Functional Movement Screening (FMS) - Sportscotland · Need to consider how functional Need to consider how functional movement screening fits within the strategy and how dysfunctions

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Strength & Conditioning Team

Kevin Watson

Head S&C Coach

Glasgow School of Sport

Glasgow School of Sport

The Role of Functional Movement Screening at the

GSoS

BackgroundBackground

�� Common thinking that isolated muscle Common thinking that isolated muscle stretching and/or strengthening would be stretching and/or strengthening would be an effective intervention to reduce an effective intervention to reduce musculoskeletal injurymusculoskeletal injury

�� Research has suggested that this alone Research has suggested that this alone will not be effectivewill not be effective

�� Isolated rehab after injury is not sufficient Isolated rehab after injury is not sufficient to normalise performance which involves to normalise performance which involves the whole body (the whole body (NadierNadier et al., 2002)et al., 2002)

BackgroundBackground

�� Data also suggests isolated injury adversely Data also suggests isolated injury adversely affects other body regions (Hewett et al., 2006)affects other body regions (Hewett et al., 2006)

�� Concept of regional interdependence exists Concept of regional interdependence exists where dysfunction in one body region where dysfunction in one body region contributes to weakness, tightness and pain in contributes to weakness, tightness and pain in another (another (WainnerWainner et al., 2007)et al., 2007)

�� Suggests a tool that can measure injury risk Suggests a tool that can measure injury risk and regions of movement dysfunction and and regions of movement dysfunction and muscle imbalance would be beneficial in muscle imbalance would be beneficial in reducing the overall potential for injuryreducing the overall potential for injury

Functional Movement Screening Functional Movement Screening

(FMS)(FMS)

�� A way to assess multiple domains of function A way to assess multiple domains of function

simultaneously is attractive in a number of simultaneously is attractive in a number of

ways:ways:

�� Injury preventionInjury prevention

�� Determining muscle imbalancesDetermining muscle imbalances

�� Identifying movement dysfunctionIdentifying movement dysfunction

�� Targeting interventions to address Targeting interventions to address

dysfunctions/imbalances to improve movement dysfunctions/imbalances to improve movement

�� Tracking adaptations to training/interventionsTracking adaptations to training/interventions

�� FMS is FMS is oneone method of doing thismethod of doing this

The Performance PyramidThe Performance Pyramid

Functional

skill

Functional performance

Functional movement

Buffer zones

Optimal Performance PyramidOptimal Performance Pyramid

�� The optimal performance pyramid The optimal performance pyramid assumes that by improving functional assumes that by improving functional movement, functional performance and movement, functional performance and ultimately functional skill will be improvedultimately functional skill will be improved

�� It could then be purported that if functional It could then be purported that if functional skill can be improved, the array of motor skill can be improved, the array of motor skills will be improved and thus the skills will be improved and thus the opportunity to improve sport specific skill opportunity to improve sport specific skill would be increasedwould be increased

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OverOver--powered Performance Pyramidpowered Performance Pyramid

Functional

skill

Functional performance

Functional movement

OverOver--powered Performance Pyramidpowered Performance Pyramid

�� This is characterised by an emphasis on too This is characterised by an emphasis on too much functional performance (physiological much functional performance (physiological measures)measures)

�� There is too little emphasis on functional There is too little emphasis on functional movement which will ultimately limit functional movement which will ultimately limit functional skill development and thus sport specific skill skill development and thus sport specific skill development and performancedevelopment and performance

�� Athletes will be very fit but are likely to lack Athletes will be very fit but are likely to lack functional skill and have an increased rate of functional skill and have an increased rate of injuryinjury

UnderUnder--powered Performance Pyramidpowered Performance Pyramid

Functional skill

Functional

performance

Functional movement

UnderUnder--powered Performance Pyramidpowered Performance Pyramid

�� This is characterised by too much This is characterised by too much emphasis on functional movementemphasis on functional movement

�� There will be a limited development of There will be a limited development of functional performance (physiological functional performance (physiological measures)measures)

