No athlete is perfect.
There's always something to improve upon, something to fine-tune, something to optimize. Knowing those things is essential to becoming the best athlete you can be. Lucky for you, a simple test that takes roughly 10 minutes to administer and costs virtually nothing can provide you with an incredible wealth of information about your body. That test is known as the Functional Movement Screen.
The Functional Movement Screen (or FMS) was developed by physical therapist Gray Cook in 2001. According to Cook, the FMS helps "determine the greatest areas of movement deficiency, demonstrate limitations of asymmetries and eventually correlate these with an outcome." That's why nearly every top training facility on earth uses it with their athletes. On its face, the FMS looks deceptively simple. It consists of just seven simple unweighted movements. But to the trained eye of an expert, those seven movements provide a great deal of information about how your body moves.
"Many people are able to perform a wide range of activities, yet are unable to efficiently execute the movements in the screen. Those who score poorly on the screens are using compensatory movement patterns during regular activities. If these compensations continue, sub-optimal movement patterns are reinforced, leading to poor biomechanics and possibly contributing to future injury," Cook wrote in his The Functional Movement Screen Home Study Course Manual.
As part of Nike's Limitless Potential program—an 8-week experience curated in the spirit of the Olympics to show how the world's best athletes train—I got the chance to go through an Advanced Athlete Assessment at Michael Johnson Performance Center in McKinney, Texas. The assessment included all sorts of high-tech analysis with ridiculously expensive equipment, but the most indispensable of all their tests was the FMS. It is something that every high-level athlete who walks through their doors must perform.
To help you better understand the FMS and the insights it can provide, here's a step-by-step guide along with my own personal experience with each of the movements.
Scoring of the FMS: Every movement is scored on a scale from 0-3. If any pain is felt during a movement, it's an automatic 0. A 1 means the person can perform the movement but not very well. A score of 2 means they can perform it but there's some form of compensation going on. A 3 is a perfect score. The test administer grades each of the seven movements (selecting the lower score of the two for tests performed on both sides of the body), adds them together, and is left with a score between 0 (which would indicate pain on every test) and 21 (which would indicate a perfect score on every test).
Movement 1: Shoulder Mobility
Instructions: The trainer measures the length of your right hand from the wrist to the tip of the middle finger. From there, stand with your feet together and make two fists with your thumb on the inside. In one motion, wrap one arm behind your neck and the other arm underneath your shoulder and try to get them as close as possible. Once the measurement is taken, switch sides.
What does a 3 look like? The scoring here is based entirely on how close you're capable of getting your fists together. If you can get your fists within one hand-length (which the trainer just measured), that's a 3. One-and-a-half hand lengths is a 2.
Common problems: This test focuses solely on shoulder mobility, so a low score is a direct result of poor mobility. "We're looking at a few things here. When you're coming over your back that's external rotation, when you're coming down below that's internal rotation. We need mobility before we can built stability, so we have to get you to move before we can stabilize it," says Lindsey Anderson, CSCS and MJPC performance specialist.
My experience: This was my first movement of the day, and no warm-up was performed prior to the FMS. When I went to touch my fists together, I was greeted by a symphony of joint pops. I wasn't told my exact score, but I think my best-case scenario was a 2. Maybe it's time to invest in a back scratcher.
Clearing Test 1: Elbow Raise
Instructions: In addition to the seven movements of the FMS, there are also three "clearing tests." These aren't scored on the 0-3 scale like the other movements. They are simply tests to determine if you can perform the movement without pain. "If you do have pain in a clearing test, let's say on the shoulder for example, that might be impingement. Then our physical therapists can go in and look closer to see what's really going on," Anderson says. The first clearing test requires you to simply place your palm on the opposite shoulder and raise your elbow. Fortunately, I experienced no pain on any of the clearing tests.
Movement 2: Overhead Squat
Instructions: Begin with your feet shoulder-width apart. Ankles underneath armpits. Toes straight forward. Dowel on top of your head with your elbows at a 90-degree angle. Push the dowel above your head to lock out your arms, squat down as far as you can while trying to keep the dowel over your feet. Perform three repetitions.
What does a 3 look like? Upper torso parallel with tibia, femur below horizontal, knees aligned over feet, dowel aligned over feet.
Common problems: "We see a lot of compensations down below. Toes are coming out, knees are coming in. Your body's searching for ways to get you in that depth. Then we're adding that upper stability. Because whether you're training or you're playing, you need stability up top and below," says Anderson.
My experience: As a guy who measures 6-foot-6, Overhead Squats have always been a special challenge for me. I can't seem to get the proper depth without having the bar drift forward. Such was the case here. "That's a sign you might need some more stability through your core and glutes," said Anderson. To help me compensate for that, Anderson slid an FMS beam under my heels. That gave me some assistance by taking the load off my glutes, and I was able to keep the dowel at the proper level. Proper form without the beam under the heels is scored a 3, proper form with the beam under heels is scored a 2.
Movement 3: Trunk Stability Push-Up
Instructions: Lie on the ground. Curl your toes under your feet. For men, thumbs should be at forehead height. For women, thumbs at chin height. Elbows up. Legs straight. From this position, push yourself up while keeping your body "straight as a board."
What does a 3 look like? Proper Push-Up form with the body lifting as one unit and no lag in the spine or core.
Common problems: Lagging in the mid-section and core, showing a lack of trunk stability. "(This test) is used as a basic observation of reflex core stabilization and is not a test or measure of upper-body strength," Cook writes.
