Every year there are new methods, new programs, and new screenings designed to “protect” athletes from injuries. Take the Functional Movement Screening (FMS) for example. It consists of seven mobility screens used to identify incorrect, imbalanced, and compensatory movement patterns throughout the body. The theory being that proficiency in all seven tests lessens your chance for injury. But since when have sports become so predictable?
httpv://www.youtube.com/watch?v=KDxeJVIc7iM
The video above showcases a group of NFL guys being taken through the FMS. I know they didn’t work with the athletes long enough to develop proficiency in all seven areas. At the least, they were educated about it. But it is interesting to see how the season is panning out for these guys. Here’s the injury list: Steven Jackson (quad), Greg Jennings (hamstring), Jahvid Best (concussion), Jonathan Stewart (possible ankle), Hakeem Nicks (hamstring), Leon Hall (ruptured achilles), and Patrick Chung (foot). Insane, isn’t it? Only three of the athletes featured have yet to have an injury. Two of which aren’t regular players (Dennis Dixon is second stringer, Aaron Curry has been traded).
Maybe—just maybe—the fancy things we do to prevent injuries don’t do a damn thing. Maybe they contribute to the problem. Here’s what Carl Valle of Elite Track has to say:
The Posture Police coach that is overzealous tends to get athletes bracing too much and living in a tight world instead of a balanced relaxation and contraction environment. Interesting to note the increase in hip tears, sports hernias, and lumbar injuries with “Modern Core Training Performance”. Coaches need to guide the trail not blaze it for the athlete.
The “core” transmits force, no doubt. But rotational athletes flirt with fluidity, grace, and relaxation. They can’t always assume a neutral spine.
If I can remember, Dr. Yessis once said something like, “injuries are more likely caused by improper programming, not muscular imbalances.” It all stems back to adaptation. If adapting is necessary for the good of the organism, it will adapt. A martial artist and a baseball pitcher will surely score differently on the FMS. Shouldn’t we expect that? Shouldn’t we allow individual variances between sports and athletes? Or, should I say, how can’t we allow for variances between sports and athletes?
Edit: In light of the responses this post has been getting, I posted an informal follow up here.
This article makes all the sense in the world, can’t expect same proficiencies from different specialities.
Definitely thought provoking and from a different perspective than I’m used to reading. In regards to injury prevention, what would you suggest then? I think the most important thing regarding athletes is injury prevention and ‘do no harm’; so in that light, how do you personally tackle injury prevention?
Anthony, I agree with you that the FMS is not the end-all-be-all of injury protection. I don’t even think Gray Cook would say that. The screen is that it is a tool to help assess people’s ability to perform a handful of basic human movements. Notice I said “a” tool. Not “the” tool. Any competent trainer is going to put a lot more into his or her initial assessment than a single screen. In fact, a screen in diagnostics is just a first step to determine what other tests need to be run. It’s like triage. So whether it’s a handful of alternative strength moves, years of experience and a watchful eye, or the vision tests in the video, you make an assessment sport specific by choosing the appropriate tools and applying them to your population. What matters is that the assessment is repeatable and has some objective validity. We can argue about the validity of the FMS, but the literature has shown it to at least have test-retest and inter-rater reliability. And even if it doesn’t have much other use, the fact that it’s easy to administer quickly to a large population with verifiable norms means that it’s not “worthless.” I do not think it should be the only test in an assessment, but there is some evidence to show that is does serve a purpose. As for injury prevention… http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953296/
I was expecting your reply. I know the post was a little directed in saying the FMS is worthless, but that wasn’t my main goal. My main goal was to just bring up whether or not we should start questioning things we take blindly. It can have uses, I agree. But the study you linked doesn’t give me any convincing information as, “The subjects were professional football players who made the final team roster before the start of a competitive season.” It’s just not detailed enough. And, as you know, I could pull up dozens of studies showing that eggs are bad for you and that coffee kills. But at the same time I can pull up dozens that say otherwise.
