The Functional Movement Screen

Functional Movement Screen and Chiropractic

A screen is just a tool. You can use it to let the little pieces through, and catch it big stuff.  Think of a screen door, it keeps the bugs out, but lets the air pass through, even if that air might not be 100% pure.  That’s the essence of the Functional Movement Screen.  To screen out for pain, asymmetries, and significant movement issues. As a chiropractic and rehab clinic it certainly plays a roll in our office.

The Functional Movement Screen (FMS) is a screening tool used for individuals with no current pain or injury. It evaluates seven fundamental human movement patterns. While not intended to diagnose an orthopedic problem, it can highlight opportunities for improved movement.

Originating in the late 1990s, the FMS is considered now to be the best fitness based movement screening tool and is used by most pro sports, as well as many college and high school sports and in US and other special forces.

The FMS takes you through movements where stability/mobility deficits can become apparent.  Even those playing or exercising at a high level, might be compensating for these subtle limitations to achieve or maintain that level of performance. The use of compensations can lead to poor biomechanics;  limiting gains and reducing durability against the risks of injury.

How its used:

Ideally the FMS is part of a pre-participation examination to determine deficits.  In a fitness setting they would be missed entirely.  In a tradition physical exam, they may be overlooked. Muscle flexibility, strength imbalances or compensation due to previous injury are all acknowledged as significant risk factors for injury. In many cases, the FMS will highlight these issues, which may not be identified in a standard evaluation. The functional movement screen will identify deficits related to movement, mobility and stability. If these risk factors can be identified and addressed, then decreases in injuries and improved performance should follow.

The FMS can also be used to re-screen for feedback every 4-6 weeks. Re-screening provides feedback into the effectiveness of the current program design and provides insight on how and when to progress.

The FMS is scored with each screen receiving a 0-3 rating.  Pain during any test will get you a 0, which indicates a problem that fitness alone is not going to fix.  We’d move you to a full evaluation in our office. A 1 means you were unable to do the test or meet the criteria, a 2 means good enough, and a 3 means perfect. This means the maximum score is a 21, that doesn’t mean that the goal is a 21. The goal is actually a symmetrical score of 14 or more.

There is a built in hierarchy to the test.  You can divide them into 2 mobility test (even though its more than just ROM), 2 stability test, and 3 functional test.  It goes Mobility > Stability > Functional.  Your lowest test in the hierarchy, will take precedent.

The Movements

Mobility:

Active Straight Leg Raise

This pattern looks both at the mobility of the flexed hip, and also at the core stabilization in the pattern, as well as the amount of hip extension of the down leg. This is less of a test of hip flexion on one side, and more of an appraisal of the ability to separate the lower extremities in a non-weight bearing position.

Shoulder Mobility

This assesses the natural rhythm of the scapular-thoracic region and rib cage during reciprocal upper-extremity shoulder movements. This pattern observes bilateral shoulder range of motion, combining extension, internal rotation and adduction in one extremity, and flexion, external rotation and abduction of the other.

The Stability test

Trunk stability Push up

This pattern is used as a basic observation of reflex core stabilization, and is not a test or measure of upper body strength. The goal is to initiate movement with the upper extremities in a push up pattern without allowing movement in the spine or hips. The movement tests the ability to stabilize the spine in the sagittal plane during an upper body push movement.

Rotary Stability

This pattern assesses the bodies ability to control and resist rotational forces in a quadruped position.

The Functional Test

Hurdle Step

This movement assesses stepping and stride mechanics.  This also highlights stability and control in a single- leg stance. The hurdle step requires bilateral mobility and stability of the hips, knees and ankles. The test also challenges stability and control of the pelvis and core. It offers an opportunity to observe side to side symmetry as well.

Inline Lunge

This places the body in a position to simulate stresses during rotation, deceleration and lateral movements. We use a split- stance with the upper extremities in a reciprocal pattern. This replicates the natural movement. This test also challenges hip, knee, ankle and foot mobility and stability.

Over Head Squat

The Deep Squat pattern challenges total body mechanics and neuromuscular control. We use it to test bilateral, symmetrical, functional mobility and stability of the hips, knees and ankles. The dowel overhead requires bilateral mobility and stability of the shoulders, scapula and thoracic spine. The pelvis and core must establish stability and control throughout the entire movement to achieve the full pattern.

The Goals

Our goal is to see that you move well enough to train harder.  If you can’t score a 2 on an ASLR (hip mobility) I’m not sure doing deadlifts is going to be that safe.  If you have a 1 on the left and a 3 on the right in shoulder mobility, that asymmetry should be narrowed before you do much upper body strength training.  If you can’t score a 2 on a hurdle step I worry about how your body will handle running a 10K, and so on.

For the average person, the non-athlete, the person that might not be doing any dedicated exercise, the FMS can show the lowest lying fruit.  The things that they could spend minimal time working on, and yield the most profound results. For the conditioned athlete, it can highlight subtle chinks in the armor, or just give us a green light to train harder.

An FMS screen can’t prevent and injury, but it serves as the best tool available to guide interventions and tweaks to optimize movement, performance and longevity. Heres a good video going through the tests.

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