My experience: This was probably my best movement of the day. It felt like a 3. Please, just let me have this.
Clearing Test 2: Upward Spinal Extension
Instructions: Perform a press-up from the Push-Up position, similar to an Upward Facing Dog in yoga.
Movement 4: Hurdle Step
Instructions: Hurdle height should be adjusted to the top of your tibia. Dowel held across shoulders. Feet together and as close to the board as possible. Keeping a tall posture, reach one leg up and over the wire and touch your heel to the floor. Bring it back up and over to the starting spot while maintaining tall posture. Perform three steps on the right and three on the left.
What does a 3 look like? Hips, knees and ankles remain aligned in the sagittal plane. No movement in the lumbar spine. The dowel and the hurdle remain parallel throughout the movement.
Common Problems: A lack of alignment in the hips, knees and ankles, and movement in the lumbar spine. "Basically, we're looking for stability and mobility. If you're standing on your left leg and bringing your right foot over the wire, you need to be stable on your left side and mobile on your right," says Mark Pryer, CSCS, functional range conditioning mobility specialist and performance specialist at MJPC.
My experience: This one was tougher than it looked. I had some external rotation in my hips as I was bringing my leg over, preventing my hip, knee and ankle from staying aligned in the sagittal plane. "Little bit of hip mobility issues, it could be something as easy as trying to open up your hips a little bit or needing some extra core strength. Something simple like that," Pryce said. I scored a 2 on both sides.
Movement 5: Inline Lunge
Instructions: Back foot behind the zero, front toe at the length of your tibia measurement. Arm of your front leg holding the dowel on your lower back, arm of your back leg holding the dowel against your head. Eyes straight ahead. Drop the front knee straight down into a Lunge and come up, keeping the dowel vertical.
What does a 3 look like? Dowel maintains contact from lower back to back of head throughout the movement while remaining vertical. No torso movement. Knee touches board behind heel of front foot.
Common problems: Loss of balance, dowel contact not maintained, proper depth not achieved. "It is intended to place the body in a position to focus on the stresses as simulated during rotation, deceleration and lateral movements," Cook writes.
My experience: Although I wasn't aware the dowel needed to touch the back of my head when my left foot was in front, Pryor got me right before I switched sides. I was able to keep the dowel in contact throughout the movement and achieved the proper depth on both legs, earning me two 3s.
Movement 6: Rotary Stability
Instructions: Get on all fours straddling the beam. Hips directly on top of knees. Hands directly underneath shoulders. Hands and knees touching the beam. First, see if you can perform an ipsilateral movement—meaning you extend both your arm and leg on the same side at the same time. If you can, then touch your elbow to your knee and return to the starting position. If not, perform a contralateral movement where you extend opposite arm and leg before touching knee to elbow and returning to the starting position.
What does a 3 look like? Performing the ipsilateral movement while keeping torso parallel to the board and your elbow and knee in line earns a 3. Performing the contralateral movement with proper form earns a 2.
Common problems: Inability to reach full extension in the ipsilateral movement before losing balance. Cook describes it as a test of "multi-plane pelvis, core and shoulder girdle stability during a combine upper- and lower-extremity movement. [It's] complex, requiring proper neuromuscular coordination and energy transfer through the torso."
My experience: The words "Rotary Stability ipsilateral movement" will probably be burned in my brain forever. Why? Because it was tough. Really tough! I was (barely) able to pull off the ipsilateral movement while lifting my right arm and leg, which in and of itself was something to be proud of. According to the estimate of an MJPC trainer, 75 percent of the pro athletes they put through the FMS cannot correctly perform the ipsilateral Rotary Stability movement. However, I was not able to repeat the movement on the other side. I'm naturally left-handed and have had a variety of injuries on my right half, so I wasn't surprised that my right side didn't have enough stability. My failure resulted in me being tested on the contralateral movement, which I was able to perform without issue on both sides.
Clearing Test 3: Downward Spinal Flexion
From an all-fours position, place the top of your feet on the floor and rock your hips back while keeping your hands on the ground in front of you. Relax your head. This is similar to a Child's Pose in yoga.
Movement 7: Active Straight-Leg Raise
Instructions: Lie flat on your back with your legs fully extended. The dowel is held vertically at mid-thigh, which usually corresponds to the mid-point of the patella. Keeping both legs as straight as possible, pull one leg as far back as possible. Perform up to three repetitions on each leg, but if a 3 is recorded, there's no need to perform additional reps on that side.
What does a 3 look like? Like this. The ankle bone (or malleolus) of the raised leg goes past the dowel.
Common problems: Leg on floor externally rotating at the hip, knees excessively bend.
My experience: Not much to say about this one. I only performed two reps on each side, so I'm hoping that means I was able to score a 3. Also, MJPC performance specialist Juan Robles told me "(my) hamstrings weren't bad," so I'm basically a gymnast.
A higher score on the FMS has been equated with multiple positive trends among athletes. For example, a 2015 study in the International Journal of Sports Physical Therapy found that collegiate athletes who had a total score of 14 or below and had a self-reported past history of injury were found to have a 15 times higher risk of future injury. While the FMS certainly isn't the end all be all of athlete evaluations, its convenience, accessibility and ability to test a wide range of movement patterns make it a valuable tool. If you'd like to be evaluated in the FMS, ask your strength and conditioning coach if he's familiar with grading it. If not, you can use this tool to find a certified tester in your area.
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