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.
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
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.
FMS can identify people who are at risk of injury, and by correcting these faulty movement patterns can alleviate injury and even improve performance.
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.
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.
Erik Petersen | Wed December 15, 2010
And it all comes down to…......semantics. Nothing will make you superman (women),and guarantee that no wrong will befall your body, ever! Are you going to load an asymmetrical body or will you try to get balance back into it. Bill…...of course, yoga serves no purpose other than to serve satan and meridians don’t exist, stupid accupuncture practitioners. And let’s all do the Super Slow workout!
Yep, I’m a questioner! Even of some B.S. gobblety goop that’s been around for decades. Hell, astrology’s been around for centuries, right?
http://saveyourself.ca/articles/reality-checks/myofascial-release.php
Anoop | Thu December 16, 2010
This is the most common misconception: If it existed for years, it should be true and should work. I wish they could name a bias for this.
Erik Petersen | Mon December 20, 2010
I think you guys have distilled the known world into that which is known only to you. Next you’ll discover that walking is harmful because there is no empirical evidence for it. Can you prove that watching a sunset is beneficial for the body?
Anoop | Tue December 21, 2010
Hi Erik,
You just have to be more skeptical. That is the essence of science.
One example: We used to believe that Hormone replacement therapy was the way to go for post menopausal women. It makes complete sense to give a hormone which is lacking due to ageing. it was like the fountain of youth. And the experts (doctors with incredible credentials agreed too) and observed the same in their patients too.
And they did a experimental study to confirm how great the hormone replacement therapy was. And guess what, they had to prematurely stop the study because HRT increased breast cancer, heart disease, stroke and blood clots!!
This is just one example. And there are 100’s of other examples where we have again showed how experts were wrong and how we NEED an evidence based approach to test claims. Does it make sense, Erik?
Erik Petersen | Thu December 23, 2010
I saw your post on Dragon Door. I am glad to see that you are not upset at my posts here. I am always trying to find the truth but it is difficult as life as we know it is not so black and white.
I’m not sure how I stumbled upon this webpage but I found these comments to be objectionable at the very least.
Coming from someone with a PhD in Human Movement - this thread is absolutely ludacris. The skeptics clearly don’t have a grasp or true understanding of meta-analysis research methods in order to develop evidence based practice. Especially if they are tossing around one or two (poorly written may I add) research articles. I’m all for being skeptical of the information that is presented to us but finding a couple research articles to support a very bold stance toward approaching human movement dysfunctions and compensations is foolish and one-sided. Did you ever think to question why these articles, written years ago, never caught on?
In regards to FMS - there are over a dozen teams in the NFL utilizing the system as well as the NFL combine. The NFL is by far one of the most elite sports organizations in the world and to say that they are wasting their time with a system like FMS is nothing short of laughable.
Erik I applaud your attempts to support ancient methodologies like yoga or rolfing but arguing with these dimwits is a waste of your time.
What is more frustrating is that I wasted five minutes of my time to write this usefless post.
The idea that you hold a PhD is “ludacris” (isn’t he a rapper?).
I’m assuming that the “poorly written” articles to which you refer are Dr. Lederman’s? Poorly written? Really? I guess if you think brilliance qualifies as poor writing. It’s obvious that you did not read them. The articles are also only a few years old and are hardly ancient history. If they have “never caught on” it is because a lot of people have a lot on the line if the papers should “catch on”. Most also can’t handle the cognitive dissonance that the information presented creates.
The fact that the NFL uses a method is not proof of the efficacy of that method. Also, assuming that it might have some benefit to a pro athlete, using something on elite athletes doesn’t mean it would also translate or be of benefit to the average person who isn’t trying to compete at the highest athletic levels. Again, if your imbalances are so minor in character that you need something like FMS to find them, then are they really ever going to be a problem?
The fact is, there really isn’t any evidence that they will. What is on the line if being a bit unbalanced and crooked isn’t really a big deal? It’s good news in my book! That way I don’t have to waste my time and money on FMS.
