I got a nice treat a few weekends ago. I got to sit in the seats of a continuing education course instead of leading one. I thoroughly enjoyed Gray Cook and Lee Burton’s 2 day presentation of the Functional Movement Screen Level 1 workshop sponsored by perform better. It was right down the road in Providence, RI at the RI Convention Center. I made sure to say “hello” and introduce myself to Gray and Lee at the end of day 1 even thought I felt that I already new them to some extent since we have presented at the same events several times in the past.
I’d like to write about my experiences and what I took away from the workshop. If you are unfamiliar with the Functional Movement Screen (FMS) it is a system designed by Gray and Lee that entails the assessment (or screening) of seven different movement patterns. There is a 0-3 scoring system for each of the patterns and ensuing corrective exercise recommendations based on the results of the assessments (screens). I should stick with their vernacular and use screen. Gray and Lee differentiate between screens and assessments. What I would call a movement assessment, they would call a movement screen. They reserve the term assessments for their Selective Functional Movement Assessments (SFMA). Specifically they call them “Top Tier Movement Assessments.” The FMS screens are designed to provide a “systematic way to observe movement patterns(1).” Practitioners are looking to identify “significant limitations or asymmetries (1)” and challenge mobility and stability.
The seven movement screens are:
- Deep Squat
- Hurdle Step
- In-Line Lunge
- Shoulder Mobility
- Active Straight Leg Raise
- Trunk Stability Push-Up
- Rotary Stability
If a client/patient/athlete (CPA) reports experiencing pain during one of these movements the practitioner scores this movement a “0” and it is recommended that they refer the CPA out to a licensed healthcare practitioner to either complete the SFMA or or other necessary evaluation techniques to identify the source of the pain.
If the CPA cannot complete the movement, they are assessed a “1.” If the CPA completes the movements with compensations they are assigned a “2”. If a CPA earns a “2” on screens 1, 6 and 7, they are provided modified movements to attempt. If the movement is perfect, the earn a “3.” For screens 2-5 and 7 a score is assigned to both the left and the right of the body.
This is a basic overview of the FMS and there is more depth to the system as well as it’s rationale, but it’s a start. The Deep Squat is the movement that I am most familiar with and it is the first movement in the FMS screen. I find more similarities with Gray and Lees work and NASM’s Overhead Squat Assessment (OHSA) than I find differences.
Some similarities in the set up and movement: the feet are positioned about shoulder with apart (acromion for the FMS and the gleno-humeral joint for NASM), feet are to be pointed straight ahead, and the shoulder/arm position is similar, however the FMS utilizes a dowel and is more precise in the positioning.
Some differences in the set up and movement: the FMS, like the title of the screen states, is looking at a deep squat and requires the CPA to sink as low as they can go, NASM’s OHSA asks the CPA to squat to parallel or a 90 degree angle at the knee.
The scoring is quite different. NASM is checking off compensations at the five major load bearing joints of the kinetic chain. The FMS hangs a number on the overall movement. Both assessment/screening tools consider the feet turning out (inability to keep the feet pointed straight ahead), knees moving in (inability to maintain alignment of the tibial plateau and the 2nd and 3rd toes), excessive forward lean (inability to keep the tibia and torso parallel).
NASM counts an excessive lumbar extension and anterior pelvic tilt as well as spinal flexion and posterior pelvic tilt as a compensation. FMS just wants to see the depth while maintaining alignment at the aforementioned check points. NASM looks at the ability to maintain a neutral arch in the foot and documents over pronation at the lower extremity. Now, in passing, Lee came over to our break out group and he agreed that was a compensation, but the FMS is practitioner is taught to focus on easier to identify compensations.
Here is video on the FMS deep squat that is over 5 years old, but gives you a visual:
Here is a run down of NASM’s OHSA if you have not seen it:
I feel like I could go joint by joint and work through why each organizations either emphasizes or deemphasizes certain movements. I look forward to applying the FMS for longer to get a better feel for things. The FMS does not focus on muscles, only movements, and this translates into the screen. This is attractive. Don’t get caught up in anatomy, is it this muscle or that muscle? Just score the movement as it is.
On the other hand, some of the movements might be termed synergistic dominance according to NASM’s school of thought. This is something I would like to explore further as well as the fascial lines superimposed across these 7 FMS movements and NASM’s OHAS, Single Leg Squat and accompanying movement assessments.
More of that on another day!
Thanks for stopping by.