apply-functional-movement-screening

name	apply-functional-movement-screening
description	Use when assessing an athlete's or client's movement quality to identify dysfunction, asymmetry, and injury risk before designing a training or rehabilitation program
source	Cook, Burton & Hoogenboom "Functional Movement Screening" IJSPT (2006); Cook "Movement" (2010); Kiesel, Plisky & Butler "Functional Movement Test Scores Improve Following a Standardized Off-Season" (2011); NSCA movement assessment guidelines
tags	["fms","movement-screening","injury-prevention","assessment","dysfunction","asymmetry","movement-quality"]
verified	true

Apply Functional Movement Screening

Administer the Functional Movement Screen (FMS) to score movement patterns, identify pain and dysfunction, and prioritize corrective exercise interventions before training begins.

Disclaimer: This skill is educational and not medical advice. Any pain score, suspected injury, or condition uncovered during screening must be evaluated by a qualified healthcare provider before training continues.

Why This Is Best Practice

Adopted by: NFL teams (Green Bay Packers, San Francisco 49ers FMS-documented programs), US Army, Fire departments (occupational readiness screening), NCAA programs, and physical therapy clinics in 45+ countries Impact: Kiesel et al. (2011) showed that NFL players scoring ≤14 on the FMS had a 51% injury risk vs. 5% for those scoring >14; a pre-season FMS-guided corrective program raised average scores from 13.6 to 16.0 and reduced injuries by 40%; Cook et al. (2006) established reliability coefficients of 0.81–0.90 for the 7 test patterns Why best: Standard strength and fitness testing measures capacity; FMS measures movement quality and asymmetry, which are independent injury predictors not captured by strength, endurance, or power tests — athletes can be strong and dysfunctional simultaneously

Sources: Cook, G., Burton, L. & Hoogenboom, B. IJSPT (2006); Cook, G. "Movement" (2010); Kiesel, K., Plisky, P. & Butler, R. NAJSPT (2011); Minick, K. et al. JSCR (2010)

Steps

1. Set up the testing environment — FMS requires a dowel rod (standard broomstick), measuring tape, and clear space; administer on a firm, flat surface; tests must be administered in the standardized order (Deep Squat → Hurdle Step → Inline Lunge → Shoulder Mobility → Active Straight Leg Raise → Trunk Stability Push-Up → Rotary Stability); order affects warm-up state and must not vary
2. Brief the client on scoring before beginning — Explain the 0–3 scoring system: 3 = performs correctly without compensation; 2 = performs with compensation or partial completion; 1 = cannot perform minimum criteria; 0 = pain during movement (automatic score, stop the test, refer for medical evaluation before proceeding); record all scores on a standardized FMS scoresheet
3. Administer Test 1 — Deep Squat — Client holds dowel overhead with wide grip, arms fully extended, feet shoulder-width apart, toes forward; squats as deep as possible; score 3: torso parallel to tibia, knees aligned over toes, dowel over feet, heels flat; common compensations: heel rise, forward lean, knee valgus, dowel forward of feet; note side of asymmetry if any
4. Administer Test 2 — Hurdle Step — Set hurdle at tibial tuberosity height; client stands behind hurdle, steps over with one leg touching heel to ground on other side, returns; score 3: no hip/spine movement, stance leg stable, dowel and shoulders horizontal; test both sides; asymmetry flag: ≥1 point difference between left and right
5. Administer Tests 3–5 — Lunge, Shoulder, Leg Raise — Inline Lunge: assess hip, knee, ankle stability in split stance with dowel held vertically behind back; Shoulder Mobility: reach behind back from above and below, measure fist distance; Active Straight Leg Raise: supine leg raise to 70° while keeping opposite leg flat; each test scored 1–3, both sides, asymmetry flagged
6. Administer Tests 6–7 — Push-Up and Rotary Stability — Trunk Stability Push-Up: prone push-up from standardized hand position (thumbs at forehead level for men, chin level for women); tests spinal stability under load; Rotary Stability: quadruped ipsilateral and contralateral limb extension; these tests assess the anti-rotation and spinal stability patterns essential for loaded sport movements
7. Calculate the composite score and identify pain tests — Sum all 7 test scores (maximum 21); any test scored 0 (pain) must be cleared medically before training program design; note every asymmetry (≥1 point L vs. R difference); composite ≤14 = elevated injury risk; asymmetry present = injury risk independent of composite score
8. Prioritize corrective interventions using the FMS hierarchy — Address in this order: (1) clear pain (0-score tests) — refer and resolve; (2) correct asymmetry in bilateral tests (even if scores are 2–2, asymmetry patterns elevate risk); (3) improve lowest-scoring bilateral patterns; (4) strengthen movement patterns once quality is established; never load dysfunctional patterns — this reinforces compensation

