The FMS is a screening tool used by clinicians, trainers and coaches to assess the quality of 7 functional movement patterns that require a balance of mobility and stability. These movement patterns replicate movement patterns that are fundamental to us in day-to-day life, work and sport. The idea behind this is that although the “parts” (e.g. hip, shoulder) of our body may have adequate strength and mobility in isolation, it does not necessarily mean we are able to coordinate these “parts” together to create good, clean movement. We believe that people should move well first, and then move often. In today’s fitness industry, it is often encouraged to “move often” first by going to a gym or fitness class regularly without any pre-screen to check movement competency; leading to loading of less than ideal movement patterns which could result in injury/pain. With the FMS, we stress the importance of “moving well” before “moving often”.
We will therefore score each of the 7 patterns based on the quality of movement to help us identify the “weak link” which would be a pattern that is asymmetrical or does not meet our criteria. Keep in mind the FMS is in no way an injury prediction tool, but just an aspect of a complex, multi-faceted process.
All these movements will be observed and you will be given a score from 0-3 based on the best of three attempts. A score of zero will be given if there is any pain during movements or clearing tests which indicates that the test must be stopped and further investigation is required as we know that pain always alters movement. A score of 1 means movement is inadequate and needs to be corrected with “corrective exercises”. It also means due to lacking a good movement pattern, you will be temporarily restricted from doing certain movements and exercises whilst we correct this pattern to the baseline score of 2. If we try to build on a poor movement baseline, then compensations are inevitable to occur leading to poor biomechanics and possibly contributing to future injury. A score of 2 or 3 in movement means you have good baseline movement and it is therefore safe for you to load and train these patterns to a higher capacity using “conditioning exercises”. 2s and 3s can be an issue if there is an asymmetry in the score with patterns where the right and left sides are compared.
29 year old Patrick is a recreational runner who also plays social football twice a week. He currently doesn’t have any pain or injuries and wanted to come to the clinic to have a running assessment performed on him to see how he can improve his running pace and biomechanics. After taking him through the FMS, these were his results:
The raw score represents the right and left side results of the five tests that allow bilateral comparison. The total score is then calculated by adding the lower of the two raw scores for all movements together which in Patrick’s case would be 10/21. A higher total score does not necessarily mean that someone moves better; as the individual scores will tell you which movements are the “weak links” which are our priorities.
Patrick didn’t score any zeros on any of the tests because he did not get any pain. He scored four 1s in his FMS — ASLR, TSPU, DS and IL (left side was 1, right side was 2 meaning this pattern is asymmetrical) and because a 1 is considered below minimum baseline, we aimed to treat one of these four patterns. The Corrective Strategy Algorithm helps guide us towards which of the patterns we should focus on. Just like with the SFMA, we will always prioritise mobility first, before motor control thus the “weak link” that we wanted to correct first for Patrick is the ASLR. Patterns are corrected in this order: Mobility > Motor Control > Functional Patterning.
The Active Straight Leg Raise movement pattern looks at your ability to flex one hip whilst extending the opposite hip and also looks at the ability of your pelvis and lumbar spine to appropriately stabilise during the execution of the movement. Because Patrick was restricted in this, this would limit his ability to accelerate, decelerate and change direction and is therefore highly applicable to his running and football. For Patrick we gave him strap-assisted stretch, leg raise core engagement and hip hinge single leg with dowel to improve this pattern. Because we did not want him to exercise poor movement patterns (scored as 1 or 0), we recommended that Patrick does not run, hip hinge or jump until this movement pattern improves; this is because loading a poor pattern will only cement the dysfunction. This was only temporary, while we corrected the pattern to 2/2 and although there were other 1s in his FMS, we reassessed his whole FMS to check if any of the other patterns (TSPU, DS and IL) improved as correcting one pattern can indirectly improve the others.
Upon re-assessment of his FMS, Patrick’s IL improved to 2/2, but his TSPU and DS were still below the baseline. Continuing down the Corrective Strategy Algorithm, we see that TSPU is the second priority to focus on which is a high-threshold bracing pattern that is important when pushing heavy objects forward or lifting something overhead and helps transfer forces from the lower body to the upper body such as when we are running or jumping in sports. Thus you can see it was another highly relevant pattern to Patrick. Corrective exercises such as mountain climber from the floor, half kneeling chops and halos were prescribed, and again, activities that would cement his dysfunction was advised against.
This time around Patrick’s four 1s transformed into 2s and he was ready to be discharged as his FMS now looked like this:
We stressed the importance of maintaining scores above the baseline of 2 by continuing to work on supplementary exercises as participating in sports and physical activity can result in scores slipping below the baseline again. Patrick has decided that he is happy to come back to the clinic every few months to reassess his FMS to ensure that he is still moving well and has found that his running and football skills have improved.