This is a follow on post to Looking at an Alternative to the FMS for Client Assessments, and To FMS or not to FMS: That is the Assessment. In those posts I discussed why I was looking at alternatives to the FMS as a means to see how my clients move so that I can better create their first training program, the alternative approach I tried, as well as the outcome of my trial.
I came to the conclusion that I still preferred the FMS, but I have issues with some aspects of it. Initially I hesitated to make changes to address these issues. This is a reflection of my engineering background: If I’m going to modify a system, I want to be sure I have really thought it out. It’s now two months after that post, and I have thought about it. And I have officially moved to implementing a modified FMS instead of the FMS. This post shows the changes I made, and the rationale. I would love it if the FMS would address some of these aspects going forward, although I would understand if they didn’t. There is something to be said for maintaining a consistent system, especially one that has widespread use across different organizations. That said – no system is ever perfect from the start, and sometimes it makes more sense to make the difficult decision to change than it does to stay the course.
Here are the modifications I now use, and the ones that would be made if I was involved with the FMS:
These changes are listed in the order that the FMS test is done.
1. Replace the Deep Squat test with an Arms Crossed Squat. I don’t think anything would be lost with this, as the In Line Lunge, Shoulder Mobility, Trunk Stability Push Up, and Rotary Stability tests still provide plenty of insight into upper back and shoulder mobility and stability. I also removed the requirement for feet straight ahead and replace it with a requirement that feet stay within 10 degrees of straight to fit more people’s anatomy. I recognize the challenge in set up for that, but I know a great engineer turned trainer who loves problem solving who might be able to come up with an idea.
2. Keep the Hurdle Step as is. I know some complain that everyone gets bilateral 2s on this, but that’s not quite true, and the qualitative information one can draw from this is meaningful, including balance and hip flexion quality. That said, if there was a desire to drop a test, this would be my pick.
3. Keep the In Line Lunge test as is, making sure the scoring and set up are clear. I think they are now, but there was a period where many practitioners, including myself were not clear on some of the details of the scoring. This might be the fault of us as practitioners, but I personally have a motto that if most of my clients misunderstand my instruction, the fault is mine, not theirs.
4. Keep the Shoulder Mobility (SM), but adjust the corrective hierarchy to accommodate close scores. The FMS says to address SM first if there is an asymmetry, but I would suggest changing that to: “Address SM first if it is 1s or an asymmetry involving a 1, or a 2/3 asymmetry where the difference is more than one inch. A 2/3 asymmetry where the difference is less than an inch would still take precedent over other 2/3 asymmetries, but not over 1/2 or 1s in other tests.” Maybe that wording is too clunky, but I think you get the idea.
5. Keep the Active Straight Leg Raise (ASLR), but add a Passive Straight Leg Raise as a secondary test in the event that the person scores a 1. This helps to differentiate between whether the problem is range of motion or stability. This is what I currently do, and plan to continue. While I noted in the earlier post that I think the ASLR is not a great screen for whether someone possesses the movement to deadlift, I do think it provides valuable insight into hip stability and mobility.
6. Keep the Trunk Stability Push up as is.
7. Adjust the Rotary Stability test as follows. Keep the “2 position” test, where the test involves the opposite arm and leg, and replace the “3 position” test with either a bird dog with 5 reps of 5 second holds (or 3×5 would probably suffice) or a side plank. For more on why I like this approach, read To FMS or not to FMS: That is the Assessment.
8. Add a Hip Hinge test. I use a dowel held horizontally at the waist and ask them to bend over by pushing their hips back while keeping their back straight and shoulders back. I recognize that this is contrary to the notion of not coaching the test, and I accept that maybe it should remain an add-on. My goal with this is to determine whether or not a deadlift variation is a viable strengthening exercise for the client. The FMS proposes that the ASLR is the clearing test for deadlifts, but it does not address whether someone has the movement comprehension to deadlift. I have had many clients who score 3s on the ASLR but have a hard time doing a hip hinge. They are cleared to deadlift, but they are not deadlift capable. I see this most among people with desk jobs, runners, cyclists, and those who practice yoga. (Note that wasn’t meant as a knock against athletes in those sports; it is just an observation. My guess is that it’s the result of movement patterns or prolonged postures that are similar but different). Sometimes those who aren’t deadlift capable require a lot of coaching to get them there. In these cases, I would much prefer to program a hip hinge as a corrective exercise and do a different hip dominant exercise to strengthen their posterior chain so that they can start getting stronger in the backside right away.
Side note: For the past six months or so I have been doing passive hip rotation range of motion tests as part of my assessment for all of my clients. I look at passive hip internal and external rotation range of motion with the hips flexed and extended. It’s something I was initially doing for my own curiosity, and I am now starting to come up with why and how this might be meaningful for programming. I presented my preliminary findings and suggestions about in my talk about variations in anatomy and their impact on exercise at the Women’s Fitness Summit at the end of August. I’ll share the results as a blog post soon.