Functional Training Zones

Mastering Your Craft: The Functional Movement Screen

By Robert "Skip" George, DC, CCSP, CSCS

Sports science is evolving every day as rehabilitation and personal/performance training are "bridging a gap" in the ever changing fitness world. This new direction in the fitness world is offering a more complete and effective approach to addressing weaknesses and dysfunctions that not only cause pain and injury but effect athletic performance as well. Whether you are a personal trainer, athletic trainer, physical therapist, massage therapist or sports doc the opportunity to help people be fit, functional and injury free has never been greater!

Adding tools to your toolbox and mastering them is the key to not only professional success but personal satisfaction as well. Todd Durkin describes becoming "World Class" in your profession as one of these essential keys. If you are a fitness trainer the focus of the client and you is getting them in the best shape possible in a reasonable amount of time. Throw in some side bridges and stability exercises on an exercise ball and we have the core exercise portion of the workout covered, right? Well, maybe.

As sports therapists or sports docs the focus is often solely on the location of pain when it also needs to be seen as a messenger or signal. The potential exists to become near-sighted on just one body part as being the problem or source of pain versus thinking in terms of movement patterns for the entire body and prescribing specific corrective exercises or treatment that address a significant dysfunction or "compensation". This is true if we are trying to treat a painful condition or help our clients perform at a higher level.

Much is talked about "functional" and "core" training. Several questions need to arise regarding this issue: How do I assess the core and how do I design a program that addresses the specific needs of that individual? Often the "What comes first: The chicken or the egg?" question arises when defining the topic of function and how it relates to determining what is a priority, mobility or stability.

One of the most effective and essential tools in addressing this question and assessing "weak links" in your clients is the Functional Movement Screen developed by Gray Cook, MSPT.  The Functional Movement Screen, or FMS, grades seven different movement patterns to assess mobility, stability, balance, symmetry and proper movement sequence.

Gray Cook says "Movement, especially moving well and often, is at the heart of not only our early growth and development but remains a central issue throughout our lives."  This is not only true for all athletes of any age and skill level but is especially important for the largest emerging population, the ageing baby boomers who want to stay vital into and beyond their senior years! 

One way to look at how we function and perform is to visualize a three layered pyramid that separates first function, then strength/ power performance, and finally sport specific skills. Think of the rectangular base of a pyramid that defines how well your client’s body functions in terms of mobility, stability, balance, symmetry and proper movement patterns. This base is the widest part of the pyramid and upon what all else is built . In the middle is a layer of strength and power performance and on top of the pyramid are specific sports performance skills.

Often fitness is "piled" onto dysfunction without addressing the functional base of the athlete's "pyramid". This is where potential trouble begins and is a reason professional and recreational athletes becoming either injured or experience limitations on how well they can perform and what they can achieve. Many talented athletes can perform at a high level because they are such good compensators. However, they are an injury or accident ready to happen because they are working around a pre-existing problem and simply are not aware or neglect to train their functional weaknesses before beginning their strength and conditioning programs. As Gray Cook says in his book Movement: Functional Movement Systems,  "Movement is how we survive, communicate, recreate and thrive." The performance pyramid applies to us all if we are to function well not only in sports but for our daily activities.

The following tests are brief descriptions of the Functional Movement Screen. The screen takes about 10-15 minutes to perform and is easily integrated into your training or treatment schedule with your clients, The seven tests of the FMS are graded 0-3 with a total score of 21 possible. If during any of the movements there is pain, 0 is the score and that particular issue is addressed with appropriate treatment modalities after the entire screen is performed. If one of the tests is performed perfectly, it is graded a 3. A minimum of 2 points for each of the seven tests for a total score of 14 with no asymmetries for any of the tests is used as a minimum to participate in strength training or athletics. A score under 14 increases probability of injury and decreased performance.

The first screen is the Deep Overhead Squat Movement Pattern.

It demonstrates fully coordinated ankle, hip and thoracic spine mobility and core stability with the hips and shoulders functioning in symmetrical positions. By the way, this test is critical especially for your golfers!

The second screen is the Hurdle Step Movement Pattern Test.
It is designed to challenge the body's proper stepping and stride mechanics as well as stability and control in single leg stance. This is really helpful in determining symmetry left and right side while assessing hip mobility and balance.

The third screen is the In-Line Lunge Movement Pattern Test.
This provides a quick appraisal of left and right function in a basic pattern and is intended to place the body in a position that will focus on the stresses as simulated during rotation, deceleration and lateral type movements. This one is done balancing on a 2x 6 inch board with feet in line and maintaining perfect posture.

The fourth screen is a Shoulder Mobility "Reaching" Movement Pattern Test.
This test demonstrates the natural complimentary rhythm of the scapular-thoracic region, thoracic spine and rib cage with reciprocal upper extremity shoulder movements. In other words, you are really testing thoracic spine mobility in addition to gleno-humeral movement and scapular stability.

The fifth screen is the Active Straight Leg Raise Movement Pattern Test.
This is an "apparently" simple test that has the patient supine on the ground and identifies active mobility of the flexed hip and initial and continuous core stability while the opposite hip remains extended and flat on the ground. Don't be fooled by the simplicity of this test as it also demonstrates the ability to disassociate the lower extremities while maintaining stability in the pelvis and core. It is also common to see differences or asymmetries with this test as well as the Shoulder Mobility Test as mentioned previously.

The six screen is the Trunk Stability Push-Up Movement Pattern Test .
It is used as a basic observation of reflex core stabilization and is not used as a measure of strength since only one repetition is required. The goal is to initiate movement with the upper extremity without allowing movement of the hips or pelvis. That is, no sagging or rotation of the pelvis in relationship to the torso while pushing up!

The seventh and last screen is the Rotary Stability Movement Pattern Test
This is a complex movement requiring proper neuromuscular coordination and energy transfer from one segment of the body to another through the torso. It has roots in the basic creeping pattern that follows the crawling pattern in the developmental sequence of normal human growth and locomotion. It looks like a birddog, horse stance, quadraped or whatever you want to call getting on all fours!

The purpose is to find the weak links in your clients and alleviate them with specific corrective exercise strategies. This means that the FMS is predictive of injury and used to discover pain in your client. If during any of the movement tests pain occurs, then referral to a trained health professional is needed.

When weak links are corrected with the proper application of exercise, your client or athlete will have greater movement efficiency which will lead to not only improved performance but a significantly greater durability in their fitness endeavors as well! Clinical research has shown that the FMS is predictive of injuries occurring in athletes. It is really a simple concept. If your body is not functioning well, it is only a matter of time before a breakdown or injury occurs. Remember, it is not only how fit you are, but really how functionally fit you are!

The Functional Movement Screen is now being used by many teams in the NFL and is the foundation of their strength and conditioning programs. In addition, collegiate football, professional golfers, and U.S. military special forces use the FMS as well. This is a partial list and it is growing! 

Personal mastery is a consequence of learning and growing every day to become more effective and expert at what you do. Success is just bound to follow when you "Master your Craft" both in terms of financial but personal satisfaction as well. The FMS is an essential tool for your enduring professional advancement and to become a "World Class" fitness professional.

Robert "Skip" George, D.C. owns a training facility in La Jolla, CA where he "bridges the gap" between chiropractic, rehabilitation and sports performance training. He is a Certified Chiropractic Sport Practitioner (CCSP) and a Certified Strength and Conditioning Specialist (CSCS). He has treated and trained amateur and professional athletes, written numerous articles on sports and fitness, and lectures to physicians, strength and conditioning coaches and trainers about the Functional Movement Screen.