Safety / Injuries
Improve Your Performance: FMS + Corrective Exercise
No matter what type of client you work with, good mobility, balance, and functional strength are goals for most fitness programming. Every personal trainer should be able to accurately assess a client’s functional limitations and injury risk. This is key to properly design a corrective exercise and fitness program aimed at injury prevention.
Functional Movement Screens and Corrective Exercise
The functional movement screen (FMS) can be an effective tool for fitness and health professionals. It screens for and identifies movement dysfunctions and compensations that put clients at risk for injury. For athletes, the FMS can also help improve athletic performance by identifying weaknesses in optimal stability and mobility.
Corrective exercise, in conjunction, has the aim of working to correct movement dysfunctions and poor motor control with the use of muscle activation, inhibition, stretching, and strengthening.
When you use the FMS tests to screen a client’s movement patterns, the resulting details and movement score give extensive data helpful in designing effective corrective exercise programs for functional mobility and stability.
Elements of FMS Corrective Exercises: Testing and Scoring
There are seven FMS tests to conduct prior to developing a training program and through that same program to assess for progress. During those tests, there are seven functional movement patterns to observe and assess:
Each movement pattern provides vital information regarding overactive or underactive musculature.
Deep Squat Screen
Also referred to as an overhead squat assessment, the client will complete a full squat with arms locked out overhead.
This assessment is for observing the shoulders, hips, ankles, knees, and thoracic spine. Look for shin and thigh angles, forward lean, rounding or arching of the thoracic spine, and asymmetrical weight shifting.
Hurdle Step Screen
A hurdle is set at or just below knee height for this screen. Stepping over and across is a functional daily movement. Observe this while the client carries a pipe or dowel on their shoulders in a back racked position.
This assessment observes the hips, knees, and ankles before, during, and after the step by observing balance, hip shifting, and excessive or unnecessary movement of the upper body.
In-Line Lunge Screen
With a pipe held horizontally along the spine and neck behind the back, the client will stand in a split stance. They’ll complete a full lunge until the knee touches the floor and return to the starting position.
This screen looks at knee and ankle stability as well as leg adductor and abductor activity. Also look for mobility issues concerning the hinge, torso stability, and balance.
Shoulder Mobility Screen
Complete on both sides of the body. The client will bring both hands behind the back, one from the top with elbow up and one from under with elbow down. The client will attempt to walk their hands as close together as possible before switching arms.
This screen observes the scapular range of motion, internal and external rotation, and overall posture. It identifies rounded shoulders, asymmetries, and how close together the hands can get.
Trunk Stability Push-Up Screen
The client will complete a push-up with their hands deliberately placed above the shoulders. Hand placement for female clients is at chin level. Placement for men is even with the forehead.
This screen looks at core strength and full-body movement during the push-up. The observer is specifically looking for spine hyperextension and hip placement.
Active Stretch: Leg Raise Screen
Complete on both sides of the body. The client will lay on their back with arms at the sides. Keeping one leg flat on the ground, they’ll raise the other leg as high as possible without bending the knee.
This screen identifies hamstring and calf flexibility as well as pelvic and hip mobility and stability. Record the angle of the raised leg and any bends at the knee or ankle.
Rotational Stability Screen
Like a birddog, your client will start on all fours. They will raise one arm and the same leg until they are parallel to the floor. They’ll then slowly bring that same side knee and elbow together under the body before extending again.
This screen observes core stability, symmetry on both sides of the body, as well as the alignment of the knee and elbow.
Scoring the Screens
Each screen performed receives a score between 0 and 3.
0 = the movement caused pain and may require a healthcare professional referral
1 = the movement pattern could not be completed
2 = the movement pattern was completed, but with some compensation observed
3 = the movement pattern was completed with no compensation
After completing all seven screens, there is a possible score of 21. With this score, you can determine a clients’ injury risk.
A score of 14 or higher suggests a low probability of injury during functional movement. A score of 13 or less suggests a higher likelihood of injury during functional movement.