It’s not so much a directed attack at the FMS, but rather a broad questioning of out methods trying to “predict” something that’s very unpredictable. Contact sports can be likened to the chaos theory. A minor change, no matter how minuscule, has the potential to have a big impact. Anytime you have bodies flying around, there’s bound to be some destruction, whether or not you can overhead squat with a broomstick.
We should never accept blindly and we should always question. But we make predictions about chaos all the time, especially in sports. The reason we can is that sports have rules which makes them less chaotic than real life. They are, by definition, a controlled environment. Because the conditions are relatively consistent, we can make predictions that are usually true. Like that tall people tend to be better basketball players. And that strong people tend to be better football players. We can even start using those predictions to make choices in the present that we hope will impact future play in our sport, which is all that strength and conditioning is (“if I am stronger and faster then I will play better in the future”). You are correct that sports are not **totally** predictable, but so what? Do we give up all predictions because they won’t be perfect? Do we stop helping people get stronger and faster because there is no way to know 100% of doing so will help them at their sport (“There’s no point in training you, kid. There’s a possibility could tear your ACL in 20 years and be hurt for a season. I just have no way of knowing!”)? The FMS is just a system that allows trainers to rank how people move so that changes to movement quality can be (more) objectively measured. You can find fault in the specific movements and measures of the FMS (I do), but I don’t think you have a problem with assessing movement quality as a concept. I think you take issue with using it to make predictions. The good news is that any predictions made based on any assessment (“better movement quality lessens the odds of being injured”) can be proven or disproven. My point in posting the study isn’t to say the FMS is right (no single study can ever say that), but rather to say that it is testable. So my question is: if the FMS doesn’t make people less prone to injury on the field, do we stop assessing movement quality or stop making those claims?
I think I might just have a problem with the FMS being a blanket. I think everyone needs to move well, but “moving well” is sport dependent. It may sound contradictory, that I care about movement but not parts of the FMS, I know. But being able to overhead squat with a broomstick tells me little about everything but being able to overhead squat. Yes it has implications elsewhere such as an integration of upper and lower body mobility, but it’s so non specific. I think we should take drills that apply to our population (via a careful observation of what’s necessary/useful) and use them.
And when I said chaos, I meant the theory of chaos, not just the word chaos. The chaos theory is that minute alterations have the possibility to cause drastic long term changes. It’s not that the FMS is bad, because I don’t think it is. I think everyone should be able to move well, and being able to move well will ultimately make you a better sportsman. But the question is how well should we expect certain athletes to move? Where should the standard lie and how should we determine what it is? All athletes have different demands, and if they are trained to tailor those demands, there are going to be variances.
I think the FMS is a good tool. But I also realize that athletes have been thriving without it for decades because, ultimately, you only need to be developed enough for what the demands of the sport require — passing FMS score or not.
You guys are having a great debate and I love it. I’ve seen gray cook speak a few times and have his books. I personally think that the FMS is a neat little tool for an initial assessment to judge mobility, BEFORE ever really working with the athlete/client. I know gray doesn’t really follow the FMS himself, he does what’s needed/necessary for his specific clients. It is a product above all else. The important thing to realize is that it’s mainly judging mobility. Mobility doesn’t dictate performance; it dictates positioning. So increased mobility may, but won’t necessarily make you better. But, mobility will allow you to properly position yourself for certain lifts/movements which should then increase efficiency. We all know that positioning in a lift can really help with injury prevention but will that affect their chances of getting a concussion in a game? no not really. So I think when they say the fms reduces injury risk, it’s more toward that angle. As in, scoring well on the fms means you have good mobility/structural balance and thus should have better positioning. At the end of the day we’re assessing our athlete’s every day, but having something you can actually test/retest is nice.
Really good insight here Kyle. Thanks for responding
The goal isn’t perfection in the FMS. The goal is at least a 2, with no left to right score discrepancies. I didn’t say asymmetries on purpose because it also isn’t trying to have zero asymmetries-just point out really big ones. Except in some cases, the FMS doesn’t tell someone to stop training heavy. It has you work on your lowest score (if you have a 1, or an asymmetrical score), then do your regular workout as well-some exercises may be problematic, until the issue is resolved.
