Brad Eggebraaten PT, SCS, ATC FUNCTIONAL MOVEMENT SCREEN Brad Eggebraaten PT, SCS, ATC

If I were to the question : What makes an great athlete If I were to the question : What makes an great athlete ? OR What makes and athlete great ?

Optimum Performance Pyramid Functional Skill Functional Performance Functional Movement

Optimum Performance Pyramid Mobility ROM / flexibility Stability core stability / neuromuscular control Testing FMS / Y balance test Functional Movement

Optimum Performance Pyramid Kinetic linking movements gross movement not isolation Power production movements Olympic lifts / plyometrics Testing vertical leap / medicine ball toss Functional Performance

Optimum Performance Pyramid Sports specific training Control and proper technique coaching / video analysis Testing 3 point shooting / baseball infield testing Functional Skill

Functional Performance Key question Are we building fitness and skill on top of dysfunction? Functional Skill Functional Performance Functional Movement

What is the FMS? A series of movements designed to evaluate stability and mobility (i.e. functional movement) Uses extreme positions where weaknesses and imbalances become noticeable Ultimate goal is to identify athletes at increased risk for injury

Who Developed the FMS™? Gray Cook, PT, OCS, CSCS Lee Burton, PhD, ATC, CSCS Danville, Virginia

Key Principles Optimum functional movement Balance between mobility and stability Tightness = weakness Example : Hamstring seemingly become tight when the core is too weak to control the pelvis Targeting the tightness only will result in a short term gain at best

Functional Movement Screen Consists of 7 tasks Scored 0 (lowest) through III (highest) Lowest score counts on bilateral tests Best possible score = 21

Scoring the FMS™ III – Able to complete task II – Able to complete task with compensation I – Unable to complete the task 0 – Pain during test (or clearing exam) Max Score = 21 points Also looking for asymmetry

Asymmetry musculo-skeletal asymmetry is a well established risk factor for injury Ekstrand & Gillquist, 1983; Knapik et al., 1991; Baumhauer et al., 1995; Nadler et al., 2000; Soderman et al., 2001; Plisky et al., 2006; Myer et al., 2008; Yeung et al., 2009

Functional Movement Screen Deep Squat Hurdle Step In-line Lunge Shoulder Mobility Active Straight Leg Raise Trunk Stability Push Up Rotary Stability

DEEP SQUAT Requires: closed kinetic chain dorsiflexion of the ankles flexion of the knees and hips extension of the thoracic spine flexion and abduction of the shoulders

DEEP SQUAT Requires: mobility : ankle, knee, hip, thoracic spine, and shoulders stability : core in symmetrical stance

DEEP SQUAT Upper torso is parallel with tibia or toward vertical Femur below horizontal Knees are aligned over feet Dowel aligned over feet FunctionalMovement.com

HURDLE STEP Requires: stance-leg stability of the ankle, knee, and hip closed-kinetic chain extension of the hip step-leg open-kinetic chain dorsiflexion of the ankle flexion of the knee and hip adequate balance-dynamic stability

HURDLE STEP Requires: mobility : step leg ankle, knee and hip stability : stance leg ankle, knee, and hip with closed chain hip extension core stabilization to maintain adequate balance in single leg stance

HURDLE STEP Hips, knees and ankles remain aligned in the sagittal plane Minimal to no movement is noted in lumbar spine Dowel and hurdle remain parallel FunctionalMovement.com

IN-LINE LUNGE Requires: stance leg stability of the ankle, knee, and hip apparent closed kinetic-chain hip abduction step-leg mobility of hip abduction ankle dorsiflexion, and rectus femoris flexibility adequate balance due to the lateral stress imposed

IN-LINE LUNGE Requires: mobility : stance leg ankle, knee, and hip kneeling leg thigh flexibility stability : bilateral ankle, knee, hip core stabilization to maintain balance in asymmetrical stance

IN-LINE LUNGE Dowel contacts remain with lumbar spine extension No torso movement is noted Dowel and feet remain in sagittal plane Knee touches board behind heel of front foot FunctionalMovement.com

SHOULDER MOBILITY Requires: shoulder mobility in a combination of motions including abduction/external rotation, flexion/extension, and adduction/internal rotation scapular and thoracic spine mobility.

SHOULDER MOBILITY Fists are within one hand length (Assume one hand length is 8 inches) FunctionalMovement.com

ACTIVE SLR Requires: functional hamstring flexibility, which is the flexibility that is available during training and competition (this is different from passive flexibility, which is more commonly assessed) adequate hip mobility of the opposite leg lower abdominal stability

ACTIVE SLR Requires: Mobility : functional hamstring flexibility, which is the flexibility that is available during training and competition (this is different from passive flexibility, which is more commonly assessed) adequate asymmetrical hip mobility Stability : lower abdominals

ACTIVE SLR Ankle/Dowel resides between mid-thigh and ASIS FunctionalMovement.com

TRUNK STABILITY PUSH UP requires: symmetric trunk stability in the sagittal plane during a symmetric upper extremity movement (Many functional activities in sport require the trunk stabilizers to transfer force symmetrically from the upper extremities to the lower extremities and vice versa) If : the trunk does not have adequate stability during these activities, kinetic energy will be dispersed and lead to poor functional performance, as well as increased potential for micro traumatic injury

TRUNK STABILITY PUSH UP Males perform one repetition with thumbs aligned with the top of the forehead Females perform one repetition with thumbs aligned with chin

ROTARY STABILITY Requires: asymmetric trunk stability in both sagittal and transverse planes during asymmetric upper and lower extremity movement

ROTARY STABILITY Performs one correct unilateral repetition while keeping spine parallel to surface Knee and elbow touch FunctionalMovement.com

Clinical Implications Identifies athletes at risk of injury Targeted Objective Exam Narrows the scope Implement Exercise Progressions Specific to deficiencies found during the FMS

Research J Occup Med Toxicol. Apr 2007. NFL Data 433 firefighters 62% reduction in lost time with intervention 42% reduction in 12-month injury rate NFL Data If FMS score is < 14, and there is an asymmetry, then the probability of suffering a time loss injury increased from 15% (pre-test probability) to just over 50% Scores can be improved with a specific off season training program.

Research Intrarater and Interrater Reliability Minick, KI, Kiesel, KB, Burton, L, Taylor, A, Plisky, P, and Butler, RJ. Interrater reliability of the Functional Movement Screen. J Strength Cond Res 24(2): 479–486, 2010 Teyhen,DS, Donofry DF, Shaffer SW, Walker MJ, Lorenson CL,Dugan JL, Halfpap JP, Childs MD. Functional movement screen: a reliability study in service members. US Army Med Dep J. 2010 Jul-Sep:71

References Cook, Gray Athletic Body in Balance, 2003. Functional Movement.com