Hahaha, Bill you sound like a bitter old man who has a limp, a hunchback and will soon be bedridden from your lack of understanding brilliance. If Dr. Leder"WHO” is brilliant then explain why his papers haven’t “caught on.” You really don’t understand meta-analysis research or eveidence-based practice do you? And yes, I do hold a Ph…never mind you don’t have the education to grasp brilliance…my bad I forgot.
This is my last reply Bill because it is a waste of my time so I’ll let you get the last word to boost that self-esteem while I go enjoy me career and hard earned money.
E to the Rock! | Fri January 14, 2011
Bill, Ida Rolf had more intelligence in her big toe than you ever will attain with rebuttals such as this! Check her credentials and those (Thomas Myers) who learned from her! I will assume that Anatomy Trains is well beyond your polarized viewpoint to ever allow into your feeble “mind”.
Anoop | Fri January 14, 2011
Hi RW,
Thanks for the comment. I don’t think anyone wrote it is useless for NFL. Try to read the full article again.
And it is true that you have wasted your time (and everyone’s time) since you don’t have anything of substance to add.
If you are unaware, Ph.D is all about critical thinking, and I don’t see that in your post.
Hi Anoop,
I have enjoyed reading your site tonight and I have in particular enjoyed your comments in the 2 articles here on FMS. I hate reading posts from people who disagree just to standout from the crowd but that is also the case with people who agree without critical thinking. I have a Facebook account and it seems so common now for the fitness gurus to say something stupid only to see a rush of “friends” so eager to agree. Sickening really.
Anyway, I don’t see myself as educated, just someone trying to learn, and finding it damn hard in this environment. I like what you have to say but I want to make a few comments.
1. have you read Dr Stuart McGill’s books on the low back? He seems to have some answers to some of your questions in regards to posture. His findings are that poor posture leads to injury.
2. In a podcast Dr McGill was talking about the hip joint, and commenting that the shape of it in a specific person will determine squat depth. Well he might have said a lot more but that is all I could take in at the time. This seems to go against the FMS? I don’t know the FMS but would you say that a person’s anatomy may not allow a posture or movement that the FMS requires?
3. Your earlier post about loaded/unloaded squat being different. I have seen a video of Gray Cook saying a flexed upper back was fine when squatting unloaded, as in squatting in asian countries.
4. Eric Cressy mentions in a article that most people may not be average. Average in the sense of expected anatomical design and function. He also used the example of a deep squat in a video, with one of his clients who had an extra vertebra or 3? I also had a client who had extra vertebra. Eric was saying that deep squats would force lumbar flexion and so might not be a good idea for everyone.
5. What else? Someone mentioned another Dr writing an article on the core or core training being wrong. I looked at the article which was written in 2007. I have no idea what inspired that article but it was a dollar too little and a day too late. He is reporting some Australian research which showed incorrect timings in the TVA following injury. This led to core training which focused on TVA timing corrections led by Paul Chek. Dr McGill writes that many muscles suffer this problem not just the TVA; and says that a focus on any particular muscle or group of muscles is wrong. He emphasizes core training as critical, and states that the most important muscle in a task is continually changing. He concludes that core training must incorporate all muscles which co-ordinate in their operation.
6. I listened to another podcast where some guy was saying that a 15 minute assessment of the feet could tell him all he needed to know. I know that is a very weak report but I just wanted to include it to say that there are different methods.
7. Also want to say to Gray Cook, “naughty naughty,” in regards to his exclusion of those other 2 groups that did not fit his graph. That is very disappointing.
8. Want to mention that everything I have ever heard about the FMS has been good but also that 99% of those comments come either from Gray or friends of.
Well done. I would like to see your comments more broadly posted. Not to give Gray Cook a hard time but to get people thinking.
Regards
Anthony
Anoop | Mon April 25, 2011
Hi Anthony,
Thanks for the comments and taking a critical approach to evaluating ideas and theories.
About posture, you should read my article here: http://www.mindandmuscle.net/?q=articles/a_balachandran/posture
Once you read that, you should read the article about pain. It clearly tells us what we got wrong and what we got right.
http://www.exercisebiology.com/index.php/site/articles/a_revolution_in_the_understanding_of_pain_and_treatment_of_pain/
I think they had my recent FMS article on their website.