As far as saying that overhead squatting with a broomstick will not help predict if you will get injured by contact-the FMS never makes this claim-and it’s a silly argument to make. The FMS is trying to clean up fundamental movement patters -but only if they are faulty. For example, you could score a 14, and that’d have no effect on any training recommendations. That’s 7×2. Yet most people see 14 out of 21 and think it’s predicting injury. Nope, those people make assumptions based on what they’ve been told-it’s basically the game of telephone.
Moving well isn’t sport dependent. Moving well is needed by all athletes and people, true that within each sport there are specific needs-but they are ultimately deviations of fundamental patterns.
Athletes have thrived for decades without the FMS. Athletes also thrived for years without barbells, kettle bells, trx’s, etc….but does that mean those tools are worthless?
“As far as saying that overhead squatting with a broomstick will not help predict if you will get injured by contact…” I never said that. I just said overhead squatting doesn’t tell me much except for the ability to overhead squat. And comparing the FMS to training means is a bit extreme as they are two completely different tools. As I said before, my beef isn’t really with the FMS, it’s with the concept that all athletes should be fit into a mold. I may not be describing it right, but this is what I’m talking about:
Eric Cressey: ““Once again, we realize that just about everyone is “abnormal…” Cressey says, “…and that we really don’t even know what ‘healthy’ really is.””
Bret Contreras: “…I, and my professor, have similar thoughts on the matter. We were having a talk the other day and we don’t agreed that neither of us knew the answer to the “imbalance” issue.”
How do we know that mobility imbalances from one side to the next in rotational athletes isn’t one of the reasons that they are successful? After all, the body is just adapting to the demands it’s exposed to.
That’s why I’m saying that EACH SPORT (and the positioning within) need to have their own diagnostic tests. The FMS is a blanket. It’s the GPP, if you get what I’m saying.
So just so i get this right… Injuries are chaotic and there is nothing we can do to prevent them. Also, as someone who researches the FMS… I am expecting the cut points and factos of ghe fms that are related to inuury as well however the research has not supported that as of yet. Similar example, if i have a patient where proxkmal control is an issue it seesms logical from a neurodevelopmental srand point to clear the in line lunge before running and clear the squat before jumping. Not research based , logic based… Just like taking a plate off if the weight is too high.
Sorry for my previous incomprehensible comments (smart phone user issues).. Here is a cleaned up version with additional thoughts
So just so i get this right… Injuries are chaotic and there is nothing we can do to prevent them. The goal of the FMS is injury prevention. If injury prevention is worthless than so is the FMS. A tire pressure gauge is equally worthless if you don’t care about tire pressure.
Also, as someone who researches the FMS… I am constantly expecting the cut points and factors of the FMS that are related to injury to change and be sport and occupation specific however the research has not supported that as of yet. The FMS provides a standardizes way to efficiently assess movement in a standardized manner. Reaching a 14 is a pass theoretically, however what needs to be added to that baseline depends on the patient I am working with. For example, if I have a patient where proximal control is an issue it seems logical, from a neurodevelopmental stand point, to clear the in line lunge before running and clear the squat before jumping. Not research based , logic based… Just like taking a plate off if the weight is too high. I am not waiting for an RCT to determine this for me… it just makes sense…. which if you look at levels of evidence… theory is the foundation for all levels to build upon. So it is an evidenced based decision, however, not at the highest level and I’m not sure it has to be.
Regarding performance, there is currently limited evidence supporting a correlation between scores on the FMS and performance. The majority of data would suggest a minimal to no relationship between these constructs. As a result, it appears that you may be able to change the FMS all you want and not expect it to effect performance measures. There is no research suggesting a strong relationship between FMS scores and performance.
Thanks for clarifying Robert. I looked at your reply this morning and kind of had a blank face haha, smart phones be damned! Really like how you take it on a patient by patient basis.
Anthony; I agree 100% with you. You might be interested in this link:
http://www.exercisebiology.com/index.php/site/articles/functional_movement_screen/
Thanks for the link. Read it and I agree. Haven’t seen that site much, thanks for recommending it.
