FMS is a battery of 7 movement tests which claims to predict injuries and even prevent injuries. It is becoming very popular among NFL players and other fitness professionals.
From what I have seen, the majority of people who use the screen are personal trainers. I wrote a review about FMS when I attended a 2-day seminar 3 years back here (Functional Movement screen).
Gray Cook, one of the brightest and most eloquent in the industry, in one of his recent podcasts talks about how FMS screen should be used on everyone just like a blood pressure screen. Let us see if FMS can be used as a screen or not.
In the FMS study for NFL players, the sensitivity was 46%. That means out of 100 people who will get injured, the test only identified 46 of them correctly, which is less for a screening test. A screening test needs high sensitivity (90%) because we want to identify as many people with the disease because we think this disease is of such importance that people need to be screened for.
So you have to ask yourself, with any screen, does all this time, money, and anxiety people have to go through, will it improve the quality of life in anyway? Will trying to minimize an injury which has the chances of next to nil in years improve her quality of life? Probably not.
But what about an NFL player? For the NFL players, the benefits are huge. The severity and frequency of the problem is so high, the risk of getting injured is next to losing millions and their career. FMS also shown to predict injuries in NFL in one study. Injury prevention should be their primary goal.
| Mon January 24, 2011 
I agree and disagree with the article. Through my education in functional performance I used FMS, and apply it today in my practice. I think where the screener or interpreter looses traction is in the application of the screens. Just like when you have a patient with bilateral (0) DTR’s, this doesn’t mean they have bilateral neuropathy. Thus is true in the FMS screening procedure. You are looking for the aspect of the screen, that one thing that jumps out at you as the professional that will determine the likelihood of injury. Say for instance a long distance runner scores low and fails quite a few screens but fails the deep squat exam due to restrictions in the ankle complex. Giving that athlete the tools to fix that ONE problem will save the SI joints and the probability of their low back getting chewed up from poor biomechanics. Take home message with FMS screens is to find the primary biomechanical fault and fix it!
Anoop | Tue January 25, 2011 
Hi John,
Thanks for the comment.
I don’t think you are interpreting FMS right. The whole point of FMS is not too look at isolated muscles & joints, but look at movements as a whole since it is based on the theory of regional interdependence. So an ankle problem could be due to a core stability problem and so forth.
And why deep squat? Why not hurdle step or lunge which mimics the running motion way better than a deep squat? And if you have shoulder mobility issues, you will fail the deep squat too.
And just so that you know, running is the most simple sport. It is studied to death and the strongest predictor for injury was shown to be weekly mileag - the other variables looked at included stretching, warm up, hip abductor strength, eccentric strength, anatomical factors (leg length, cavus foot). So imagine the complexities for injury prevention in sports like football and such.
| Tue January 25, 2011
I couldn’t agree with you more 
. I guess my interpretation of the article was the fact FMS was not accurate in “finding” the problem, and posed a problem when practitioners wanted to treat the positive findings. It also stated that FMS has failed to prove its relevance in injury prevention. And that is what I couldn’t disagree with more. My examples were arbitrary and not really to prove any point.
| Sat January 29, 2011 
The FMS is not only a screening tool. It is a program design tool.
It tells you what not to do, but it also tells what to do.
Corrective exercise can be hard work for the person who it is corrective for. And it doesnt have to be slow paced, lying on the ground stuff.
You just have to be creative in your movement choices and be aware of your communication with the client.
“You have a risk of injury” would not be something you should be saying. In fact dont say anything. Screen them, get them moving…the right way
Anoop | Sat January 29, 2011
Hi Gerrit,
Thanks for the comment.
I am not sure what you are saying. FMS means functional movement “screen”.
I do get them moving but not the right way because I really don’t know the right way. Who defined the right way and on what basis? I can see plenty of people moving in the “wrong way” and still with no problems whatsoever.
| Sat January 29, 2011 
The Screen tells you the right way.
By letting you quantify fundamental movement patterns and their limitations, their intertwining, and their progressions, it gives you a powerful program design guideline.
Say somebody scores low on the inline lunge. From a program design perspective you know your gonna have him work in the half kneeling position and NOT in a split position. Since the Split position is too challening a good regression is the half kneeling position.
Med Ball tosses from half kneeling, presses and pulls from half kneeling. Make him do work within the functionality of his own body.
As he progresses you recheck the inline lunge. If its okay it gives you green light to progress him to split stance work or lunging patterns.
