Posted December 12, 2011

Improving the Functional Movement Screen

I don’t write a lot of posts about different assessment techniques as most people who tend to read this site would probably rather get a thousand papercuts on their corneas than to consider the importance of something like an overhead squat and its’ implications to life in general, but I figured this would be a good one to do since it raises controversy, shows a solution to a common problem, and makes me sound all super-smart and stuff by using big words with a couple of syllables in them.

I’m sure a lot of people out there are probably thinking that just the title of this piece is pure sacrilege, and that the FMS is the most perfectest of all assessments in the history of ever. I’ll be honest, I really do like the FMS, primarily for its ease of use, practicality, and application to a wide range of clientele. It’s a staple in all my initial assessments, follow-ups, as an explanatory tool to show clients what’s going on with their movements and why something isn’t quite right. In short, it’s the bees knees, baby!!

For those who are unaware of the FMS, it was created by Gray Cook and Lee Burton with the goal of creating an assessment system that can document and grade movement patterns that are key to normal function. To find out more, check out FunctionalMovement.com.

There’s a growing body of conflicting research showing how it may or may not be applicable in different settings. One paper by Keisel et al showed that it can be a reliable predictor of football players likelihood of injury based on their ability to perform foundational movements in an unrestricted manner. Another paper by Parchmann and McBride looked at athletic performance markers in golfers and whether the FMS or 1RM back squat was a better predictor of athletic performance, and found no correlation in any of the sprint, jump, or field tests performed to the FMS, but found high correlations to the back squat. More specific to the direction of this article, Okada et al
looked at the reliability to each test as a method of predicting performance in athletic situations, and there was no correlation to rotational stability in predicting the results of any tests performed.

The point is, it’s great at seeing what is present, but not in predicting what may be present. One constant that seems to exist is a lot of people’s general loathing of the rotational stability test.

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Aside from buddy not dorsiflexing his left foot or using a doweling to line up and make sure his base of support wasn’t too wide, he did pretty well here. Most people flop around like a mudskipper as soon as they move their arms or legs, and wind up feeling like they’re broken on the inside as a result.

If the point of the test is to check on lateral or rotational core stability, I have a better idea than this, one that gives way more information, is easy to set up, and can be regressed to get an idea of the individuals’ level of strength through the core and their integrated stability.

Enter the side bridge leg lift.

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I’ve started replacing the rotational stability test with a side leg raise, and have found it to be a better predictor of low back risk and overall core strength. Additionally, there’s a body of research that shows a big correlation to side bridge performance with low back pain. McGill even states in Low Back Disorders that given the evidence from EMG analysis of all the muscles involved, it’s the best way to get core muscle activation without loading the spine, which makes it a safe test to use to determine core strength.

Ekstrom et al showed that in addition to core muscles, the side bridge also had a
greater effect on the glute medius than any other exercise tested, which is stupidly important due to the fact that a lot of people have such poor glute med strength and control, and any movement like a squat, lunge, jump, lift or pull would rely heavily on glute med activation to help control the stability of the hip and knee. They also showed a higher recruitment of the lumbar multifidus, longissimus thoracis, and external obliques than any other exercise tested, which makes it pretty much way more baller of a test than the rotational stability test.

But not everyone can achieve the big nasty shown above, which is why there will be a regression scoring system, similar to that in the FMS. I’ll break it down like this:

3 points: can perform the bridge, maintaining a linear body position, while raising the leg without losing stability

2 points: can perform the bridge from the toes, maintaining a linear body position, without raising the legs

1 point: cannot perform the bridge from the toes but can perform it from the knees

0 points: cannot perform the bridge from the knees, or pain is present.

 

It’s pretty simple and straight-forward to accomplish the test, and all you need is a mat to lean on. You can even compare left side and right side to see if there is any imbalance through the core present, and if in combination with other tests, if there’s any issue with the hips, core, or shoulders. Again, BALLER!!

I’ve found that in the vast majority of people who try out the FMS rotational stability test, there’s a great deal of difficulty in performing the movement and a lot of it comes down to simply being able to balance in the position. When side bridge leg raise doesn’t require a lot of balance, it’s still pretty powerful for determining core imbalances between left and right. On top of that, showing someone they have a core dysfunction on one side versus the other and ways to make their life not suck anymore just makes you look like a straight up Jedi. “Weak, your core is! YEESS!!”