Strength Report: Screen, Evaluate, and Correct

The Functional Movement Screen (FMS) was developed by Gray Cook and is used by many NFL, NHL, and MLB teams as well as colleges throughout the country. The FMS is a screen of seven movements, giving a grade of 0-3. Using the FMS, we can look at imbalances and dysfunctions in our athletes and prescribe corrective exercises that will help them move better. Why do we want them to move better? The answer is simple: they will be more athletic and also more injury-proof. The FMS also allows us to see any issues an athlete may have before we ever send them on the field or into the weight room.
 
The Screening
 
Note:  If there is pain, a score of zero is noted, the FMS is stopped and the athlete is referred to medical help to address the pain.
 
Let’s start a screening. The first exercise is the deep squat, which measures hip and shoulder mobility (Photo 1). The athlete puts the dowel on his head and with his arms at a right angle, extends his hands over his head. He then squats as deeply as possible. A score of three is attained when the athlete has his hip crease below his knees, knees track over the toes, his back is straight and dowel is over his toes. If this is not attainable, then a 1 ½ inch block is placed under the heels. With this, a score of two is noted. A score of one is noted by knees collapsing, inability to get hip crease below knees, or dowel is not over the toes.

 
The second screening is the hurdle step (Photo 2). The athlete places a dowel across his back, holding it with his arm at a right angle. A measurement is taken from the ground to the athlete’s tibial tuberosity (tt). This is basically a measurement from the floor to the bottom of the kneecap. This distance is marked on two poles and a string is mounted at the height. The athlete places his right foot over the band and touches his heel to the other side. This is done three times, then repeated on the left. A score of three is achieved with hip, ankles and knees remaining in alignment during the lunge with no loss of balance. A score of two is noted when alignment between hips, knees and ankles is not met or upright posture is not achieved. A score of one is noted with a loss of balance. Scores are given for each leg.

 
The next screening is the inline lunge (Photo 3). Taking the tibia tuberosity(tt) length from the previous screen, we have the athlete place his toe on zero of the FMS kit and the heel of the other foot on the tt length. The dowel is placed vertically down his back, keeping contact with the head, shoulders and lower back/buttocks. The athlete then kneels. A score of three is given if the hips, knees and ankles remain aligned in the sagittal plane, minimal to no movement is noted in the lumbar spine and the dowel and hurdle remain parallel. A score of two is given if alignment is lost between the three, movement is noted in lumbar spine, and dowel/hurdle do not remain parallel. A score of one is given if balance is lost or hurdle and foot make contact. Scores are given for each leg.

The shoulder mobility pattern drill demonstrates range of motion in both shoulders (Photos 4A and 4B). The player makes a fist with both hands with the thumbs inside the palm. He then reaches one arm over his back and the other arm under. A measurement is taken. This measurement is the distance from the hand crease to the tip of his fingers. If the measurement between fists is less than one hand length, the score is three. If the measurement is 1.5 x hand length or less, the score is two. Over 1.5 x hand length makes the score a one. A clearing test is then performed to check for pain. Scores are given for each side.
 

The active straight leg raise (ASLR) measures hamstring flexibility as well as core stability (Photo 5). With the player lying on his back, place a pole vertically halfway between the knee and hip. A score of three is given if the heel of the player can pass the pole vertically. A score of two is given if the foot bisects the pole. A score of one is given if the foot does not reach the pole. Scores are given for each leg.

The trunk stability push (TSPU) measures reflex core stability (Photos 6A and 6B). The player lies on his stomach and with his arms at right angles and then performs a push up with his thumbs at the same level as his forehead. A score of three is given for this if his body rises in unison. If the player is unable to perform, the hands are lowered so the thumbs bisect the chin. This is a score of two. If unable, a score of one is given. A clearing test is then performed to check for pain.

The last screen is the rotary stability test (Photos 7A, 7B and 7C). This screen measures multi-plane pelvis, core and shoulder girdle stability during combined upper and lower body movements. The player gets on his hands and knees straddling a 2 x 6 (or screening box). With the knees, arms and toes touching the box, the player attempts to extend, then touch the same side leg and arm for a score of three. A score of two is given for opposite knee/elbow touch. A score of one is given if unable to complete the drill. A clearing test is then performed to check for pain. Scores are given for each side.

The Results

With the screen complete, scores are tallied. For bilateral movements where scores are given for each side, the lowest score is used. Studies have shown that with a score of 14 or less, a player is 2 ½  times more likely to be injured than a player who scored greater than 14. This score has been used by many professional organizations to predict success (See Chart).

 
Correctives
 
Corrective exercises are used to address imbalances and deficiencies in the following order:
 
1.  A score of zero - pain. Address this immediately with proper medical diagnosis
 
2.  A score of one.
 
3.  A score of imbalance (a score of one on one side/ two on the other or two on one side/ three on the other).
 
4.  Shoulder mobility and hamstring flexibility/strength.
 
The FMS provides detailed corrective exercises that are easily laid out for the coach using the FMS 360 program (www.functionamovement.com). The recommendation is to do the corrective exercises at the beginning of each player’s workout, two-three times a week. The player can then be rescreened in two-three months later to check for improvement. My biggest discovery was the balance issues our big (300 pounds +) linemen had after their screen. I quickly moved them to single leg/single arm exercises for corrective action. This paid huge dividends during the season.
 

Many of the materials for FMS – a dowel, a measuring board, and screening box – are available at most hardware stores. 

About the Author: Dan Leary is an assistant football coach as well as strength and conditioning coach at Seaside High School (OR). He is certified with FMS and HKC kettlebells and is a USAW Olympic lifting coach. For more information on FMS, go to www.functionalmovement.com.