Why don’t you register in the forums and we can have a discussion. It is hard to discuss stuff here. All good points and you are the right person to be in our forums.
Erik Petersen | Fri April 29, 2011
Anthony,
Perhaps you have (ass-u-me)-d that those 99% are friends (not objective) instead of those (starting from neutral) positively influenced by what they have objectively found out for themselves. Dare I say….naughty lil Anthony?
p.s. McGill and Cook are both into “patterns”, therefore not at odds.
I stumbled upon this website while looking for corrective exercises to throw in the FMS. I perform the FMS on patients in a fitness studio located in a chiro office. This seems to be a very polarizing debate you guys have going on here. Please take the FMS for what it’s really worth…a tool. It’s up to the practioner/coach/trainer to interpret the data obtained and follow up with appropriate corrective exercises that ANYONE can benefit from. That’s all. Just like with anything else in our field, it’s not a one size fit’s all. Nothing in our field is (did you hear me CrossFitters?). It’s a tool to be used to help identify problems. That’s all.
Anoop | Sat February 04, 2012
Hi Rob,
It is a ‘tool’ for what?
As I wrote in the article, it is not justifiable on the general population.
And maybe people don’t need corrective exercise. There are people with disc herniation going around in their life happily without even knowing they have one.
T Barr | Wed February 15, 2012
The FMS does not say that a person WILL get injured if the fail the FMS. If anyone says that they are wrong. What the FMS group is saying is that there is evidence that movement patterns are a modifiable risk factor involved with musculoskeletal injuries. But movement patterns are just one of many biological factors that must be considered with other psychological and social factors that may contribute to injuries.
I have heard the FMS talk about the limitations of the screen in low velocity/intensity situations. An example is high school athletes, where the FMS cut off score has not been able to predict an increase risk in injuries, most likely due to other factors (most likely psychological). Does this mean that the FMS should not be used? In my opinion, that would mean that you are ignoring the other evidence that supports its use.
In the case that you do not use it, what are you using to screen people? What sort of systematic and replicable steps are taken to ensure that a person can take part in activity without elevated risk. Again, that is risk, not guarantee, of injury. I like Rob’s idea that it is a tool that the practitioner has to effectively incorporate into all the other information to use. If it dominates all of your decision making, you are mis-applying it. So that hypothetical recreational jogger (5 miles/week) who fails the FMS does not necessarily need to quit running, they may not be taking part in enough activity to cause an injury. However, if a personal trainer increases the activity level of someone with poor movement, might that not put them in the category where the FMS score is more important?
Other thoughts:
FMS cannot point out muscular tightness and weaknesses. It points out a faulty movement pattern. Is a failing score on the Overhead Deep Squat the result of gastric-soleus tightness? Hip flexor? Hip adductors? You cannot tell that from the movement itself. It only exposes the movement with the problem, the practitioner has to take extra steps from there.
The FMS should only be used in situations where there is an intact Central & Peripheral Nervous System and no acute distress. So the example of a some one with a stroke, amputee, etc does not apply here. Same goes for someone who walks in with a painful back, or right after ACL reconstructive surgery. They fail the screen without even taking it.
There IS evidence that movement patterns do play a role in injury outside of the FMS. The female ACL injury issue is a clear example. If a female continues to be a valgus squatter with poor stability of the knee and hip, the ACL will not get stronger as a result of the increased stress placed upon it, to the point that it will not tear.
One of the central philosophies of the FMS is that movement is not sport or person specific, it is species specific. There are certain movements that humans (all humans with an intake central nervous system, free from gross musculoskeletal pathology or other diseases) should be able to move. FMS sets the baseline in this situation.
I am not ignorant of the limitations of FMS. I will never “Pass” the FMS. Knee surgery has left me with chronic right knee pain with flexion past 45 degrees. But I know that I should continue to pursue the baseline of a deep squat, even though I will never get there.
FMS is part of the puzzle. There is evidence (Citations can be provided) that it is useful. However, it does not have to be used. If you evaluate it, judge it to be not useful in you situation, delete it an move on. I simply think there is much useful information contained within the FMS.
Final thoughts:
I love discussing this stuff, I hope everyone keeps a productive discussion going!
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