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The Basics of the FMS | Boddicker Performance

Filed under: Program Design, Testing and Evaluation

The Basics of the FMS

by on Jul 12th, 2010

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Today, I had my friend Dr. Perry Nickelston share a little bit about how the FMS paradigm fits into his program, assessment, and a few other tidbits. Enjoy!

Carson Boddicker

One of the questions I get asked most frequently about the Functional Movement Screen is how I implement it into my evaluation procedure and what type of system I use based on the results. Well, I decided to give everyone an inside peek at my thought process whenever I have a new client coming in for the FMS. My perspective will be from a Sports Medicine point of view, but it can apply to any fitness professional. The thought process of gathering information is what you want to duplicate. The FMS is a system for movement evaluation, but it is also a process for gathering information about what your client should and should not do when exercising.

For those unfamiliar with the FMS, here is a brief overview. The (FMS) Functional Movement Screen is exactly what is implies; a screening for movement. It was created by Gray Cook, PT and Lee Burton, Phd. to look deeper into movement patterns, particularly dysfunctional movement of the body. It consists of seven movements; Deep Squat, Hurdle Step, In-line lunge, Shoulder Mobility, Active Straight Leg Raise, Trunk Stability Push-up, Rotary Stability. There is a scoring system of a possible 21 point perfect screen. These seven tests are designed to be used on a client who is NOT in pain. If someone experiences pain during a screening, it should be discontinued and further evaluation by a health professional is recommended to diagnose the cause. Why should the screening be stopped with pain? Movement patterns will be altered because a patient will compensate for pain and results may be skewed. Health professionals can utilize a more detailed evaluation to look at dysfunctional movement via the (SFMA) Selective Functional Movement Assessment, created by Gray Cook, Phil Plisky and Kyle Kiesel. This assessment is used to discover where the non-painful dysfunctional movement pattern exists that is causing the pain. You can visit www.functionalmovement.com to locate a healthcare provider in your area who is trained in the SFMA. Working directly with a healthcare professional who understands the primary role of movement is in the best interest of your client. They understand the ‘lingo’ and also work directly with you as a fitness professional in restoring proper function.

Your evaluation of a client starts from the moment you see them. Look at how they move. Look at how they walk, sit, stand, and the transition from sitting to standing. Observe their posture, taking notice of shoulder height, head tilt, upper back rounded or hunched, hip height, and foot flare. Do they shift to one hip when standing? How are they breathing (labored/chest breathers)? Do you notice asymmetrical muscular development (particularly in the glute structure)? In the words of Yogi Berra, You can observe a lot by just watching”. The idea is to really look at their posture in movement and in static positions. Look for asymmetries. This is the key to predicting injury. All of the previously mentioned observations combined with the FMS will show you asymmetries; weak links in the kinetic chain and energy leaks. These leaks are loss of power, speed, agility, flexibility, speed, performance and durability. All of which will be negatively affected if an athlete moves poorly. The lower the FMS score, the more you will be building physical fitness on top of dysfunctional movement, which will lead to poor performance and possible injury.

Take an in depth health and fitness history. No, I am not asking you to be a doctor and nor should you try. But, you must know the base foundation of a person’s health before you start moving them in loaded positions. A thorough history will help you determine the likelihood of injury and build a solid program to get maximum results based on their fitness goals. Note any prior injuries and if they had treatment. If so, what type of therapy? Was it surgical, physical therapy, chiropractic, etc. History of a prior injury is extremely important because it is a number one predictor of whether someone is at risk for re-injury. Don’t make the mistake of assuming just because someone went through rehab and no longer has pain, that they were released from care with the ability to move correctly. Absence of symptoms has no correlation to functional movement. It is safe to assume that if a client has suffered some type of lower back injury, they will typically have Inner Core dysfunctional firing patterns. So an integrated program should be done with your training to rebuild the Inner Core. As a professional side note on networking, I recommend you send an introductory letter to your client’s healthcare provider introducing yourself explaining your programs and the FMS.

During the FMS it is important that you not prejudge or jump to conclusions about what may be causing dysfunctional movement until you complete all seven tests. Gather all information before deciding on the course of action and corrections to take. All seven tests act as a filter and each one show more layers to the movement patterns. For example, if someone has difficulty completing an Overhead Deep Squat, don’t assume it’s because of restricted ankles or tight lats, you do not know that for sure yet. The other six movements will pick up the areas again if they are truly an issue. I have talked at length in the past on the need to have adequate mobility before you can build stability. That is what you strive for first. Remember the mantra mobility before stability. There are two tests in the FMS that focus on mobility (Shoulder Mobility and Active Straight Leg Raise), the others are looking primarily at stability. So these two mobility directed movements should address first if there are asymmetries or dysfunctions. Corrections to these will typically have the greatest impact on improving overall screening results and the other tests.

My plan of action on correcting these two areas include soft tissue work to the hip/glute/quad/thoracic spine/shoulder structure with foam rolling, tennis balls, medicine balls, The Stick and hands on fascial work. Then add rotational mobility drills to the t-spine and hip structure. Have your client perform these corrections for 2-weeks and then do the entire FMS again. There should be an improvement in previous asymmetries and better overall movement. If there is no improvement in movement, the FMS score goes down, or stays the same then you are not going in the right direction. You must reassess and change your course of action. This is assuming that your clients have been doing the corrections, and doing them correctly. If a client has the opportunity to perform an exercise wrong, they will. So you must watch them closely to make sure they ‘own’ the movement.

The FMS is a wonderful tool for observing progress. Your clients will love the instant feedback and value it adds to showing them how their body is improving, not only in how it looks but more importantly how it performs. Because when you move smarter, you move better and then you can perform great. The better you move; the more muscles you use in any given exercise and the risk of injury is reduced due to force load distribution in your body. Not to mention, the more calories you burn and bodyfat you lose by utilizing more muscle during movements. That is reason enough for most people right there to improve movement patterns.

Perry Nickelston, DC, SFMA

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Website: www.stopchasingpain.com

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