This January I traveled down to Sydney to take the Functional Movement Screen (FMS) Levels 1 & 2. To be honest, it was quite overdue as I had been looking at the material for over two years but never had a chance to get taught it correctly. In essence, the Functional Movement Screen is a series of seven movement patterns that require some form of balance, stability or mobility. It is massively popular in the United States at the moment (most NFL teams use the FMS in their training programs) and it is a great method of getting a good idea of where you are at in terms of your injury risk; whether you are an athlete or not.
Now people can get confused with the actual purpose of the FMS and it is not designed to be used to predict athletic performance (which recent studies concur on). For instance, just because you score less on the FMS than another athlete does not make you a worse athlete in your chosen sport.
What it is designed to do however is to give you an idea of the quality of movement patterns and an indication of injury risk based on biomechanics. Now before I go further, I must mention that biomechanics are only one factor that contributes to your injury risk. For instance, some researchers have found that back pain is almost 60% genetic so if your parents had back pain, sorry but you are likely to have it too. Other proven factors include chemical makeup of individuals (i.e. an imbalance of fatty acids, low cellular pH), proprioception and neuromuscular control at joints, gender, hormonal levels, previous injury history, previous activity levels and BMI (sometimes you just have to lose some weight to take the loads of the joints!). So although as health professionals we would love it if biomechanics were the be all and end all for improving injuries because it is something we can assess and control easily, unfortunately it is really multifactorial. In saying that though, we need to address biomechanics and the FMS is a great place to start.
Here is the FMS being used on Nike's top basketballers in the U.S. - if you are a sports geek like you'll love the video!
The FMS consists of as mentioned seven movements: the overhead squat, hurdle step, inline lunge, shoulder mobility, active straight leg raise, trunk stability push up and rotary stability. There are a few orthopedic screening tests that are also included but basically you get scored out of 3 for each movement and if you score less than 14 – 16 out of 21 (depending on the study and population i.e. NFL players vs. firefighters) you are around 4 times more likely to be injured. Also if you have asymmetries in the test (one leg you get a score of 3 and another you get a score of 1) then you are also much more likely to be injured.
The 7 Movements of the FMS
So after attending the course and becoming certified, I consider the FMS a great tool to check up on how you are doing in regards to injury risk. You can think of it as being similar to using your blood pressure to check your cardiac risk or going to a dentist for a yearly annual check up. It is something you should do to know what is going on. Anyway apart from learning the nuts and bolts, there were also a few great little pieces of advice I picked up or was reminded of that I thought I would share with you. Here they are:
For most cases, if you mobility problems (i.e. you cannot get enough range of motion at a joint) that needs to be addressed before trying to add stability exercises. So it is no good doing full squats with weight until you can get in the full squat position first.
Your ability to dorsiflex the ankle (pull the toes up to the knee) decreases the need for flexion of the lumbar spine during locomotion (i.e. running or walking). This is crucial as we don’t really want the lumbar spine to be doing countless flexion cycles during running or walking as it will potentially place a heap of wear and tear of lumbar structures and vertebral discs. Because of this I really like machine dorsiflexion movements.
Improving dorsiflexion function will help lower back function during running
If you have problems with the hips, you are probably going to have to address those first before you look at shoulder issues. The shoulder has a really intimate relationships with both the ipsilateral (same side) and the contralateral (opposite side) hip. As a tip, this relationship also exists with the ankles as well! Nevertheless, it never ceases to amaze me how fixing hip problems leads to a decrease in shoulder issues and if you both at the same time, always concentrate on the hips.
If your hips are not up to speed, they are going to play havoc on your shoulders
Another thing to check over before addressing shoulder problems or injuries is both thoracic extension and thoracic rotation. If either of these are deficient it means the shoulder (and especially the external rotators as they decelerate the arm in punching, pressing or throwing motions) will have to go through a whole lot more wear and tear than what you would like. This will eventually lead to overuse and chronic injuries like rotator cuff tendosis.
In athletic positions, you normally generate power from three positions: a squat stance, a split squat (or lunge) stance or on one leg. The FMS does a nice job of seeing if there are issues in one or the other and which one you might need to devote a bit more time to. So for instance, if someone scored a 3 on the overhead squat (which is perfect) but only a 1 on the hurdle step then they are more than likely going to need more work on one leg exercises than on squatting type exercises.