Functional Movement Screen

The Functional Movement Screen (FMS) was developed to help clinicians and health professionals identify individuals who may be at increased risk of injury or who demonstrate dysfunctional or performance-limiting movement patterns¹². Later, the Selective Functional Movement Assessment (SFMA) was introduced as part of the same system³.

The FMS was originally presented as a screening tool for athletes. Over time, the concept expanded to include equipment used for testing, certification programs, seminars, books, and educational resources related to functional movement analysis⁴.

The primary aim of the FMS is to identify asymmetries and movement limitations that may lead to functional movement deficiencies. The screen evaluates the interaction between mobility and stability through a series of fundamental movement patterns.

What the FMS Measures

The FMS is designed to detect imbalances in mobility and stability during fundamental movement patterns. The tests place individuals in challenging or extreme positions where weaknesses, compensations, or asymmetries become visible if adequate mobility or motor control is lacking.

These movement patterns represent basic locomotor, manipulative, and stabilizing movements. When such limitations are identified through the screening process, a corrective exercise program can be developed with the aim of improving movement quality and potentially reducing the risk of musculoskeletal injury.

Structure of the Test

The FMS consists of seven standardized movement tests that require both mobility and stability.

These movement patterns include:

• deep squat

• hurdle step

• in-line lunge

• active straight-leg raise

• trunk stability push-up

• rotary stability

• shoulder mobility

Each movement pattern is scored on a scale from 0 to 3 points.

The scoring criteria are:

• 3 points – the movement is performed correctly without compensation

• 2 points – the movement is completed but with compensation

• 1 point – the individual cannot complete the movement

• 0 points – pain occurs during the movement

The total score ranges from 0 to 21 points.

Target Population

The FMS was developed as a screening tool to identify individuals with functional movement deficits that may indicate an increased risk of injury.

It has been used across a wide range of populations, including:

• young active individuals

• middle-aged adults

• elite athletes

• collegiate athletes

• professional athletes

• military personnel

• firefighters

Research has also shown that lower FMS scores may be associated with higher body mass index, increasing age, and lower levels of physical activity⁵.

Use and Interpretation

A total FMS score of 14 points or lower has often been used as a cut-off value for increased injury risk. Some studies have reported that individuals scoring below this threshold have a higher likelihood of sustaining injuries⁶.

However, the current body of research remains limited. It is still unclear for which sports or occupational groups the FMS is most effective in predicting injury risk. Additionally, the original cut-off score of 14 may not be valid across different populations⁷.

Reliability

Multiple studies have demonstrated good reliability of the FMS when administered by different evaluators.

Research has shown:

• good inter-rater reliability

• good intra-rater reliability

A study by Teyhen and colleagues found that even novice raters with limited training (approximately four hours) were able to achieve moderate to good reliability when administering the FMS⁷.

Validity

Although some early research suggested that lower FMS scores may be associated with a higher risk of injury, the overall evidence remains mixed.

One study reported that professional American football players who scored 14 or lower on the FMS had an increased likelihood of sustaining time-loss injuries⁶.

However, more recent systematic reviews suggest that the association between FMS composite scores and future injury risk is relatively weak¹⁰¹¹. As a result, several researchers have argued that the FMS should not be used as a standalone tool for injury prediction.

Some evidence also suggests that pain during testing may be a stronger indicator of injury risk than the overall composite score¹³.

FMS vs SFMA

The Functional Movement Screen is often confused with the Selective Functional Movement Assessment (SFMA).

Both tools are part of the Functional Movement System developed by Gray Cook and colleagues, but they serve different purposes.

The FMS is designed as a screening tool used to identify movement limitations and asymmetries in individuals who are not experiencing pain.

The SFMA, on the other hand, is a diagnostic tool used by clinicians to identify musculoskeletal dysfunction in individuals who already have pain or injury.

Therefore, the FMS is primarily used for preventive screening, while the SFMA is applied in a clinical diagnostic context.

References

1. Cook G, Burton L, Fields K, Kiesel K. The Functional Movement Screen. Danville, VA: Athletic Testing Services Inc; 1998.

2. Cook G, Burton L, Hoogenboom BJ, Voight M. Functional movement screening: the use of fundamental movements as an assessment of function. International Journal of Sports Physical Therapy. 2014;9(4):549–563.

3. Cook G. Movement: Functional Movement Systems – Screening, Assessment and Corrective Strategies. Santa Cruz, CA: On Target Publications; 2010.

4. Beardsley C, Contreras B. The functional movement screen: a review. Strength and Conditioning Journal. 2014;36(5):72–80.

5. Mitchell UH, Johnson AW, Vehrs PR, Feland JB, Hilton SC. Performance on the Functional Movement Screen in older active adults. Journal of Sport and Health Science. 2016;5(1):119–125.

6. Kiesel K, Plisky PJ, Voight ML. Can serious injury in professional football be predicted by a preseason functional movement screen? North American Journal of Sports Physical Therapy. 2007;2:147–158.

7. Teyhen DS, Shaffer SW, Lorenson CL, Halfpap JP, Donofry DF, Walker MJ, Dugan JL, Childs JD. The functional movement screen: a reliability study. Journal of Orthopaedic & Sports Physical Therapy. 2012;42:530–540.

8. Schneiders AG, Davidsson A, Horman E, Sullivan SJ. Functional movement screen normative values in a young active population. International Journal of Sports Physical Therapy. 2011;6:75–82.

9. Parenteau GE, Gaudreault N, Chambers S, Boisvert C, Grenier A, Gagne G, Balg F. Functional movement screen test: a reliable screening test for young elite ice hockey players. Physical Therapy in Sport. 2013.

10. Bonazza NA, Smuin D, Onks CA, Silvis ML, Dhawan A. Reliability, validity and injury predictive value of the functional movement screen: a systematic review and meta-analysis. American Journal of Sports Medicine. 2017;45(3):725–732.

11. Dorrel B, Long T, Shaffer S, Myer GD. The functional movement screen as a predictor of injury in collegiate athletes. Journal of Athletic Training. 2018;53(1):29–34.

12. Moran RW, Schneiders AG, Mason J, Sullivan SJ. Do Functional Movement Screen composite scores predict injury? British Journal of Sports Medicine. 2017;51(23):1661–1669.

13. Alemany JA, Bushman TT, Grier T, Anderson MK, Canham-Chervak M, North WJ, Jones BH. Functional Movement Screen: pain versus composite score and injury risk. Journal of Science and Medicine in Sport. 2017;20:S40–S44.