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.

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