Anthony,
What is your experience with the FMS?
(workshop, book, etc…)
Do you have Gray’s book – Movement?
The FMS is predictive of injury risk – meaning that scoring poorly on the FMS indicates increased risk of injury.
(smoking increases cancer risk but not smoking does not protect you from cancer)
Scoring well on the FMS indicated reduced risk of injury but does not protect you from injury.
Do you know the FMS scores for the athletes you listed as getting injured?
how do you know that the FMS didn’t predict their increased risk of injury?
Were the injuries contact related or did they come about after another contact related injury/pain?
Could be related to many factors that we don’t have information on – yes?
The FMS is not sport specific but is a species specific starting point that can identify and address restriction and asymmetry and assist in directing programming (which as you indicated is a MAJOR factor).
It is FAR more that the deep squat test (the test we “go after” last out of the 7 screens) and it does not look for perfect symmetry and is not part of the “posture police”.
It is a movement competency baseline for working with the individual.
Look forward to your response
Brett
Just reread you statement that FMS is the “blanket” – similar to what I stated about it being the starting point for the individual etc….
Brett
Anthony-thank you for your post. More conversation regarding any program is always a good thing, provided the conversations are measured and reasonable. You asked a valid question and thanks to Charlie Weingroff’s re-posting of your piece, we have a chance to answer what you openly asked. I use FMS in a clinical enviornment (actually within a medical practice) each day. It is a highly valuable tool, just as a stethoscope. However, if one of the docs places the stethoscope on a patient’s shoulder and asks them to inhale deeply…well, it becomes a useless tool and the act becomes a charade, a Kabuki dance of checking off boxes in an assessment regardless of whether or not the assessment was done correctly.
I watched the video link and to be frank some of the FMS assessments that I saw were administered in the most inapproporiate and unprofessional manner I’ve seen. Letting an athlete complete the assessments in cross trainers is a joke. The height difference between the toes and heel mask ankle mobility issues that the FMS is designed to point out. I appreciate that some of the athletes were wearing Nike Free’s, and honestly, I don’t hold those in much higher regard; do the assessments barefoot or in stocking feet. The Rotary Stability assessment was a joke, the athlete’s right foot was in another time zone, the In Line Lunge failed to have the athlete attempt to place his rear heel flat at the end of the movement. Poor assessments yeild poor results, don’t blame FMS, blame the guys who botched the assessments and shame on them for the dis-service they performed to those athletes.
If I stick a scalpel in a patient’s forehead, I can’t call it an appendectomy, and if I do, I’m not a professional. What I saw weren’t FMS assesments and calling them such is BS.
In all fairness, a concussion isn’t screened for, so you have to give them a pass on that. Also, a guy in my gym who benches 450 put on a shirt a few weeks ago and benched 635…it looked awesome right up to the point his wrist snapped. FMS doesn’t screen for load and the hamstring issues may have been a product of asking too much from a body part not properly conditioned. Gray’s really bright, but he hasn’t found a means of screening for stupid…if he had, I’d probably not have passed my CK-FMS!
FMS is not a way to show everyone else how smart/clever/tuned in you are. It’s a serious tool, created and supported by good men like Gray, Lee and Brett. Before you write it off, may I suggest you contact my friend and fellow RKC Jeff O’Connor? Jeff’s e-mail is jeff@outlawstrengthsystems.com. He’s a two time MR Oklahoma Strongman and one of the smartest guys in the room when it comes to picking heavy things up. He embraces FMS and has the data to point as to why it’s an appropriate tool.
Thank you again for your post and the chance to engage in positive conversation.
Mark Toomey
Senior RKC, CK-FMS
NSCA CSCS
This Jones bloke makes his coin from the FMS Anthony so he needs to defend the fact that 7 magical tests are doing wonders. I only know Rugby down here, but looks like that Indianapolis team in American football uses the FMS and they are hurt all the time. Looks like they should fire that staff mate since they can’t fix the problems that FMS tool is picking up.
Cheers!
