I’ve been such a big proponent of the FMS (Functional Movement Screen) since I started my personal training career that it feels weird to be looking at other options. Am I really going to break up with the FMS? For now I suppose I’m just experimenting. But let’s face it: when a relationship gets to the point where you want to see other people, it’s usually a sign that the end is near. Still, I haven’t given up on the FMS yet. We may still have a future. But there are doubts.
The doubts have been coming on for a while now. Interestingly, they reached a peak while I was writing my “why I use the FMS” answers in a blog debate about the FMS with Bret Contreras. It felt a bit odd to be writing about how great I think the FMS is, while at the same time evaluating alternatives. I do mean what I said in that article, and in fact I noted in it that I was looking at options.
Why are my eyes wandering?
I think my doubts actually started with some FMS discussions on the StrengthCoach.com forums. While most people on that site have a pro-FMS philosophy, there is still discussion. In particular there has been a lot of discussion in recent months about FMS scoring details. It’s these discussions that first planted seeds of doubt for me about the FMS. One of the aspects I like most about the FMS is the simplicity, but I don’t love the level of nit-picking for some of the scoring details. Or more accurately, I have a hard time relating these details to anything functional.
Once I start to question the small details, it’s almost inevitable that I will soon start questioning some of the bigger details. Such as:
- The scoring criterion for the Shoulder Mobility test is that a 3 is scored if the distance between hands is less than the length of the person’s hand, and a 2 is scored if the distance is less than 1.5 times the hand length. This means that in some cases a half inch difference from left to right could score an asymmetry, while another person could have a two inch difference and score symmetrically. I don’t believe that human movement is a place for step function scoring.
- Feet pointed straight forward is a requirement in the FMS Overhead Squat test, meaning if one or both feet turn out during the movement, it is scored down. I initially thought about this as a problem while attending a Dr. Shirley Sahrmann seminar as she talked about how common structural hip differences are. Not everyone has a hip structure such that feet forward is neutral. Given that, it doesn’t make sense to me that everyone should be able to squat with feet forward, or that the ability to squat with feet forward has any meaning.
Other thoughts have also been brewing. I realized that the more I used the FMS, the more I became attached to its truths. Most notably, that the Active Straight Leg Raise (ASLR) test was a useful determinant in whether someone could (or should) deadlift. I held on to this belief until a few weeks ago when I discussed the FMS with Dr. David Frost at the Toronto International Strength & Conditioning Conference prior to his presentation about an alternative assessment concept. I mentioned my belief that the ASLR is a good test to help determine if someone can or should deadlift, and he quickly asked why straight leg? Why not bent leg? Huh. Why straight leg indeed? Later in his presentation, he spoke about how our movement competency is different with legs straight or bent. Very true. And given that, what is the relevance of an active straight leg raise in functional movement? I was trying to think of a sport or occupational movement where a straight leg raise is relevant? Gymnastics was the only one I came up with.
Earlier during that same conference Dr. Tyson Beech gave an interesting presentation of some of the FMS lab tests he and Dr. Frost had run. The most interesting (to me) of Dr. Beech’s findings was that some of their subjects (firefighters) scored well in the FMS but then when they were subsequently asked to perform work tasks, their movement did not display functional competence. Test competence did not transfer to performance competence. One specific example given was of an individual who had scored an 18 on the FMS, including symmetrical 3s in the In Line Lunge, but then when asked to pull a fire hose in the way he would on the job, he did so with a large valgus collapse in his knees. The position he takes to pull the hose is effectively a weighted lunge walk. The In Line Lunge score did not ensure that the subject lunged well. Huh.
Dr. Frost also spoke about the concept of transferability in assessments. If the movement quality in the assessment does not hold when the movement is used in the field, is the assessment relevant? A good question, in my mind.
He then presented an assessment concept that I believe provides the basis for a simple, meaningful and easily transferable assessment than is the FMS. The concept is that you select appropriate movements for the individual and in each one you assess for whether or not they can control:
- Shoulder elevation
- Shoulder anterior rotation
- Back flexion/extension
- Back lateral bend
- Back twist
- Knee frontal plane
- Knee sagittal plane
Now I would guess there might be four reactions to this:
- But how do you pick the movements?
- Where’s the repeatable system?
- This is nothing new.
I for one thought all four, but upon further reflection, realized that maybe I can pick a baseline set of movements that relate to what my clients do in the gym, and then create a series of movements to have at the ready for specific sports. Even if I don’t have the latter initially, the former still provides a solid foundation. I can then set up a data table (remember I am an engineer: I love me a good table!) with the movements as row heading and the area of control I’m looking for as the column headings. For each movement I watch, I can mark an X for each cell where there is compromised movement or control. Now it’s repeatable. As for whether it’s new, well, is anything really new? I do think it is similar to what many great coaches already do: they treat each exercise as an assessment. But what I like about this is that I have a formal set of things I’m looking for in each movement and I can mark it down for myself for program creation and to remember to look at again, as well as to share with other trainers working with me so they can anticipate where they will have coaching challenges.
