Maggie | Tue December 09, 2008 at 5:56 pm
Looks good. My basic understanding is that FMS is basically form correction. If true, then why wouldn’t it be beneficial to everyone, not just elite athletes?
Functional Movement Screen
ADVANCED | November 29 2008
I read Gray Cook’s book - Athletic Body in Balance- 3-4 years back and it was my favorite book for a while. I have seen his videos and thought he was miles ahead of all the so-called rehab experts in the strength & conditioning field then. I remember Eric Creesey, now one of the well known strength & conditioning coaches, arguing for static stretching when Gray cook at that time was talking about mobility and compensatory movement patterns. These concepts were pretty much unheard about 3-4 years back. But now it seems like everyone talks about compensatory movement patterns and mobility and stability concept.
Anyway, I always wanted to learn more about it and my college was ready to pay for it. So there I went to attend the FMS 2-day seminar. The speaker was Brett Jones and he has worked with Gray Cook and made a couple of DVD’s with Gray Cook.
What is FMS?
Functional Movement Screen (FMS) screen consists of seven different tests to assess movement patterns which are thought to be the fundamental movement patterns or foundations of human movement.
The Seven different tests consist of Deep Squat, Hurdle step, In line lunge, Push up test, straight leg raises and a few others. FMS was developed by Lee Burton and Gray Cook. You can read about FMS here: FMS
What is the basis of FMS?
Gray Cook explains in his book about how these are general motor programs and specific motor programs, and these general programs forms the basis of specific programs .So if these general or fundamental patterns are faulty, the specific ones will be faulty.
These faulty movement patterns or compensatory movement patterns can be due to tight or weak muscle or coordination (motor control) issues.
The faulty movement patterns or movement asymmetries cause mechanical stress- resulting in cumulative microtrauma - and thereby injuries. So treat the cause and not the source.
What FMS Claims?
FMS can identify people who are at risk of injury, and by correcting these faulty movement patterns can alleviate injury and even improve performance.
My Thoughts
The concepts of FMS are nothing new. I can easily see the concepts being influenced by Feldenkrais, Florence Kendall, and Shirley Sahrman’s Movement Impairment Syndrome. His work is heavily influenced by Sahrmann and he mentions her book in his reference section. It is basically motor control or movement re-education which is the basis of Alexander Technique and Feldenkrais which originated in the 1800’s.
One of the problems I see with FMS is in the basic concept of FMS: faulty movement patterns cause mechanical stress- resulting in cumulative microtrauma - and thereby injuries
First, who determines what is faulty and which is optimum? There is some evidence of certain patterns can predispose you to acute injury like ACL injury and stuff. But beyond that is just hard to conclude that there exist certain postures or movements which are ideal or optimal.
Also, why should mechanical stress causes by faulty movement pattern always lead to microtruama and injury? Why can’t tissues just positively adapt and get stronger just like a normal biological tissue. If indeed faulty movement patterns were the cause of injury, all those cerebral palsy patients, stroke victims, people with neurological disorders and amputees should be in complete pain. There are double amputees who run faster than most of us and still feel no pain. The compensations and asymmetries are 100% in these amputees and they should be crying out loud in pain than running around. Maybe that movement pattern is “ideal” for them and the tissues have adapted to it.
Even in a simple sport like running and which has been studied to death, the cause of over use injuries is still inconclusive. Excessive running distance, too high of a training intensity, and rapid increases in weekly running distance or intensity has been identified most often as risk factor for running injuries. There is NO biomechanical & anatomical factor that has reliably shown to correlate with a specific type of injury though you often read about abductor weakness, arch height and so on.
Another issue is how these movement patterns, if fixed, can carry over to movements on the field like running or jumping. Unless they are given specific instructions and training on running or other specific movements, these global patterns will not carry over to the specific movements on the field or in your daily movements. Your habitual postures and movements, whether faulty or not, will always be dominant.
Another issue, and a big one, I have with FMS is the lack of scientific evidence. Logic & common sense does not always pan out in research. He showed 2 studies abut FMS which predicted injury in firefighters & NFL players. The firefighters study showed decreases in injury compared to a control group after the intervention. But the intervention had a lot more than corrective exercises as in FMS. They were instructed the right way to lift and use proper work place ergonomics and so forth.
