Regularly assessing mobility and stability will give athletes an indication of their functional status and injury risk

MOT your body with functional movement screening

At a glance

You wouldn’t take your car out on the highway without checking out its basic roadworthiness. But that’s exactly what many sportsmen and women do when it comes to subjecting their bodies to the rigours of training for competition. The answer according to Nick Grantham is ‘functional movement screening’…

Once a year, I put my car into the garage for its annual MOT in order to ensure that it’s in a roadworthy condition. More often than not, mine fails, which results in me having to get something fixed! And even when it does pass, there are usually a couple of ‘advisory’ notes, pointing out areas that are likely to need attention in the next few months or things that, while not essential, would help the car run better if they were sorted.

Although it’s a crude analogy, our bodies are rather like cars. Over time, mechanical changes take place (injuries, scar tissue, strength imbalances and weaknesses, loss of flexibility etc) with the result that our bodies don’t work as efficiently as they were designed to. In many situations, our ability to move through the most basic and fundamental movements can become compromised. If this ability to move efficiently goes unchecked, there’s a strong likelihood that we will develop compensatory movement patterns, which can eventually result in lost performance and injury.
There is no single reason for picking up an injury. Several factors can and often do contribute, including; previous injuries, gender, anthropometric characteristics, poor flexibility, decreased performance indicators such as vertical jump, a longer response time, postural sway and balance. However, by assessing the quality of some of our basic and fundamental movements with a ‘movement MOT’, we can help to ensure that we are moving as efficiently as possible and therefore reduce the risk of injury.

Functional movement screen

During the past 12 years working as a strength and conditioning coach, I’ve seen many athletes and clients who have performed high-level activities even though they were inefficient in their fundamental movements. They seemed able to get by with poor movement patterns, for example by training around a pre-existing problem or more often than not, simply avoiding training their weaknesses! These potential but initially less obvious problems can slip through the traditional process of physiotherapy screening and fitness testing, resulting in long-term fundamental weaknesses. When this happens, even the best programmes, equipment and coaching applied subsequently will not be able to produce the goods.

One tool that I now use during every evaluation of an athlete or client is the functional movement screen (FMS), which is an extremely effective evaluation tool. The functional movement screen was developed and continues to be refined by Gray Cook, a board certified orthopaedic clinical specialist with the American Physical Therapy Association. Originally developed for use with athletic populations, this simple screening system can easily be applied to non-athletic individuals. The underlying premise is that we should all be working on developing quality of motion before quantity of motion (1, 2). The FMS consists of seven tests that assess mobility and stability as an indication of an athlete’s functional status and injury risk (3,4). The purpose of the screen is to:

  • Develop an athlete’s ability to move through fundamental patterns of movement;
  • Improve performance related gross athleticism;
  • Improve sport specific skills and performance.

While more traditional screening methods are still important for identifying potential injury and movement problems, the FMS is a simple screening tool that can be used by pretty much anyone to evaluate function. The beauty in practice is that the FMS focuses on movement oriented tests, is portable and easily administered (you can get this done in about 10 mins) and it has good levels of reliability.

Research conducted on American football players showed that the FMS was able to assess fundamental movement dysfunction and improve the probability of support staff being able to predict a time loss injury. Players with a FMS score of 14 or less had a greater chance of injury and were approximately 11 times more likely to be injured. Moreover, players with an asymmetry were three times more likely to injured (5).

Other studies have shown that the FMS is a useful tool for exposing possible movement weaknesses in male and female collegiate level athletes (3) and firefighters (6). The research on firefighters showed that following a FMS and an appropriate intervention to improve flexibility and strength, the time lost due to subsequent injuries fell by 62% and the number of injuries fell by 42% over a 12-month period compared to historical data (5).

Benefits of FMS

  1. Improves functional and athletic performance;
  2. Helps reduce the potential for training and sports injuries;
  3. Provides a simple grading system to assess athlete/client movement;
  4. Can be used by both athletic/sports medicine and general fitness professionals;
  5. Identifies physical imbalances or weaknesses;
  6. Allows trainers to better individualise training programmes for better athlete/client results;
  7. Teaches the trainer and athlete/client to identify the difference between movement quality and movement quantity;
  8. Allows athletic trainers, strength and conditioning specialists, personal trainers and physiotherapists to identify current injury trends and stats as they relate to the prevention of non-contact injuries;
  9. Allows trainers to identify potential cause and effect relationships of micro-trauma as well chronic injuries in relation to movement asymmetries (1,2).

Scoring

The scoring for the FMS is very simple. There are just four possibilities for each test; these can then help identify where any potential problems lie and indicate how the athlete/client can best reach their goal(s). The scoring is as follows:

No problems – score 3 points

Issue (minor limitation in movement) – score 2 points

Major issue (gross limitation in movement) – score 1 point

Pain associated with movement – score 0 points (a medical professional should perform a thorough evaluation of the painful area).

The tests

The basic seven-test FMS forms an ideal basis for an athlete assessment. It is beyond the scope of this article to provide a comprehensive overview of all the tests and corrective exercises but this next section will provide you with an understanding of the FMS, how to administer the three lower body tests (the upper body tests will follow in part 2) and how to interpret the results in order to determine what some of the potential problem areas could be.

Conclusion

The purpose of this article was to introduce you to a simple and effective movement screen that could help you to improve the functional and athletic performance of your clients, whilst at the same time reducing the potential for training and sports injuries. In the second part of this two-part article, we’ll look at the remaining four functional movement tests of the seven-test functional movement screen. These are for shoulder mobility, trunk stability during push ups, rotary stability and stability during active straight leg raises.

Deep Squat

 

Hurdle Step

 

In-line Lunge

References

1. Cook, G Athletic Body In Balance, Human Kinetics 2003
2. G Cook, L Burton & K Fields Functional Movement Screen (self published training manual for the FMS)
3. C Murphy Functional movement screening of NCAA Division II male and female athletes. MS Thesis, 2001
4. J Strength & Conditioning Coach 2007, 15 (4) 3-4
5. NAJSPT, 2007;2 (3):147-158
6. J Occupational Medicine & Toxicology 2007, 2 (3)

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