I did like Dr. Frost’s 7 movements to control, I opted for a few slight variations to make it fit my needs. In particular, I opted for controlling the hip in the frontal plane (instead of lateral bend of the spine), and I separated spinal flexion and extension. I also added two extra columns to my table: Where did they feel the exercise, and a notes column for my observations. Here are the exercises I have selected (so far):
2. Hip hinge
4. Single arm cable row or TRX inverted row
5. Split squat
6. Single leg squat
7. Active bent leg raise
8. Bird dog
a. Side plank
Here’s what the table looks like for a recent new client at Custom Strength, and for comparison I have also attached the FMS result.
It is true that we can interpret some of this from the FMS, but lately I’ve been wondering if the transferability from FMS to exercises we do in the gym is always as clear as I hope it would be, and when it isn’t, I am left having to make changes in the first training session. My gym is called Custom Strength, so of course I don’t mind customization, but I wonder if I can get more out of a different assessment such that I’ll have less need for change to the program I create based on the assessment.
There are three additional reasons I like this approach: (I had another in mind but can’t think of it)
1. Most of my clients see me one or two times per week, meaning I have them on a one day program. Given that, I really only have time for one knee dominant (squat family) exercise and one hip dominant (deadlift family) exercise. Because I am a proponent of both bilateral and unilateral exercises, I typically give my clients either a bilateral hip dominant exercise and a unilateral knee dominant exercise, or vice versa. Periodically I go with unilateral or bilateral for both. I don’t always find that the FMS reliably gives me enough information to decide which combination is most suitable for the given client. I say that in conjunction with some observations I have made from clients to date:
a. Some people can perform beautiful goblet squats but do not score well in the overhead squat.
b. Not everyone can perform split squats comfortably. Those who can’t should work on it, but if I make that their primary squat pattern, they are going to be staying with very light resistance as they build that movement. While score in the In Line Lunge sometimes predicts this, I haven’t found this to be a reliable predictor.
c. Some people really struggle with the hip hinge pattern, and score in the ASLR is not always predictive of this. In some cases, I have seen bilateral threes in the ASLR, but it has taken a long time to teach the hip hinge. If I could have seen the hip hinge in their assessment, I would have had given these clients a different hip dominant exercise and worked on their hinge as a corrective pattern initially.
2. Adding the “where do you feel it” question is really important for me, especially with the split squat, and bird dog. I have seen many people who have a good looking split squat but who feel the exercise primarily in the back leg hip flexor/quad. In some cases, I haven’t noticed until I realized after several sessions that they were not able to progress the resistance as I would have thought they should. I am starting to realize that a good portion of the population needs extra coaching to perform this exercise properly, even though it may look like they already are. Similarly, the bird dog was my choice to represent rotary core stability. For now. When I ask where they feel it, I am on the lookout for people who feel it primarily in their shoulders or back. My current thought is that this is a sign of someone who does not engage their rotary core muscles well. I see this enough that my guess is many of your clients are also in this situation, even if you don’t know it yet. I don’t mean that as a knock, but rather I was surprised to learn that some clients who were doing great looking Pallof presses and side planks weren’t actually feeling their sides at all. Now that I am asking this question in the assessment, I am starting their first training session several steps ahead. Perhaps there is a way to do this with the FMS, but I have not figured it out.
3. Reassessment is a breeze, as I can now pick intervals where I will bring out the table and mark Xs while my clients are doing their workout rather than pulling them aside for a re-FMS. I train clients in a semi-private environment, so this is logistically a better option for me.
While I think this post suggests that I’m quite excited about this approach, I am still trying to remain logical and scientific about the decision of whether to use this with all of my clients, or whether to continue with the FMS. The FMS has served me well for years, so throwing it out based on a few ideas and discussions would not be prudent. Instead I am spending a couple of months test driving the new assessment approach while also continuing to use the FMS. It means my time spent on assessments during this period is longer, but I feel it is worth that time investment to make a sound decision. During this test drive, I am running each client through both tests, and am making the following notes both when I create their program and after I have trained them a few times:
1. What did I learn from the FMS that I didn’t learn from this new assessment?
2. What did I learn from this new assessment that I didn’t learn from the FMS?
It is too early to tell which direction I will go with this in the end. Early indications suggest to me that the new assessment will be more favourable in selecting the exercises I use in the strengthening portion of the workout but may leave me with less guidance about what to include as corrective exercises, which I believe is an important part of our programs, even though it occupies a fairly small portion of their workout time.
I actually wrote the main draft of this post two and a half months ago, meaning I have already test driven the dual screening approach for just over two months, and have come to a conclusion about how I will screen clients in future. That will be part two, which I’ll share next week.
Elsbeth Vaino, B.Sc., CSCS, is a personal trainer in Ottawa Canada.
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