I couldn’t find the said NFL study on pubmed for some reason. The study showed that athletes who scored less than 14 (total of 21 points) on FMS were 11 times likely to get hurt than players who scored above 14 points. That’s pretty huge if you are an NFL player. If you are not, then there is nothing much to be excited about. You cannot extrapolate data from elite level athletes to the average joes, high school athletes, or even college level athletes.
If you are unaware, research is always population, gender and sport specific. I guess not many people who attend these seminars are aware of it nor care. As long as they know there are studies showing some benefit, they are all merry. They are more impressed by logic and anecdotes. And he had plenty of both.
There were 2 studies done on high school football athletes and marathon runners which did not support FMS. And guess what, they weren’t on the slides.
Conclusion
Personally, I think it is a good screening tool for elite levels athletes in sports like football, rugby, handball which involves a lot of high force, high velocity, and unpredictable movements which can test the limit of joint mobility and stability.
Using the screen on the lay person or a runner and saying he WILL get hurt if he cannot deep squat or move beautifully (symmetrically) is either just sheer ignorance of the complexities of injury and pain or just marketing at its finest.
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Anoop | Wed December 10, 2008 at 11:24 pm
Hi Maggie
Form correction in what?
I know where you are coming from: You are thinking from a lifting perspective. And that’s understandable. For instance, you don’t want someone doing squats with a rounded back with 300 lb on their shoulder. But that is entirely different from someeone squatting down with no weights. People have been squatting down with a flexed back for centuries in Asia.
And what is the perfect form for walking or standing? Who defined it and on what basis? Look around and you will see plenty of people moving imperfectly with no problem whatsoever.
Also performance and injury prevention do not always allign. For example, hypermobilty in throwers allows greater arm cocking and higher velocity at ball release. In swimmers, hypermobilty has been drectly correlated with increases stroke length , swiming speed and overall performance. They might look imperfect in their movements due the high mobilty, but thats why they are good at what they do. Make their shoulders more stable and they are just ordinary.
I say for elite athltes mainly because of the study shown in NFL athletes. The study is kind of a supsect because it is not indexed in pubmed and I don’t see even the study mentioned in the reference page of the FMS course manual! Also, as I said in the article, you cannot take what works for elite athletes and just casually generalize to everyone. Heck, I dont think I will ever get to see an NFL player, let alone train one.
Hope it helps
Matthias | Thu August 06, 2009 at 7:40 pm
> “For example, hypermobilty in throwers allows greater arm cocking and higher velocity at ball release.”
Baseball players have a lot more external rotation but less internal rotation than the average person so the total amount of rotation that they can perform isn’t a lot higher than “normal”.
Anoop | Thu August 20, 2009 at 11:10 pm
Hi Mathias,
“Baseball players have a lot more external rotation but less internal rotation than the average person so the total amount of rotation that they can perform isn’t a lot higher than “normal”.”
As you rightly said , baseball players and all overhead throwing athletes are hypermobile (external rotation) and hypomobile (int rotation). And that’s why I wrote greater “arm cocking” which is basically external rotation.
Greg Specht | Mon November 16, 2009 at 10:16 pm
I appreciate the analysis however there is gathering evidence that musculoskeletal asymmetries are predictive of injury, particularly lower extremity injuries. if you would like references a good place to start would be at this site.
http://www.kieselplisky.com/content/research
the reference for the NFL study is there too.
best, Greg Specht, PT, OCS
gregspecht.com
Anoop | Tue November 17, 2009 at 12:35 am
Hi Greg,
Thanks for the comment.
The only published FMS study is the football study and I have the full text now. There are a few problems in the study like no basic descriptive data, no description whether the testers were blind, and the FMS was only tested on one team. But looking at the validity measures and the NFL league, it can be somewhat of a valuable test for NFL players.
But FMS for rest of the athletic population will definitely have to wait.
Greg Specht | Tue November 17, 2009 at 2:04 am
Hey Anoop,
Since taking the course have you done many screens? I’m curious, do you use corrective exercise with your clients/athletes?
Greg
Anoop | Tue November 17, 2009 at 3:42 pm
Hi Greg,
My clients are mostly non-athletes. I use the corrective exercise for deep squat and lunges to work on their exercise technique so they get better range of motion. I don’t say that this will make you injury free or pain free if you do this right.
Even if I say something about corrective exercise, I do make sure to mention that it is mostly theoretical and we don’t have too much evidence. For athletes, there is some evidence for corrective exercises but a lot depend on the sport and the specific muscles. You cannot extrapolate that into every sport or every muscle group.