When you use the same process with all movement patterns you almost have a readymade program specifically designed for each individual client.
Follow this blueprint and you will be having your clients move better. And this will fit every definition of “better movement”.
Its not only a screen, but a program design blueprint
| Sat January 29, 2011
and regarding your comment on “they move the wrong way but still dont have any problems”
Dont look for the car accident. Look for worn out brakes, slick tires, the broken AC, dirty car seats. Even though it could be this might not present a problem right now, but there is a chance it will present a problem in 10,15,20 or 40 years.
Good Program Design has to eliminate that chance.
P.S.: I give credit to Charlie Weingroff for the car accident analogy
Anoop | Sat January 29, 2011
Hi Gerrit,
Thanks for the reply.
I used to give these examples 8-1o years back when I knew little about pain and such. The human body and the pain mechanisms are extremely complex to compare it with a car.
It is now pretty clear that the biomechanical model of pain has very little to do with pain. That is the reason why people who are moving the” wrong way” or have “bad postures” are doing fine. That is also the reason why multiple studies have shown problems like disc herniations, spinal stenosis, tendonitis and other extreme dysfunction in asymptomatic people (with no pain ). That is also the reason why the physical therapy field is moving from a tissue based model to a neurological based model.
The whole thing of you won’t get pain now, but you will in 10, 15, and 40 years is just fear mongering. And if you didn’t get in 40, they say you will in 60!
And moving in a certain way might be more applicable to acute acute injuries & populations who are involved with extreme forces, like athletes. So there is big difference when you talk about pain and acute injuries and when you talk about the general population and athletes.
| Sat January 29, 2011
I appreciate your response but I respectfully disagree. Although I certainly do not have the same experience as you have, we could have clinical conversation on that topic, but in my opinion we have to set a base before specifics even matter.
While actually everything is grey, to understand and organize it you have to first think black/white. In that realm : analogies a great tool to understand complex systems.
I think we agree on the importance of proper movement in athletes. High Velocity, High Forces, High Volumes. Little changes can become magnified. Seconds matter, little injuries can cost millions.
But dont you think it becomes hard drawing a line between athletes and general population?
And more important, and probably the only question that matters : What is a good reason NOT to care about movement in general population?
You are right, I dont want to have my clients pay me for 15 minutes of mobilizing&stabilizing; without knowing if it reduces their risk of injury.
But that is not what the screen forces you to do. It just gives you a guideline of how to program movement. How you design your sessions is still up to each individual trainer.
And I totally agree that “fear” is not an appropriate trigger and is not to be used to explain the benefits of a screen.
The benefits lie in setting a baseline, teaching proper movement and improving communication about movement with other professionals.
I strongly believe in having something to quantify movement quality and using this data to modify program design. Be it athletes or general population.
Every performance coach tests performance (power output, energy systems), body composition and health parameters and modifies his programs according to these numbers. Why not quantify movement and modify movement according to these numbers?
| Sat January 29, 2011 
I think if you have a better system, share it with us instead of trying to destroy something that has been in place for several years and proven to have had a positive benefit in several individuals who participate within the context of the entire system. I think it is easy to try and discredit something as opposed to offering a better solution. Give me that and I will listen, otherwise, take your poor spelling and bad grammer elsewhere!
Anoop | Sat January 29, 2011
Hi Gerrit,
I do appreciate keeping the discussion to the point and civil.
We know it is extremely beneficial to keep a low back arch when you lift heavy weights. But do you keep a low back arch when you lift a pencil too? Probably not. Doesn’t quality of movement matter?
And it is not hard to draw the line when you evaluate the client goals and needs which you should know before working with any client, which I am sure you do.
“What is a good reason NOT to care about movement in general population?”
When you talk about good movement, you have to define why we need it in the first place. And if it for injury prevention (and it the reason why FMS is for), then the above article clearly explains why not to care. If it for some other reason that cannot be defined, this article probably won’t apply.
And you are walking on very thin ice when you make statements like “strongly believe in quality of movements”. We don’t have very much evidence if the FMS movements will indeed carry over to other sports movements as claimed. We don’t know if indeed we changed movements, it will show up as improved quality or performance either. We know it can somewhat predict injuries in NFL players & firefighters from moderate quality studies. That’s all.
There is some value to the athletic population as I wrote because of the reasons in the article. Injury prevention is pretty complex and hence not as black or white to give a yes or no answer.