Rob
I posted a lengthy reply here and will edit it into the original post:
http://justpaste.it/lfa
Anthony, it’s been a pleasure meeting and sharing ideas and opinions with you. Please call me Mark. I look forward to reading your future posts.
Mr. Berkman,
Yes I teach FMS as part of my work – but I guess we should wait for people without knowledge of the system to comment on it.
Or do we have that already?
What is your knowledge and experience with FMS?
I’m sure the idea that athletes get injured is not new to you and the sport of rugby – does that mean you do nothing to try to reduce that risk?
Brett
Anthony,
I read your response and did not see answers to many of my questions.
What is your knowledge and experience with the FMS?
workshop, book etc…
Have you read Movement?
You admit that you don’t know how they were trained or if any issues found in a screen were actually addressed and you have to admit that you don’t know how they were injured – contact, non-contact, in the presence of other pain or injury etc…. so looking at a small sample with almost zero information you draw a conclusion that the FMS is flawed – exactly how did you come to that conclusion?
It is a movement competency baseline – a starting point to address restriction and asymmetry and make programming decisions and that does apply to and cross any population group.
I have no problem with people questioning FMS and i loo forward to continuing the conversation.
Brett
Sorry Bret, kind of got lost in a ramble. My experience with the FMS would be considered minimal, at best. I know the tests. I know what they test for. I know compensations. I know compensatory patterns. That’s about it. I haven’t looked further into it because — not to sound “high and mighty” — but I believe that assessment is assessment, and that there are a lot of them that work as long as you’re consistent with your measures, with some being more appropriate in certain scenarios than others.
And I encourage you to go back and read my post. I didn’t conclude that the FMS was flawed. The title poses a question. The body of the post ends with the question, “how can’t we allow for variances between sports and athletes.” My dealings with the FMS in the post were only to point out that the presence of injury among the athletes featured in the video were ironic. I said that maybe the special things we do to try to prevent injury don’t matter. Maybe.
And as far as I’m concerned, the FMS is neither flawed nor flawless right now. In more controlled settings like track and field and weightlifting, I think it has more of a merit as compared to the dynamic nature most team sports present. But even then, assessment has to become a bit more specific and objective at points as I mentioned. Good coaches have an “eye” for movement and it doesn’t always stem back to the FMS since it’s only the competency baseline.
Mr. Jones,
Instead of evangelizing everyone with your religion (one book, one church) why not look to other systems mate. You expect everyone to jump on this screening system of yours while other great thought leaders have much to offer the therapy world. I have looked into your system and we do EMG and gait analysis, real movement- not holding wood poles behind our backs in balance lunges. Rubbish!!!!! Real physiotherapists do more than what you share and your american teams are always injured.
Rob
Rob,
That is a nice combination of insults and “religion” throwing there – well done.
When you would like to have an actual conversation about this I am willing but throwing insults etc… is poor taste.
BTW – I have been an Athletic Trainer and Strength and Conditioning professional for a combined 21 years so to think I haven’t investigated MANY other forms of evals etc… is well not true.
Everyone is free to pick there own “recipe” and somehow I do it without throwing insults.
Rubbish indeed….
Brett
Anthony,
Where are you located?
I would like to try to get you hooked up with an FMS professional in your area to answer you questions etc…
I highly recommend Movement by Gray to also answer your questions.
Please email me if you would like to continue this conversation since there are some “unsavory” comments being made and I will not be visiting this site again.
Brett
Brett Jones,
Good morning. I was sent this URL yesterday and read some of your posts and would like to have a fair and open discussion on a podcast. I use two tests from the FMS and score them differently with using degrees instead of rounding them to convenient scores of 0-3. I have read Movement by Gray Cook and it was excellent and enjoyed it. Still the FMS is rather shallow in it’s ability to screen athletes. If you wish to contact me please give me a shout and we can create a professional arena and talk about things that people are requesting.
Take care,
Carl
Thanks for offering both your services and opinion Carl. If Brett agrees, this is something that will benefit a lot of people.
Anthony,
You asked a lot of good questions and so long as they are fair it’s fine. I would like Brett to comment on the FMS testing in the video as Mr. Toomey said they were not valid.
