mechanics.
• Performance Optimization: By addressing fundamental movement dysfunctions, the FMS can lay the groundwork for improved strength, power, and overall athletic performance.
• Personalized Programming: Provides objective data to create highly individualized exercise programs, focusing on corrective strategies before advancing to more complex or intense training.
• Objective Baseline: Offers a standardized and repeatable assessment to track improvements in movement quality over time.
• Common Language: Creates a consistent framework and vocabulary for fitness and healthcare professionals to discuss and address movement issues.
• Prioritization of Issues: Helps identify the most significant "weak links," allowing for a focused and efficient approach to corrective exercise.

Limitations and Criticisms of the FMS

Despite its widespread use, the FMS is not without its limitations and criticisms:

• Predictive Validity Debates: While some research supports its ability to predict injury risk, other studies have found weak or inconsistent correlations, particularly in diverse populations or specific sports.
• Not Diagnostic: The FMS identifies what movement is dysfunctional, but it does not explain why it is dysfunctional (e.g., is it a mobility issue, a stability issue, or a motor control problem?). Further assessment may be needed.
• Limited Scope: It assesses fundamental movement patterns, which may not fully capture the complexity or specific demands of highly skilled or sport-specific movements.
• Reliance on Tester Skill: Proper administration and accurate scoring require training and experience to ensure reliability.
• Lack of Normative Data: While a score of 14 is often used as a general cutoff for injury risk, comprehensive normative data across various demographics and activity levels is still evolving.

Who Can Benefit from FMS Testing?

The FMS can be a valuable tool for a wide range of individuals:

• Athletes (Professional to Recreational): To identify movement limitations that could hinder performance or increase injury risk in their sport.
• Individuals Starting a New Exercise Program: To establish a safe and effective starting point, preventing injury as they increase activity levels.
• People with a History of Recurrent Injuries: To uncover underlying movement dysfunctions that may be contributing to chronic issues.
• General Fitness Enthusiasts: To improve overall movement quality, reduce aches and pains, and enhance daily functional capacity.
• Personal Trainers, Coaches, and Physical Therapists: As an objective assessment tool to guide program design and track client progress.

Integrating FMS into Your Fitness Routine

If you're considering incorporating FMS principles into your training, here's how:

• Get Assessed by a Certified Professional: Seek out a personal trainer, physical therapist, or other health professional who is certified in FMS. Their expertise ensures accurate scoring and interpretation.
• Focus on Corrective Exercises: Based on your FMS results, prioritize exercises that address your lowest scores and asymmetries. This might involve mobility drills (e.g., foam rolling, stretching), stability exercises (e.g., core bracing, single-leg balance), or motor control drills to re-educate movement patterns.
• Build a Foundation: Before adding significant load, intensity, or complexity to your workouts, ensure you have achieved competence in fundamental movement patterns.
• Re-test Periodically: Re-testing your FMS every few months can help you monitor your progress, adjust your corrective strategies, and ensure your training remains aligned with your body's needs.
• Listen to Your Body: The FMS is a guide, but always pay attention to how your body feels during exercises. Pain is a signal to stop and reassess.

Conclusion

The Functional Movement Screen (FMS) is a powerful and systematic screening tool that offers valuable insights into an individual's fundamental movement quality. By identifying asymmetries and limitations, it serves as an excellent guide for developing targeted, corrective exercise programs aimed at reducing injury risk and enhancing overall physical performance. While it is not a diagnostic tool and has its limitations, when applied by a qualified professional, the FMS embodies the critical principle that moving well is the prerequisite for moving often and moving strong.