What Personal Trainers Need to Know About FMS Corrective Exercises
Studying the movement patterns of a client with functional movement screens offers great insight into the overactive and underactive muscles and imbalances. As a personal trainer or corrective exercise specialist, you are fully prepared to help correct these issues.
A sports medicine and general fitness training program should always focus on stability, balance, and fundamental movements to ensure that a client remains injury-free.
Head to the ISSA blog if you’d like to read more about relieving tight muscles!
Movement dysfunctions can arise in any part of the body and prevent people from moving optimally. Corrective exercise components like self-myofascial release and stretching will help realign the muscle tissue before strengthening can begin.
Some clients choose to go through physical therapy for more extensive dysfunctions or as a part of a post-surgery protocol. However, the personal trainer and corrective exercise specialist armed with functional movement screens are just as equipped to address issues and get clients moving better.
Improving FMS Screening Results
It is not enough to perform functional movement screens at the beginning of a training program. As the client improves, repeat the FMS tests and log the scores to observe any improvement or areas of continued opportunity. As your client’s movement patterns and activities change, the potential for movement dysfunction will also shift. It is your job as the fitness professional to keep track and always be observing the fundamental movement of clients, checking for injury risk.
Which FMS Screens Are Best?
Each client is unique and all the functional movement screens may not be ideal for everyone. However, the stability, symmetry, balance, and movement dysfunctions they test for are good to know for all clients. Start with all seven screens. During reassessments, specific and applicable screens can be reevaluated according to the corrective exercise and training program the client is currently on.
Tying FMS and Corrective Exercise Together for Optimal Performance
Every client can benefit from FMS screening and corrective exercise programming. From the youth client, the active athlete, a senior training for balance, to the average adult looking to improve posture and strength. The data gives trainers or corrective exercise specialist all the ammunition they need to make an effective training cycle geared towards injury prevention and results!
During a corrective exercise protocol, the first stage is self-myofascial release to release any adhesions causing asymmetries. You must release overactive muscle tissue for ideal muscle fiber alignment. Continuing to stretch the overactive muscle tissue after self-myofascial release is the second step in a corrective exercise program. These steps generally can occur in the daily warm-up on a training day.
Identify Underactive Muscles
Next, the observations of the FMS screens can identify which muscles are underactive. Often, you need to address the lack of core strength. The underactive muscles may differ on one side of the body versus the other, which is why you must perform FMS screens on both sides.
The strength phase of corrective exercise programming addresses symmetry and balance with fundamental movement patterns, such as:
- Weighted squatting
- Bench press
- Lunges with the appropriate equipment
The final stage in corrective exercise training is to move into the true functional movements. For an athlete, this will include the movements required for their sport. Soccer players will incorporate change of direction, cutting, sprinting, and stopping. A football player will incorporate multi-directional footwork, stopping and cutting, and sprint work.
The movements for the general population will vary by client. However, squatting standing, sitting, pushing, pulling, and core strength are always good functional movements for general strength and stability during training.
When building an exercise protocol for a client, outside of FMS screening and corrective exercise, consider exercise selection and rest periods between sets. To learn more about ideal rest periods during training, check out this ISSA blog post with everything you should know!
You’ll need to adjust the corrective exercise programming as the client gets stronger. As the training adjusts, that is an ideal point to reassess the FMS screens as well since the results impact the training protocol.
Research has shown the benefits and improvements that result from using FMS screens to design corrective exercise and general training protocols for athletes. No matter what the sport, flexibility and strength were markedly improved when using FMS screens to specifically improve functional range of motion and flexibility, thus improving movement patterns and functional strength. Training programs range typically from 6 weeks to 20 weeks before reassessment in most studies.
If you are not already certified as an ISSA Corrective Exercise Specialist, this is the perfect time. Be better prepared to identify injury risk and get your clients results while growing your reputation as a knowledgeable fitness professional!