When Someone Says the FMS Doesn’t Work

A friend and colleague working as a Physical Therapist in an orthopedic facility was recently showed a poster presentation that suggested that the FMS was not a valid predictor of injury based on the managed 14 cut point.
Below are some points I would consider in engaging such an individual.


1.  It is very true that this and other research projects have found the FMS to not demonstrate the predictive value that it has with the NFL and tactical populations.
Remember that’s just what research says.  I think EBP is a combination of what the statistics say, what your skill set set provides, and what makes common sense.

2.  Previous research on the FMS as an injury predictor has used a far more concrete definition for a positive reaction.  In most studies, they measure a missed game, practice, work day, activation of an worker’s compensation first incident.  This takes out the subjective levels of tolerance.  Without a doubt, the endurance athlete population is considered both as under-reporters and with a high tolerance of symptoms.  Qualification of an “overuse injury” is also very suspect in my opinion.

3.  Some of these questions are next to impossible to answer in as much as this literature was presented in the form of a poster.  Publication standards and backdrop to the scientific method are of much less breadth in a poster versus a peer-reviewed journal publication.

4.  It is worthy of mention that the full depth of FMS literature would say a cut point of 14 with asymmetries would still incur a +30% incident of injury.  Did they account for that, or did they just look at the total score.  If you have 3 3s, 3 1s, and a 2, would you think, just using common sense, that they were well prepared for action?

5.  Long before the FMS should be considered an injury predicting metric, it should be considered a screen.  That statement does not discredit this piece of literature even though it does have some holes.  My point is that the FMS as a screen is based upon what the literature already has established as the #1 and #2 predictors of injury.  The #1 predictor is previous injury.   So if an individual presents with pain, we know there is previous injury.  The clinician should act.  The #2 predictor is asymmetry.  Even the Deep Squat and Trunk Stability Push-up have opportunities to discern asymmetries.  Again, if found, the clinician should act.  This action should be elimination, remediation, or reconstruction of “Plan A.”  This is how injury will be predicted.  This primary foci, as I see it, of the FMS is about major problems (pain) and asymmetries.  You find those, you are by default playing the literature’s already established odds on predicting injuries.

6.  Sometimes, or actually more time than not, I would like to profile some of the folks that try to shoot down the FMS.  Have they read Athletic Body in Balance or Movement?  Have they heard any of Gray’s interviews?
Have they taken an official FMS/SFMA course from a legit speaker?  Who do they train?
Do they have a fantastic training program anyway that corrects the FMS by default?
Does their method subscription have some level of competition with the FMS on a commercial level?
Do they still do isolation training and impairment-based rehab @ which point the FMS can be offensive to them and expose their retardation?
Or when it comes down to it, are they just a dickhead?

  • September 19, 2010

Leave a Reply 11 comments

Elsbeth Vaino Reply

Nice. Informative all the way through; diplomatic right to the second last drop.

Keats Snideman Reply

Love the last sentence best!

Robbie Bourke Reply

Agree Keats. That made me laugh too.

JimGlinn Reply

Recreational half marathoners? Maybe the FMS is not the best screen for recreational runners. Bet when it was being built that there was not a lot of time spent thinking “we need to make sure we can tease out the injury potential in recreational runners”….

In all seriousness however, maybe the screen is more effective in addressing those training at the edge of performance? That place where injury has to be managed and monitored?

Ryan Reply

Since when does questioning something like the FMS make you a dickhead?? Really? That’s the move?

Charlie Reply

Jim – You are correct. My understanding of the FMS is such that it did not have recreational runners in mind. I think the target audience is to be anyone targeted to engage in any active fitness program.

I think the mobility and stability that the FMS is screening for is intended for all athletes and competitors.

I think you are right though that over time the objective literature will favor certain populations over others based on reporting of pain and requirements of the activity. If you are suggesting that it takes “less” to show up for a recreational activity, I think you’re right. This will affect sensitivity. Good call.

Charlie Reply

Ryan – Perhaps you have misunderstood.

The message is not question FMS = Dickhead.

The message was for Kevin to profile the fellow he was debating with and realize that if someone is just overall a dickhead, they are probably just being a contrarian. Some people get their rocks off just annoying and getting a rise out of people.

It really had nothing to do with the FMS and more about the unhealthy debating process that is really an argument. Nobody wins an argument with a dickhead.

Ryan Reply

Oh my misunderstand must have been the title of the post–When someone says the FMS doesn’t work…

I understand what you are saying, and I agree that some people just debate to debate but if it really had nothing to do with the FMS why not just but a post up on “unhealthy debating process”

In this case we have no idea on the intent of the person in question showing the poster and their intentions..

Maybe we should profile the people who live by the FMS–what other information have the read–Have they read Kelvin Giles–Physical Competence Assesment Manual? What about gone through the NASM information? Mark Comerford information? What about talking to other great strength coaches who have brought in Gray for hours of consulting and in the end did not use his evaluation but rather used a combination of things they felt better suited.

What are they weighing this against? What else have they rejected or do they just accept based upon the present state of the market and what is most visible.

Point number 6 is always a two way street–not realizing that, now maybe that is a dickhead

Charlie Reply

Yeah, I guess if you read the title of the post and skipped to the last line, I could see how the message would be read out of context. It’s hard to think someone would actually do that though.

“I understand what you are saying, and I agree that some people just debate to debate but if it really had nothing to do with the FMS why not just but a post up on “unhealthy debating process””
—–Because it’s my Website, and I felt the message of the article was conveyed as I intended.

The Giles piece holds great merit, however, his suggestion that the FMS is cookie cutter as negative is actually as intended. The FMS is supposed to be a general movement screen as a bottom layer of fundamental movement. It is something that comes long before the athletic testing modules that Giles and Gambetta speak of. It is not one or the other. The Giles pieces would come after the FMS, and in fact, that style of evaluation does come after the FMS. At no point is there a remand to only do the FMS. There are other either more specific qualitative or quantitative measures that will govern your programming.

NASM – I was in the first group to ever be provided the CES coursework and examination as everyone in the NBA was given it for free to make the NASM and NBATA marketing agreement look strong. The CES, at that time, was very kinesiology-based focusing on the muscle groups reacting to the aberrant joint presentation. They also did not demand a depth of the OH Squat or 1-leg Squat that could potentially reveal further dysfunction.
If the knee buckled in, the assumption was roll and stretch ADDuctors, activate ABDuctors, and integrate with a squat. This is clearly myopic as this may or many not be the cause and route to correct.
Has the NASM-CES evolved since my descriptions?

Mark Comerford’s Matrix series as each specific to sports/activities is again something that would be a bridge of special and general movement and come after the fundamentals of the FMS.
Another acceptable choice to add to the pieces that the FMS does not cover.

Now the coach that has spent the time and absorbed the truths of the system with an open-mind, unlike someone like Giles or Gambetta, and still found reason to reject the system, that is a person I would enjoy listening to. I would expect them to be very smart and have an insight I have not been exposed to.

Bottom line to all of this sociology and pissing contest is to not use the specific methodology that Gray speaks of. That is what works for me. The system is what the message is about. Screen, test, and assess, and use a strata that has a common ground floor.

And if you’re calling me a dickhead, please don’t do that.
Nobody called you anything, Ryan.

Ryan Reply

Sorry wasn’t intended to come of as a name calling, more of a tie in back to the original piece, my apologies. I respect you opinion and you have seen and used many different screens and chose to use what you feel fits best in the programming.

raymccarthy3rd Reply

Charlie,

I too love that last sentence. A word I have often said my self. I do however have a new favorite. Will send it to for your use in the future.

Raymcc

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