�� The athlete will likely be very skilful but The athlete will likely be very skilful but lack the physiological development lack the physiological development required to be an elite athlete and cope required to be an elite athlete and cope with the demands of daywith the demands of day--toto--day trainingday training

Balancing Functional MovementBalancing Functional Movement

�� The long term player development The long term player development strategy at the GSoS lends itself well to strategy at the GSoS lends itself well to incorporating functional movement incorporating functional movement through the generic movement through the generic movement programmeprogramme

�� Need to consider how functional Need to consider how functional movement screening fits within the movement screening fits within the strategy and how dysfunctions are strategy and how dysfunctions are addressed through training interventionsaddressed through training interventions

Support for the FMSSupport for the FMS

�� Kiesel et al. (2007) examined relationship Kiesel et al. (2007) examined relationship between FMS scores and prebetween FMS scores and pre--season injury in season injury in 46 professional American footballers46 professional American footballers

�� Serious injury = unable to play or train for at Serious injury = unable to play or train for at least 3 weeksleast 3 weeks

�� Score of 14 or less = predicted serious injuryScore of 14 or less = predicted serious injury

�� Those who scored a low FMS score were Those who scored a low FMS score were injured more ofteninjured more often

�� Suggests that FM is identifiable risk factor for Suggests that FM is identifiable risk factor for injuryinjury

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�� Kiesel et al. (2009) reported on the effects of an offKiesel et al. (2009) reported on the effects of an off--season FM intervention in 62 American Footballersseason FM intervention in 62 American Footballers

�� After FMS athletes were prescribed corrective exercises After FMS athletes were prescribed corrective exercises to enhance relationship between core muscle activation to enhance relationship between core muscle activation and fundamental movementand fundamental movement

�� Intervention was 6 days per week for 7 weeksIntervention was 6 days per week for 7 weeks

�� Significant improvement in FMS preSignificant improvement in FMS pre--toto--post interventionpost intervention

�� 7 players pre intervention with a score of >147 players pre intervention with a score of >14

�� 39 players post intervention with a score >1439 players post intervention with a score >14

�� 31 players free of asymmetry pre31 players free of asymmetry pre--interventionintervention

�� 42 players free of asymmetry post42 players free of asymmetry post--interventionintervention


�� Butler et al. (2010) investigated biomechanics Butler et al. (2010) investigated biomechanics

of the deep squat exercise from the FMSof the deep squat exercise from the FMS

�� Conclusions:Conclusions:

�� Individuals who score differently demonstrate Individuals who score differently demonstrate

different mechanics of movementdifferent mechanics of movement

�� This suggest deep squat is a good tool to measure This suggest deep squat is a good tool to measure

joint mobilityjoint mobility

�� Different corrective interventions are needed Different corrective interventions are needed

depending on score and thus the nature of the depending on score and thus the nature of the

movement dysfunctions and muscle imbalances movement dysfunctions and muscle imbalances

Normative FMS valuesNormative FMS values

�� SchneidersSchneiders et al. (2011) established et al. (2011) established normative values for active males and normative values for active males and females aged 18females aged 18--4040

�� Average score of 15.7 with no gender Average score of 15.7 with no gender differences in composite scoredifferences in composite score

�� Females scored higher in active straight Females scored higher in active straight leg raiseleg raise

�� Males scored higher on trunk stability and Males scored higher on trunk stability and push uppush up

FMS and the GSoSFMS and the GSoS

�� All new S1’s undertake a FMS in August All new S1’s undertake a FMS in August (start of term) of the year they start GSoS(start of term) of the year they start GSoS

�� All existing S1All existing S1--S6 screened 3S6 screened 3--4 times per 4 times per year to fit with training/competition planyear to fit with training/competition plan

�� All pupils to be screened in sport specific All pupils to be screened in sport specific groupsgroups

�� Data used to establish current functional Data used to establish current functional movement ability and establish normative movement ability and establish normative datadata

FMS and S&C InterventionsFMS and S&C Interventions

�� Screen all new S1 pupilsScreen all new S1 pupils

�� Introduce new technical/functional lifting Introduce new technical/functional lifting

programme for S1 pupils aimed to improve programme for S1 pupils aimed to improve

mobilitymobility

�� Screen pupils after 8 weeks and compare FMS Screen pupils after 8 weeks and compare FMS

scoresscores

�� Detailed intervention incorporated into all Detailed intervention incorporated into all

existing pupils S&C programmes based on existing pupils S&C programmes based on

common themes across year groups and sportcommon themes across year groups and sport

Corrective Exercise SequencingCorrective Exercise Sequencing

Linear path from basic mobility to basic stabilityLinear path from basic mobility to basic stability

1.1. Mobility exercises Mobility exercises –– focus on joint range of focus on joint range of

motion, tissue length and muscle flexibilitymotion, tissue length and muscle flexibility

2.2. Stability exercises Stability exercises –– focus on basic focus on basic

sequencing of movementsequencing of movement

3.3. Movement pattern retraining Movement pattern retraining –– incorporates the incorporates the

use of fundamental mobility and stability into use of fundamental mobility and stability into

specific movement patterns to reinforce specific movement patterns to reinforce

coordination and timingcoordination and timing

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Implications of Administering FMSImplications of Administering FMS

�� Purchase FMS testing kit and manual (~£250)Purchase FMS testing kit and manual (~£250)

�� Time out of sport specific time to administer Time out of sport specific time to administer FMSFMS

�� Increased workload of (S&C) coaching teamIncreased workload of (S&C) coaching team�� Time to administer FMSTime to administer FMS

�� Time to analyse FMS results (2Time to analyse FMS results (2--3 days)3 days)

�� Time to write corrective programmes (depends on Time to write corrective programmes (depends on nature of nature of dsyfunctionsdsyfunctions))

�� Time to administer trainingTime to administer training-- Within normal S&C/sport specific training or additional Within normal S&C/sport specific training or additional

stand alone sessions? stand alone sessions?

-- Input from other support staff to write combined Input from other support staff to write combined intervention programmes e.g. intervention programmes e.g. physiosphysios

Potential research topicsPotential research topics

�� Normative functional movement screen data in elite Normative functional movement screen data in elite youth sport athletes.youth sport athletes.

�� Do differences exist in functional movement screen Do differences exist in functional movement screen values in elite sports school pupils vs. pupils involved values in elite sports school pupils vs. pupils involved in schoolin school--based physical education?based physical education?

�� Do S&C training interventions improve performance in Do S&C training interventions improve performance in the functional movement screen in elite youth the functional movement screen in elite youth athletes?athletes?

�� Are functional movement screen scores related to Are functional movement screen scores related to performances variables in elite youth sport athletes?performances variables in elite youth sport athletes?

�� The functional movement screen assessment: do poor The functional movement screen assessment: do poor testing scores predict the incidence of injury in elite testing scores predict the incidence of injury in elite youth athletes?youth athletes?

How could FMS be used in your How could FMS be used in your

sport?sport?

�� Think about the type of sport you coachThink about the type of sport you coach

�� Emphasis on skill vs. physical componentsEmphasis on skill vs. physical components

�� Level of athleteLevel of athlete

�� Advantages vs. disadvantagesAdvantages vs. disadvantages

�� What happens if we don’t screen?What happens if we don’t screen?

�� Efficient use of budgetsEfficient use of budgets

�� Screening and prevention vs. reactive Screening and prevention vs. reactive

physiophysio supportsupport

The The GSoSGSoS S&C programmeS&C programme

�� S1S1--22

�� Generic movement training programmeGeneric movement training programme

-- Emphasis on developing motor skills required to be Emphasis on developing motor skills required to be

successful in any sportsuccessful in any sport

-- Developing fitness components required to be an “athlete”Developing fitness components required to be an “athlete”

�� S3S3--44

�� Introduction of a strength and conditioning Introduction of a strength and conditioning

programme that is programme that is periodisedperiodised to fit the sport specific to fit the sport specific

competition structurecompetition structure

�� Introduction to the range of recovery strategies Introduction to the range of recovery strategies

available to athletesavailable to athletes

The The GSoSGSoS S&C programmeS&C programme

�� S5S5--66

�� Introduction of a sport specific strength and Introduction of a sport specific strength and

conditioning programme that takes into conditioning programme that takes into

account the nature of the sport and account the nature of the sport and

event/positionevent/position

�� Use of recovery strategies at appropriate Use of recovery strategies at appropriate

phases in competitive planphases in competitive plan

�� Player led focus developing weaknesses Player led focus developing weaknesses

and utilising strengthsand utilising strengths

Olympic Lifting and Functional Olympic Lifting and Functional

Movement Training InterventionsMovement Training Interventions�� Olympic lifting exercisesOlympic lifting exercises

�� SnatchSnatch

�� Clean & JerkClean & Jerk

�� Variations/derivatives of eachVariations/derivatives of each

�� Why?Why?�� Olympic lifts and squatting are fundamental to Olympic lifts and squatting are fundamental to

overall strength development, mobility and stabilityoverall strength development, mobility and stability

�� Hip, ankle, knee, back and shoulder Hip, ankle, knee, back and shoulder stability/mobilitystability/mobility

�� Mobility and stability of all major joints to enable Mobility and stability of all major joints to enable better stabilisation and more efficient energy better stabilisation and more efficient energy utilisation and transferutilisation and transfer

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Joint Joint —— Primary NeedPrimary Need

�� Ankle Ankle —— mobilitymobility

�� Knee Knee —— stabilitystability

�� Hip Hip —— mobilitymobility

�� Lumbar Spine Lumbar Spine —— stabilitystability

�� Thoracic Spine Thoracic Spine —— mobilitymobility

�� Scapula Scapula —— stabilitystability

�� GlenoGleno--humeral humeral —— mobilitymobility

Correcting Movement FlawsCorrecting Movement Flaws

�� ValgusValgus kneesknees

�� Knees track in Knees track in

relative to hip relative to hip

and ankleand ankle

�� Knee should Knee should

track out over track out over

footfoot

�� Can be Can be

corrected by corrected by

squatting with a squatting with a

band around the band around the

kneesknees

Mobility vs. flexibilityMobility vs. flexibility

�� MobilityMobility

�� The ability to move or to be moved; capacity The ability to move or to be moved; capacity

for movement or change of place; for movement or change of place;

movablenessmovableness, portability, portability

�� FlexibilityFlexibility

�� Capability of being bent; pliancy Capability of being bent; pliancy

The Functional Movement ScreenThe Functional Movement Screen

�� Devised by Cook (2003) as a means of Devised by Cook (2003) as a means of categorising functional movement patternscategorising functional movement patterns

�� Uses 7 movements that categorise the Uses 7 movements that categorise the foundation for human movementfoundation for human movement

�� Deep squatDeep squat

�� StepStep

�� LungeLunge

�� ReachReach

�� Leg raiseLeg raise

�� PushPush--upup

�� Rotational stabilityRotational stability

The Functional Movement ScreenThe Functional Movement Screen

�� The S&C coach follows strict criteria to The S&C coach follows strict criteria to administer the testsadminister the tests

�� The athlete completes each test 3 timesThe athlete completes each test 3 times

�� The screen can be videoed and reviewed after The screen can be videoed and reviewed after (use 2 different camera angles)(use 2 different camera angles)

�� Suggested that 3 S&C coaches rate the athlete Suggested that 3 S&C coaches rate the athlete on each test and collectively agree the scoreon each test and collectively agree the score

�� Each test is scored out of 3Each test is scored out of 3

�� Where there is a bilateral dysfunction the lowest Where there is a bilateral dysfunction the lowest score is givenscore is given

Scoring the FMSScoring the FMS

�� 3 = Perfect execution of the movement pattern3 = Perfect execution of the movement pattern

�� No compensatory movement can be made at allNo compensatory movement can be made at all

�� 2 = Execution that demonstrates compensation 2 = Execution that demonstrates compensation

and less than perfect formand less than perfect form

�� 1 = Inability to complete the movement pattern 1 = Inability to complete the movement pattern

because of stiffness, loss of balance or another because of stiffness, loss of balance or another

difficultydifficulty

�� 0 = Pain during the movement (regardless of 0 = Pain during the movement (regardless of

how well the athlete performed the movement)how well the athlete performed the movement)

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The FMS ExercisesThe FMS Exercises

1.1. Deep squatDeep squat

2.2. Hurdle stepHurdle step

3.3. InIn--line lungeline lunge

4.4. Shoulder mobilityShoulder mobility

5.5. Push upPush up

6.6. Straight leg raiseStraight leg raise

7.7. Rotational stabilityRotational stability

Deep SquatDeep Squat

Deep Squat Scoring CriteriaDeep Squat Scoring Criteria

1.1. To score a 3To score a 3�� Upper torso is parallel with tibia or toward verticalUpper torso is parallel with tibia or toward vertical

�� Femur below horizontalFemur below horizontal

�� Knees aligned over feetKnees aligned over feet

�� Dowel aligned over feet (within base of support)Dowel aligned over feet (within base of support)

2.2. To score a 2To score a 2�� As above with but with heels raised As above with but with heels raised

3.3. To score a 1To score a 1�� Tibia and upper torso are not parallelTibia and upper torso are not parallel

�� Femur is not below horizontalFemur is not below horizontal

�� Knees are not aligned over feet (valgus knee)Knees are not aligned over feet (valgus knee)

�� Lumbar flexion is notedLumbar flexion is noted

�� Dowel not aligned over feet (out with base of support)Dowel not aligned over feet (out with base of support)

4.4. If there is pain executing the movement the score is 0If there is pain executing the movement the score is 0

Hurdle StepHurdle Step

Hurdle Step Scoring CriteriaHurdle Step Scoring Criteria

1.1. To score a 3To score a 3�� Hips, knees and ankles remain aligned in the sagittal planeHips, knees and ankles remain aligned in the sagittal plane

�� Minimal to no movement is noted in the lumbar spineMinimal to no movement is noted in the lumbar spine

�� Dowel and hurdle remain parallelDowel and hurdle remain parallel

2.2. To score a 2To score a 2�� Alignment is lost between hips, knees and anklesAlignment is lost between hips, knees and ankles

�� Movement is noted in lumbar spineMovement is noted in lumbar spine

�� Dowel and hurdle do not remain parallelDowel and hurdle do not remain parallel

3.3. To score a 1To score a 1�� Contact between foot and hurdle occursContact between foot and hurdle occurs

�� Loss of balance is notedLoss of balance is noted


InIn--line Lungeline Lunge

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InIn--line Lunge Scoring Criterialine Lunge Scoring Criteria

1.1. To score a 3To score a 3�� Dowel contacts maintainedDowel contacts maintained

�� Dowel remains verticalDowel remains vertical

�� No torso movement notedNo torso movement noted

�� Dowel and feet remain in sagittal planeDowel and feet remain in sagittal plane

�� Knee touches board behind heel of front footKnee touches board behind heel of front foot

2.2. To score a 2To score a 2�� Dowel contacts not maintainedDowel contacts not maintained

�� Dowel does not remain verticalDowel does not remain vertical

�� Movement noted in torsoMovement noted in torso

�� Dowel and feet do not remain in sagittal planeDowel and feet do not remain in sagittal plane

�� Knee does not touch heel of front footKnee does not touch heel of front foot

3.3. To score a 1To score a 1�� Loss of balance in notedLoss of balance in noted


Shoulder Mobility Clearing TestShoulder Mobility Clearing Test

�� Perform this clearing Perform this clearing

test bilaterallytest bilaterally

�� If there is pain If there is pain

associated with this associated with this

movement, give a movement, give a

zero and perform a zero and perform a

thorough evaluation thorough evaluation

of the shoulder by of the shoulder by

referring to referring to physiophysio

Shoulder MobilityShoulder Mobility Shoulder Mobility Scoring CriteriaShoulder Mobility Scoring Criteria

1.1. To score a 3To score a 3

�� Fists are within one hand lengthFists are within one hand length


�� Fists are within oneFists are within one--andand--aa--half hand lengthshalf hand lengths


�� Fists are not within oneFists are not within one--andand--aa--half hand lengthshalf hand lengths

4.4. If there is pain executing the movement the If there is pain executing the movement the

score is 0score is 0

Spinal Extension Clearing TestSpinal Extension Clearing Test

�� Perform a pressPerform a press--up up in the push up in the push up position with hip position with hip remaining in contact remaining in contact with the floorwith the floor

�� If there is pain If there is pain associated with this associated with this motion, give a 0 motion, give a 0 score and refer to score and refer to physiophysio for a more for a more detailed evaluationdetailed evaluation

Push UpPush Up

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Push Up Scoring CriteriaPush Up Scoring Criteria

1.1. To score a 3To score a 3�� The body lifts as a unit with no lag in the spineThe body lifts as a unit with no lag in the spine

�� Men Men –– thumbs aligned to top of headthumbs aligned to top of head

�� Women Women –– thumbs aligned with chinthumbs aligned with chin

2.2. To score a 2To score a 2�� The body lifts as a unit with no lag in the spineThe body lifts as a unit with no lag in the spine

�� Men Men –– thumbs aligned with chinthumbs aligned with chin

�� Women Women –– thumbs aligned with claviclethumbs aligned with clavicle

3.3. To score a 1To score a 1�� Men are unable to perform a repetition with thumbs aligned Men are unable to perform a repetition with thumbs aligned

with the chinwith the chin

�� Women are unable to perform a repetition with thumbs Women are unable to perform a repetition with thumbs aligned with the claviclealigned with the clavicle


Active Straight Leg RaiseActive Straight Leg Raise

Active Straight Leg Raise Scoring Active Straight Leg Raise Scoring

CriteriaCriteria1.1. To score a 3To score a 3

�� Vertical line of the malleolus between midVertical line of the malleolus between mid--thigh and ASIS thigh and ASIS (anterior superior iliac spine)(anterior superior iliac spine)

�� The nonThe non--moving limb remains in neutral positionmoving limb remains in neutral position

2.2. To score a 2To score a 2�� Vertical line of the malleolus between midVertical line of the malleolus between mid--thigh and joint line thigh and joint line


3.3. To score a 1To score a 1�� Vertical line of the malleolus resides below joint lineVertical line of the malleolus resides below joint line



Spinal Flexion Clearing TestSpinal Flexion Clearing Test

�� Assume a quadruped Assume a quadruped positionposition

�� Rock back and touch Rock back and touch buttocks to the heels and buttocks to the heels and the chest to the thighsthe chest to the thighs

�� The hands should The hands should remain in front of the remain in front of the body, reaching out as far body, reaching out as far as possibleas possible

�� If there is pain If there is pain associated with this associated with this position give a zero and position give a zero and refer to refer to physiophysio

Rotational StabilityRotational Stability Rotational Stability Scoring CriteriaRotational Stability Scoring Criteria


�� Performs a correct unilateral repetitionPerforms a correct unilateral repetition


�� Performs a correct diagonal repetitionPerforms a correct diagonal repetition


�� Inability to perform a diagonal repetitionInability to perform a diagonal repetition

4.4. If there is pain executing the movement If there is pain executing the movement

the score is 0the score is 0

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Functional Movement Screening (FMS) - Sportscotland · Need to consider how functional Need to consider how functional movement screening fits within the strategy and how dysfunctions