State of the FMS: a 2013 recap

The Functional Movement Screen (FMS) came under criticism from several sources late this year, both in the academic world and within the ambit of my social media channels. While all of these criticisms should be taken into account, I would urge trainers and strength coaches to read this before making the decision on whether or not to learn and utilize this particular tool.

What we do as professionals should be heavily research-influenced. However, that doesn’t mean we should discard something altogether before a superior solution has been offered. In the words of my eight grade science teacher, “don’t give me problems, give me solutions.”

I’ve been integrating the FMS into my assessment process for about five years now. I don’t have a specific emotional attachment to it, nor would I hesitate to replace it if something better were to come along. Yet, I just keep on screening. This is, very simply, because it’s useful. I’m going to use this post as an opportunity to explain why.

Before we can really discuss the predictive value of the FMS for injury or whatever else people think it’s supposed to offer, it’s important to first and foremost view it as a tool for critical thinking. If it performs this role, it is valuable.

If you’re skeptical of the FMS, the first question I have for you is a simple one: do you believe that it’s a good idea to examine global movement patterns? In other words, does the ability to perform a pattern, such as a squat, without pain or significant compensation provide us with important information?

If your answer is no, we can amicably part ways here. If your answer is yes, let’s continue.

We’re going to deal with the details of the movement patterns specific to the FMS later. So for now, we’ve simply agreed that examining movement is useful. A good sprint coach will be able to speak volumes about a hitherto unseen athlete just by watching them run. A good swim coach will be able to do the same once they see someone in the water. That global information is more meaningful to them than a collection of measurements of joint range of motion.

Does that mean that whipping out the goniometer or muscle testing protocols can’t be helpful? Not at all. However, in the context of the FMS, these tools would be used to explore an issue exposed by faulty movement pattern. It is simply more time-efficient to first identify potential issues (the FMS only takes about 10 minutes to execute) and then explore them in greater depth.

Easy there, cowboy

Once again, the FMS simply helps us ask questions about movement. Once you know what those questions are, you can use any set of tools you have at your disposal to answer them.

Why do we have to look beyond a competitive movement? This is necessary if you believe that a lack of competency in one fundamental movement pattern (again, we’ll talk about the details later) may have an impact on overall performance.

In other words, if a person is unable to perform a lunge pattern properly (perhaps symmetrically) could that have an impact on their squat pattern? What about a larger apparent gap? For example, if someone is unable to perform a push-up without their trunk sagging into extension, could that lack of core stability negatively impact an overhead press?

Again, if you don’t think this is the case, then the rest of this conversation must be confidential. Would you wait outside?

The next concept is something that I personally find very interesting. If we can agree that there are a number of fundamental movement patterns, and that they share enough in common to impact one another, we can then begin to unravel which ones take priority over others. For example, if someone lacks the stability to bring their elbow to the opposite knee in a quadruped position (rotary stability in the FMS), could that impact their running? It’s not a guarantee but it introduces a great place to start asking questions.

If these two movements are related, we can expect that improving one will positively impact the other. We can also reasonably expect that cleaning up the variation with fewer moving parts (joints in play, stability demands, speed demands, etc) will typically be more efficient. Is this guaranteed? Of course not. Test, perform your intervention, retest. If you have something better, use it and share it with the world! The FMS is, once again, just a good way to focus your gaze.

Do I need to watch this lady press a barbell overhead or perform a deadlift to know that she’s going to tend toward lumbar hyperextension?

I have enormous difficulty finding fault with the thought process that has brought us this far. I think that the only real room for debate is what constitutes a fundamental movement pattern and whether the movement baselines are accurate.

These are fair questions and while I don’t have suggestions for improvements to the current screen, I would submit that if there’s room to improve, it will be in that direction.

For now (and the foreseeable future) FMS takes its cues from the developmental motor learning process. As neonates, we have mobility first and little stability. We then learn to look up, roll, crawl, reach, stand and so forth. Each developmental stage forms the foundation for the following one. This is what I would describe as the most fundamental example of periodization. It is the basis of how the movements are formulated and prioritized. As I’ve said before, ontogeny may not turn out to be the most significant driver but it’s as reasonable and elegant a theory as I’ve come across. To be critical of it mandates offering something better.

To sum up; the screen looks at symmetrical stance, asymmetrical stance, single leg stance and more “broken” down aspects of these patterns, such as mobility. It then prioritizes things in the order of the developmental motor learning process.

Once we’ve prioritized movement, we can create subcategories. The FMS does so simply by asking whether the movement is symmetrical and whether it’s pain-free. The screen is scored between 0 and 3. Painful movement scores a 0 because of its unpredictable impact on motor control. An inability to perform the movement (albeit without pain) scores a 1. The fat end of the bell curve is occupied by 2s (quality varies quite a bit). Superlative movement scores a 3. The goal is not to obtain 3s; it is to have symmetrical 2s. This will not guarantee performance and has never been claimed to do so. It will merely ensure that the barriers to progressive overload have been removed.

Those numbers are important, but not because of their precision. Once again, if a movement pattern is problematic, this is your time to measure more carefully with your best tools. The hope is, simply, that the FMS helped you pinpoint how to spend your time the most efficiently.

At this point I’ve screened well into the four digits and I cannot say that I worry about score totals. Frequently, I don’t even worry about the individual scores. I take the information I see and formulate a game plan.

In my opinion, the real utility of the scores is that you can communicate succinctly with anyone else familiar with the screen, including your extended health care network. You can also quantify movement to your athlete or client. You can, in other words, help communicate what you see and what you want to improve.

When you have to take people off “mainstream” programming – especially when they have an emotional attachment to it – you had better be able to explain why this is best practice. You will also have to give them a clear idea of what you need to see for them to earn their way back to squatting or benching or whatever hallmarks of your approach they want to train. The FMS allows you to do that. In fact, it helps provide a sense of purpose to what might otherwise feel like arbitrary corrective exercises or regressions.

Finally, one of the most frequent criticisms I’ve heard (from both legitimate experts and, well, other people) is that they are able to obtain all the information they need from watching other movement patterns. That may be true for some. However, the eye of a spine mechanics expert that has been developed over decades of research simply cannot be the standard. Most strength and conditioning coaches will never develop that power of observational acuity. Yet almost anyone can learn to run an FMS from a weekend course.

Naturally, learning to run a screen and learning to utilize that information effectively are two different things. However, the FMS provides a logical, consistent starting point. It will not contradict anything you learn before or after it. It will simply give you the opportunity to marshal your resources efficiently. Future successes or failures will not be based on the screen but how you respond to the information it helps illuminate.

Originally published at geoffgirvitz.com.