Functional Movement Screen (For Practitioners and For Consumers)
In the past few years, you may have heard about the "FMS" or Functional Movement Screen. Here's what you need to know about it.
It's a system that looks at 7 particular movements (each graded 0-3) and is used as a SCREENING tool. A screen is not an assessment, but rather a quick observation or tests that may indicate that a thorough assessment needs to be done to see what exactly is happening if severe pain or lack of mobility/stability exists. A total score of 15 or above (out of 21) indicates that the athlete is fairly safe in their movements (low risk for injury during performance). Scores of 14 or less indicate some exercises need to be performed to address deficiencies of the particular movement (they are at a higher risk for injury). A total score can be an indicator for higher injury risk, however individual scores of each movement should be analyzed as well. 0 is graded for presence of pain, and that is when someone should be referred to a healthcare professional such as a physical therapist.
For the practitioner: Should you get certified? For physical therapists, knowledge from your schooling goes well beyond the FMS. Physical therapists learn how to evaluate every part of the body in addition to normal/abnormal movement, not just screen. Chances are you can catch a lot of similar findings through your traditional evaluations in orthopedic outpatient settings by asking clients to perform certain movements. The one thing the FMS is excellent at is standardization. If I told you a patient received a score of 3+/5 on gluteus medius testing, you would understand exactly what I mean: you would know what position I was in, what position the patient was in, how much relative strength was present, and how strong the patient is. Similarly, FMS certified professionals understand each other when they say "patient scored 2/3 on overhead squat", rather than "patient had excessive trunk lean, poor overhead upper extremity mobility, and trouble balancing during overhead squat test". It can be especially valuable in collegiate and professional sports settings. You will have to work with Athletic Trainers and Strength and Conditioning coaches who may be certified through FMS, and assess all athletes coming through. Not only will you be able to be a team player and assist them, but you can speak the same language. It allows for a little more crossover since you will be seeing the same athletes. EXOS (formerly Athletes' Performance) is a company that works with many elite athletes and it's imperative all departments communicate well for the betterment of the athletes. It was not mandatory, but that was a reason I got my certification before I start the internship there.
For the consumer: Someone is certified if they have the letters "FMS" or "FMSC" next to their name, or on their card/resume. It is most beneficial when you are getting assessed for your body composition, weight, etc. This enables to make sure you are good to go for any exercise, and also areas that you can improve on. It is NOT appropriate after you get hurt. It does not help with diagnosing anything. In addition, the FMS certification alone does not teach trainers exercises on how to improve certain weaknesses. Lastly, patient history is huge! The test does not account for a subjective interview of the patient's past history, symptoms, pain, and prior therapy. All these play a huge part in risk of re-injury.
***Clinical Pearl: Train movement in general, not for a movement test. Many times people perform a movement test, and improve it by practicing the same movement over and over as an exercise to refine it. Once they test again, they perform better, but only at that specific movement. It is important to make sure you train movements with similar principles, and then re-test to see if they have truly become better at movement, not just the test.***
What You Should Watch: Hard-Style Kettlebell Swing
The kettlebell swing is an excellent tool for development of power in the hips while quickly engaging trunk muscles to form a strong pillar. Hip power, and fast onset of trunk stability is key in many sports.
When people talk Russian vs. American swing, I will always choose Russian. The American style has a lot of energy leak because momentum freely takes it to the overhead position without any engagement of trunk muscles to stop it. Additionally, you are going overhead in an ADducted arm position, when we know that a key component to normal pain-free overhead movement is ABduction. Lastly, arms overhead increases thoracic extension, and some people can not control their trunk muscles to offset the force that pulls the trunk into extension. "Hardstyle" emphasizes compression of joints and muscles to develop a rigid body with no energy leak at the joints. Notice the thumbnail of the video below, the instructor is at the top of his swing, yet he looks very grounded and tough to move. This is because at the top, the glutes tighten up at full hip extension, the lats are contracted to compress that shoulder joint, and the rectus abdominis (your 6-pack muscle) is engaged to avoid hyper extension of the spine. Watch the video below to see how a hardstyle kettlebell swing should look.
What You Should Read: Recovery Monitoring
This week we look at Andrew Read's article on recovery (here). A lot of athletes want to find out what they can do to be better. They work hard in and out of the gym, and even put in extra hours after scheduled team lifts. The job of a strength and conditioning coach is to primarily get athletes stronger, but equally important is keeping athletes on the field and avoiding burnout. An athlete's job is to stay fresh, while we control how much volume, intensity, duration, and frequency they go through for their whole season and off-season.
Andrew's article goes over a system that helps them monitor their own recovery easily by applying a numerical model to recovery. Every time you work out, you have a negative net balance. Certain recover methods will help you get back to net 0, or even better.
Above is the values of each recovery modality, and the article digs deeper into how athletes determine how much total recovery they need, and timeline of getting to 0. See the article by clicking here.
Vien is Doctor of Physical Therapy Student and also a Certified Strength and Conditioning Specialist through the National Strength and Conditioning Association. He has 6 years of experience training youth, college, and pro athletes in 1-on-1 and team settings. He has shadowed several Strength and Conditioning Programs in a addition to having clinical rotations in sports settings.