“I watched the video link and to be frank some of the FMS assessments that I saw were administered in the most inapproporiate and unprofessional manner I’ve seen.”
Does this mean that the tester needs to be certified? I am not certified but read the books and articles and attended a few workshops.
Carl,
Does the tester need to be certified? I think the smart answer is “yes” in as much as the tester needs to understand the tool and understanding comes from emersion in a system over time. Much as a carpenter doesn’t need to have gone through years of training before he swings a hammer, the outcome of his efforts is probably influenced by the degree to which he absorbed his training.
As I said, a doctor who performs an operation poorly shouldn’t be held up as a good example of a surgeon. I think that FMS assessments done poorly should not reflect on the FMS system, but should be taken in to consideration should the end result of the assessments yield poor results.
The question Anthony posed had several answers, many of which we’ll never know because we only have a small amount of information, but if we’re going to deal with this in a clinical, unemotional manner, then one must start at the beginning and sadly, and in my opinion only, the beginning was a poorly administered FMS assessment.
There were some comments from an FMS educator on here a few days ago. Where did they go? Did I miss something?
I just wanted to add that I have implemented FMS in my massage and coaching practice within the last month. So far, all I have are good things to say. Im sure that can’t continue for ever, but so far, so good. My clients are very appreciative of the integration of soft tissue and training in one functionally focused session. I am stealing a line from FMS and have begun to refer to these integrative sessions as “durability training”.
Is the FMS worthless? Of course not. Thats just a catchy headline. Even manure has value. From where I am standing, looking for results that boost health in a measurable way and encourage repeat business, FMS is far from BS and is quire simply the $#!t.
For anyone thinking FMS is a “blanket” or that it is a system that people are expected to get cultish about, I can assure you that all through my training it was emphasized that FMS is A standard, not THE standard. We were encouraged to think critically, bring new skill sets and information to the table, and understand that the screen and corrective exercises are just a jumping off point. We were told that what we do as personal trainers, massage therapists, Physical Trainers, Athletic Trainers, and Chiropractors is our art. We were told to use the screen as a way to communicate with other professionals. We were told to question, experiment, and share our experiences so that the FMS and sports training can improve and evolve.
The negative tone that this article’s title sets in motion is confrontational at best. I am all about the conversation, and maybe this was just a way to kick it off. Heck, it got my attention. Is there a better way? The rest of the article seemed like there were some good questions presented, but most of them would be answered by skimming the literature that Grey Cook has published, or that has been published about the FMS through clinical studies. If the article is intended to be of a more superficial nature, i.e. the author has not read the material published by the developers of the system he is being critical of, it would be much nicer to see a title that is more fitting. Something like “Im not so sure about the FMS, but I haven’t REALLY looked into it. What do you think?” Just my thoughts. Sorry they were kind of snippy at the end.
One more thing. I really respect your skepticism of any new “system” that looks like it is gaining popularity. I am still removing the kool-aid stains from my own Cross-Fit binge. Borrow the books from the library or a friend if you don’t want to give them money till you know if it is worth it. You will see that most of the things you are concerned with are addressed in the literature quite well. If you are concerned about asymmetrical athletes and FMS, you should ask Grey, or Brent, or one of the other presenters about baseball pitchers. They clearly feel comfortable deviating from “perfect” symmetry when it is for sport specific conditioning.
That’s just strange. Now my browser is displaying the comments I had seen before, but that had gone missing. If it was a browser issue on my end, my apologies.
Hi Anthony,
if you are interested, I just came across this link:
http://www.ncbi.nlm.nih.gov/pubmed/21921825
Using the Functional Movement Screen™ to evaluate the effectiveness of training.
Frost DM, Beach TA, Callaghan JP, McGill SM.
Source
1Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
I’m writing a review of the FMS research so I wanted to chime in here. Just a note about hip tears being more common. Hip labral pathology is just now becoming more diagnosed. I don’t think it’s necessarily an increase in hip injuries but a better understanding of hip injuries by docs and more diagnosis of these injuries.
Thanks