Anoop | Sat January 29, 2011
Hi Keith,
Thanks for the comment.
If you read the article, I am saying why we don’t need this system in the first place. So there is no question arising of an alternative or a better system.
I wrote it is good for athletes even when I am sure many strength coaches would not even go that far. I said it is not beneficial to the lay people .What do you expect me to say? That we should teach FMS in school? And I do understand your frustration considering you charge $200.00 for this FMS.
And for the spelling and grammar. This isn’t a full time job for me nor this is a membership based site. It takes a few hours to write an article since I am not blindly copying what he said or what is written. After all that I am too impatient to sit through and check for grammar and spelling though many people have told me that I should. And you won’t understand considering your first and last post in your blog was in 2006.
Your comment about “taking it elsewhere” is only valid if I wrote that article in YOUR blog without invitation. I wrote it in MY blog. Makes sense?
Just a final note, grammer is spelled as “grammar”. Hope it helps.
| Sun January 30, 2011
Anoop,
You do have some valid points and thank you for having this discussion as I am learning a lot.
The hypothesis is that having people move according to the Functional Movement System improves their functionality, their movement and significantly reduces their chance of musculoskeletal problems in the future.
This is what experts like Cook, Burton, Kiesel teach, this is my experience, this is the experience of a lot of other very successful trainers and from a logical standpoint it just makes total sense if you look at developmental kinesiology (innocent until proven guilty)
Until there is a valid Antithesis this is regarded as being true. This is how Science works and not the other way around.
I like the concept of your blog. There is probably too much anecdotal information out there, especially in the fitness world.
But when you want to be evidence based, what level of evidence based are you really looking to achieve?
According to the Oxford center for clinical evidence the entry level of evidence based is the opinion of an expert.
Im just a coach. And from a coaches perspective the screen helps me to have all my clients work hard within their capabilities. Athletes and Non-Athletes.
Anoop | Sun January 30, 2011
Thanks, Gerrit. And really glad to hear you are learning.
Every treatment modality or exercise intervention, or for that matter, every exercise has some benefits and costs. You don’t try to squeeze in everything right? You pick the one based on your client goals, needs , availability, cost, scientific evidence and such.
As I said, if you think injury prevention is important for your client and your think the same, you should go ahead and work on it. FMS might be a good for that. Bu do understand the limitations too. For the reasons I said, it cannot be justified as a screen for everyone. And injury prevention definitely need more than FMS. If I am preventing ACL injuries, there is some clear research about specific prevention programs which I will have to include too.
Usually the highest in the hierarchy is meta analysis and reviews. As we go lower in the level, the validity and reliability falls too. Expert opinion is considered the lowest form of evidence. There is a good reason because history has provided with countless examples of experts being wrong . It is also the large reason why evidence based approach evolved in the first place. Experts were getting it wrong, but couldn’t see through the cloud of confirmation bias.
It is also the reason Kyle and Burton are conducting studies on FMS. And that is good.
| Sun January 30, 2011
Until these studies come out I will keep using the FMS. Not primarily to prevent injuries, but to design effective programs.
As Cosgrove said it :“Sports science is sports history”
| Mon January 31, 2011 
I’d like to see any study of something like FMS be carried out by people who have no vested interest in its effectiveness. If not, I’ll be suspect of any positive result. Seems like something that would be very difficult to study in way that will give a reliable result. I mean, it can’t exactly be blind.
Anoop | Tue February 01, 2011
Hi Gerrit,
And “effective” for what?
Some of the norms and standards we usually go by are dictated by our culture and tradition than anything else. The “good” posture and movement is a good example of how we associate health with how people look. So if someone moves with a round back, we automatically associate it with bad, unhealthy, pain and so forth.
Hi Bill,
Good point. That’s why people usually wait for other independent studies to make conclusions. They can use common methods like concealed allocation and blinded outcome assessors to take out the bias. But I don’t want to go to study details and such.
| Tue February 01, 2011
Effective for Aesthetics and Health while also improving functionality (static & dynamic posture, motor control & strength).
Every good coach/trainer intuitively follows the rules of the functional movement system, sometimes without even knowing this system exists.
Its just about proper progressions. Every coach/trainer should have a system that guides his programming decisions & tells him when to regress/progress. That is all I am saying.
| Tue June 07, 2011 
Nice article, Anoop.
Where i can read more articles (get more info) about functional movement screen ?
