The Functional Movement Screen: What do we really know?
The Functional Movement Screen is a relatively new set of tests that are used to identify weaknesses and thereby predict future injuries and performance. It consists of seven movements which are assigned a score from 0-3: the Deep Squat, Hurdle Step, and In-Line Lunge, Shoulder Mobility, the Active Straight Leg Raise, the Trunk Stability Push-up, and Rotary Stability. These seven movements, or combinations of them, comprise every possible combination of (healthy) movement we would see in sport and life. If an athlete has very low scores in specific areas, a coach would presumably be able to tailor their workouts to include prehab that reduces the liklihood of future injury. However, as with any tool, it’s effectiveness remains in the hands of the craftsman using it.
The claims are enticing: predict and prevent future injury. But a review of the literature indicates that its injury-predictive ability is less than we’d hoped for (moderate), and besides requiring skill to administer, it has limited ability to predict performance. [We should note that anything that only takes a few minutes and has any predictive value at all, is worth the time to administer] Consider the following research:
On the descriptive level results suggest that the FMS is a reliable screen, if the rater is educated and has solid experience (>100 trials). Factor analysis describes the FMS as a unitary construct, which is an argument against the FMS total score. Studies clearly illustrate its limited ability to predict athletic performance. (1)
The FMS appears to have minimal capabilities for identifying movement deficiencies that could affect multidirectional speed and jumping in male team sport athletes. (2)
With manual grading methods seemingly susceptible to error, the FMS should be used cautiously to direct strength and/or conditioning programs. (3)
Analysis on scores discounting pain showed similar results. The factor structures were not interpretable, and… suggests a lack of internal consistency in FMS sum scores. Results do not offer support for validity of the FMS sum score as a unidimensional construct. In the absence of additional psychometric research, caution is warranted when using the FMS sum score…(4)
…to predict injury risk in team sports the FMS total score is supported by moderate scientific evidence. The majority of the FMS based intervention programs showed an improvement on general motor quality. However, a randomized trial does not confirm that results. Hence, to implement the findings on field a critical strength and conditioning specialist is crucial…(1)
Three-mile run time (RT) was the only PFT [personal fitness test] component predictive of injury: candidates with RT ≥20.5 min were 1.7 times more likely to experience an injury compared with those with RT <20.5 min. Prior injury, frequency of general exercise and sport participation, and length of running history were predictive of any, overuse, and traumatic injuries, respectively. Combining slow RT and low FMS scores (≤14) increased the predictive value across all injury classifications: candidates scoring poorly on both tests were 4.2 times more likely to experience an injury. (5)
So what we see here is the need for a skilled coach to administer the test, and moderate evidence for it’s ability to predict future injury and performance…but when combined with a fitness test (per the final study above, performed by the military), we see the accuracy increase exponentially. So while the FMS didn’t turn out to be a crystal ball into the future of an athlete, it shows a lot of promise when it’s added to an overall battery of tests and screens. Again, it’s just another tool in the box. If you want to learn more about how to perform the FMS, check out the following papers:
