Ask the Doc: The Functional Movement Screen

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by NICHOLE BLEUMLE|PT, DPT, MS, OCS, CSCS

Ask the Doc: The Functional Movement Screen

“An ounce of prevention is worth a pound of cure.” — Benjamin Franklin
The purpose of this article is to emphasize that your movement patterns are constantly changing. The human body is the ultimate compensating machine that is nothing short of amazing and keeps us moving for survival purposes. Unfortunately, compensation eventually comes at a cost. For the human body, that cost is usually paid with pain, injury and sub-maximal performance. Movement must be periodically screened or evaluated in order to have any chance of preventing injury, pain or functional decline.

Basic movement proficiency should be the foundation for any training program. If you have this foundation, then it is appropriate to move forward and discuss strength, endurance, power, and sport specific skill or technique refinement.
If you aren’t yet aware anything has changed, how can you address it? I am always amazed when I have an elderly patient referred for pain or injury related to a fall and so many times they (and their family members) truly did not think anything was wrong with their balance until they started having falls. The fall and the resulting injury was the culminating event that forced awareness, but their balance had probably been on the decline for years starting with subtle changes that they did not notice and no one was tracking. This is a life-threatening issue with staggering statistics that could easily be decreased with a lifetime habit of movement screening.

Waiting Can Hurt

Waiting for pain or injury to be your only cue for action is not the best plan. Imagine how long your car would last if you only popped the hood when the check engine light came on…. or worse yet, when you jumped in to head to work and the car would not start at all.

No one thinks twice about doing the maintenance and prevention tasks required to own a car and keep it running, so why is it so hard to do the same for most important vehicle you own: your one and only body?

Consider another example: Do you only go to the dentist when your tooth hurts? Most of us have been going to the dentist office twice a year for a check up since we were children, and we always hope we did enough brushing and flossing to avoid any painful and costly interventions. Even if you don’t get a gold star from the dentist, catching a cavity early and getting a filling is still easier to deal with than a root canal. The musculoskeletal system is no less important and the same practice of prevention and early detection should be made a priority through screening.

Functional Movement Screen

Functional Movement Screen
The Functional Movement Screen (FMS)™ is a research-based tool designed to screen the ability to perform 7 basic bodyweight movement patterns in pain-free, non-injured individuals. It is a screen and only a screen, not a diagnostic tool. For each of the 7 movements, an individual can receive a score of:

  • 0 (pain present)
  • 1 (not able to perform but not painful)
  • 2 (able to perform but with modification)
  • 3 (able complete the pattern in accordance with all specified criteria).
Things such as pregnancy and weight loss or gain related to activity or diet modifications alter movement patterns.
So a perfect (but extremely rare) score on the FMS is a total of 21. As a minimum standard, people (especially athletes) should be able to score at least a 2 on each individual movement (no scores of 0 or 1). Again, this is the minimum recommended standard, not optimal, and merely means that someone can complete the 7 movements without pain. Some asymmetries and compensatory patterns are most likely still present and would benefit from being addressed based on the individual athlete’s sport, competition level, and performance goals.

Basically ,if you as the athlete have pain or the inability to complete single-repetition, simple bodyweight movements, you have no business performing more complex movements with additional physical load or metabolic demands. Basic movement proficiency should be the foundation for any training program. If you have this foundation, then it is appropriate to move forward and discuss strength, endurance, power, and sport specific skill or technique refinement.

“First move well, then move often.” — Gray Cook

When is a Functional Movement Screen Warranted?

1. Every 6 months.

Go ahead and match your dental or car oil change schedule and plan to be screened even when you think your body is doing just fine. If you do find something brewing, then get it addressed before it becomes a bigger problem.

2. Once a pain-free state is achieved after injury or surgery.

The brain sends signals to modify movement to protect an area that is injured and in the process of healing. Sometimes after the healing is complete, the brain does not automatically reset to the pre-injury movement pattern. Think of anyone you have ever seen that continued to have a limp months after an ankle sprain even though they said it was no longer painful.

3. After illness.
The positions and demands required of one sport do not carry over to another and sometimes the adaptations they create can even be detrimental for the new sport because of left to right and front to back asymmetries in posture, strength, muscular endurance etc.
Especially if associated with 1 week or longer of bed rest and minimal physical activity. Relatively short-term illnesses like the flu can wreak havoc on the entire body as well as more chronic conditions and their required treatments. Cancer and chemo or radiation therapy can absolutely change the way you move.

4. Explained weight changes.

Things such as pregnancy and weight loss or gain related to activity or diet modifications alter movement patterns. Pretty straight forward here — more or less load causes adaptations in the body. Put on some body armor and see if you don’t feel and move differently by the end of the day. As for pregnancy, a physician can provide general guidance on physical training during pregnancy and post-partum that will mostly consist of cardiovascular and fall risk or positional precautions. Having a baby in the oven will definitely drastically change your musculoskeletal system — just ask any pregnant woman with back pain and carpal tunnel symptoms. Once the baby makes his or her debut, the body does not automatically reset and any remaining movement dysfunctions related to mobility or stability changes should be addressed before adding fitness back in the mix. NOTE: Unexplained weight changes are not normal and should be discussed with your physician.

5. Change of season sports.

5. Change of season sports.
I live in a mountain town, and I see my biggest spike in non-traumatic injuries during the change of seasons when athletes go from skiing all winter to hitting the trails in their running shoes or vice versa. Wolff’s law states that tissues will adapt to the loads under which they are placed. The positions and demands required of one sport do not carry over to another; sometimes the adaptations they create can even be detrimental for the new sport because of left to right and front to back asymmetries in posture, strength, muscular endurance, etc. So when you put away the running shoes and take your skis in for a tune up and wax, get yourself screened also.

6. Starting a new sport or training regimen.

Taken directly from the start of this article: Basic movement proficiency should be the foundation for any training program. If you have this foundation, then it is appropriate to move forward and discuss strength, endurance, power, and sport specific skill/technique refinement and acquisition. Enough said.

7. Plateau in training.

If you have stalled in progress towards your performance goals, take a step back and get screened. Getting one or two of those 7 movements from a score of 2 to a 3 could make a huge change and unleash some untapped performance potential.

Click here to find a functional movement expert near you that can perform your screen. Remember the FMS is intended for pain-free, non-injured individuals. If you are already in pain or dealing with an injury then find a professional such as a physical therapist to perform an evaluation and treat you appropriately. Once you are pain free again, then absolutely get an FMS and possibly additional return to sport testing based on your history and future athletic goals.

We can’t prevent 100% of engine failures, tooth aches, ankle sprains or falls, but we can absolutely lower the risk of these frustrating and often expensive occurrences by performing regular check ups and routine maintenance.

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