Anoop | Wed June 08, 2011
Thanks Macro.
You can read plenty of articles by authors who are just totally fascinated by FMS and feel like they found the answer to everything they have been looking for. I don’t think there is any article out there which takes a critical look at FMS.
Check www.somasimple.com. There are a couple of good discussions about FMS in the forum.
| Mon August 29, 2011 
Great article Anoop.
I’ve actually read this a couple times over the past month, even though its old, and finally got around to reading the comments… wow what a discussion.
There were a couple things I wanted to say though in regard to your discussion with Gerrit. And I think it applies in both accounts.
1) The scientific approach does not mean “innocent until proven guilty” nor does it mean factual until proven discredited. In fact, science works on a system of theories, once validated through a battery of trials, they become laws. Realistically, almost every scientific law we have ever had has been replaced at some point by some other law. So, in regards to Gerrit’s comment about requiring a valid antithesis- that’s misguided. FMS is a theory, or an approach. just like the scientific method is a theory/approach. So if you can understand that quantitative backing comes from science, and scientific methodology is theoretical ( because it has never actually been 100% validated), and FMS is based on scientifically obtained quantitative data, then there should be no debate as to whether or not to use it. In short, it is theory- use your best judgement.
2) As we design client programs, we do so with the consideration of bio-individuality. Gerrit even argued this point, which is 100% true. However Anoop mentioned that the FMS is a standardized screening procedure, so how can one use a standardized measure to quantify movements of non-standardized individuals, thus why would we ever consider it valid? Well I believe the answer lies in the combination of both arguments. Programs are individual specific. Movement screening should therefore be as well. So it is up to the trainer to continue their education to understand testing validity in regard to the capable specificity of each client. In essence, what I am saying is that FMS is like Gerrit said, a roadmap- even it is wrong, it can narrow down the correct path. However, we must always bear in mind Anoop’s point, which is that FMS may not be the correct map to be viewing depending upon the client. And that is where society screws up the methodology because once someone pays $$$ for a certification to do whatever, they are going to use it and confirm its validity regardless of its relevance or not.
Anoop | Thu September 01, 2011
Thanks Matt for the comments! And you make good points.
| Thu September 08, 2011 
So which assessment tool would you recommend?
| Thu September 08, 2011 
I think the lesson learned here is to make a judgement call. not one screen is particularly better than the other as they are all flawed in some way, however the situation may dictate that one is more relevant than another. so confirm its validity for your scenario and take it from there. perhaps later down the road a variety of screens during the course of the training regimen may be required. its like a tootsie pop, the world may never know.
| Sat October 29, 2011 
What a great discussion/ debate. Kudos to you guys for keeping it pro.
| Wed December 21, 2011 
Yes, PT moving to a neurological model is a good thing!
Anoop | Wed December 21, 2011
Thanks guys for the comments. I will have another review about the new FMs study soon.
| Sat January 14, 2012 
Hi Anoop,
“It is now pretty clear that the biomechanical model of pain has very little to do with pain. That is the reason why people who are moving the” wrong way” or have “bad postures” are doing fine. That is also the reason why multiple studies have shown problems like disc herniations, spinal stenosis, tendonitis and other extreme dysfunction in asymptomatic people (with no pain ). That is also the reason why the physical therapy field is moving from a tissue based model to a neurological based model. “
It appears to me that FMS and its corrective work are primarily used to address motor control issues. Someones body is ‘confused’, maybe due to previous injury without rehab, and there is a deeply ingrained compensation happening which is limiting their mobility and stability and perhaps contributing to pain. Addressing and solving these issues - is that not a neurological based model?
“The “good” posture and movement is a good example of how we associate health with how people look. So if someone moves with a round back, we automatically associate it with bad, unhealthy, pain and so forth.”
Of course we address posture when working with clients. In it’s optimal position the spine asserts it’s own inherent stiffness/stability. When a client is in hypo/hyper lordosis/kyphosis the rest of the body is compensating to do the job of the spine - inefficient, wear and tear, develops poor motor control
Anoop | Sat January 14, 2012
Hi Andre,
I have wrote one long about it: here it is: http://bretcontreras.com/2011/03/a-revolution-in-the-understanding-of-pain-and-treatment-of-chronic-pain/
Terms like inefficient, wear and tear means nothing. What we worry about is pain.
Hopefully, once you read that article, you will have a better grasp of what I am trying to say.