Rules

• Never train through an FMS score of 0 (pain) — a 0 means the movement causes pain and requires medical evaluation; continuing to train through pain patterns drives compensation and accelerates injury
• Asymmetry is weighted equally to low composite score — a client scoring 3/3/3/3/3/3/3 (but 2L/3R on one test) has an injury risk that the composite score alone does not reveal; asymmetry is an independent risk factor
• Test in the standardized sequence every time — changing test order alters the warm-up state and makes longitudinal comparison invalid; FMS validity depends on protocol consistency
• Do not coach form during testing — the screen captures natural movement patterns, including compensations; coaching the client to "do it better" during testing obscures the dysfunction you are trying to identify
• Never use FMS score as the sole training program input — FMS identifies movement quality deficits; it does not measure strength, power, aerobic fitness, sport skill, or psychological readiness; it is one layer in a complete athlete assessment

Common Mistakes

• Coaching during the screen — Trainers who cue the client to "push your knees out" or "sit back more" during the deep squat test are measuring their cueing ability, not the client's movement pattern; administer the test silently after initial instructions
• Ignoring asymmetry when composites look acceptable — A composite score of 18 with a 3/1 asymmetry on the hurdle step is more dangerous than a composite of 14 with bilateral 2s; asymmetry drives unequal loading patterns that accumulate into injury under training volume
• Using FMS as a fitness test — FMS measures movement quality, not fitness; athletic-looking individuals often score poorly; sedentary individuals with good mobility can score well; do not adjust scoring based on how fit the client looks
• Failing to rescreen before progressing load — Loading a dysfunctional pattern cements the compensation; training programs must be gated by score improvement, not time in the program; until the pattern is corrected, volume and load should remain conservative

Examples

NFL linebacker pre-season screen: Composite 13/21 with hurdle step asymmetry (2R/1L) and pain in rotary stability (score 0); medical referral for SI joint evaluation; corrective program addressing hip mobility asymmetry and lumbar stability; rescore at 8 weeks: 17/21, asymmetry resolved, pain cleared; transitioned to full pre-season training program

Recreational runner injury prevention screen: Composite 16/21 with active straight leg raise asymmetry (3R/2L) and ankle dorsiflexion restriction causing deep squat score of 2; 6-week corrective program: daily ankle dorsiflexion work, hamstring PNF stretching left side; rescore: 19/21 with asymmetry resolved; running mileage build commenced without injury over subsequent 16-week marathon program

When NOT to Use

• When the client has acute pain, recent surgery, or is in active rehabilitation — the FMS is a screening tool for training-ready individuals, not a clinical diagnostic tool; acute conditions require physical therapy evaluation first
• When the goal is fitness assessment rather than movement quality screening — if the question is "how fit is this person?" use fitness tests (VO2max, strength tests, body composition); FMS answers "how well do they move?" — different question
• When the client cannot understand or follow multi-step verbal instructions — FMS validity requires the client to understand and attempt the test pattern accurately; cognitive or language barriers require modified assessment approaches