Interview Questions for Functional Movement Assessment

The Functional Movement Screen (FMS) assesses seven fundamental movement patterns that are crucial for daily activities and athletic performance. These movements represent basic human movement capabilities, and limitations in these patterns often indicate underlying compensations that can increase injury risk. The seven patterns are:

• Deep Squat: Assesses bilateral lower extremity mobility, stability, and core control. Think of squatting down to pick something up from the floor.
• Hurdle Step: Evaluates single-leg stance, hip mobility, and balance. Imagine stepping over a low hurdle.
• In-Line Lunge: Assesses the ability to control movement in a single leg stance while maintaining hip and ankle stability. This is similar to taking a large stride forward.
• Shoulder Mobility Complex: Measures shoulder range of motion and stability, emphasizing both internal and external rotation. Think of reaching across your body and behind your back.
• Active Straight-Leg Raise (ASLR): Tests hip flexor mobility and posterior chain stability. This involves lying on your back and raising one leg while keeping it straight.
• Trunk Stability Push-up: Assesses core stability and upper body strength. A modified push-up focusing on maintaining proper posture throughout the movement.
• Rotary Stability: Evaluates rotational stability of the spine and core musculature. Imagine twisting your torso while maintaining a stable base.

Each movement is scored based on the quality of movement and the presence of any compensations or limitations.

The FMS uses a simple yet effective scoring system ranging from 0 to 3. A score of 3 indicates pain-free performance with good mechanics and full range of motion, showing a strong movement capacity. A score of 2 signifies a movement performed with minor compensations, indicating some limitations. A score of 1 represents a major compensation or significant limitations, while a score of 0 points to pain that prevents completing the movement. The significance of the scoring system lies in its ability to quickly identify areas of movement dysfunction. A lower score points to higher risk of injury and helps prioritize areas needing attention in a training program. For example, multiple scores of 1 or 2 highlight potential weaknesses that warrant a more focused corrective exercise plan to minimize future injury risk.

While the FMS is a valuable tool, it does have limitations. It doesn’t directly measure strength, power, or endurance; it only assesses movement quality. The subjective nature of scoring can introduce variability between assessors. Additionally, it may not be suitable for individuals with certain pre-existing conditions or specific athletic populations. These limitations can be addressed by:

• Using the FMS in conjunction with other assessments: Combining it with tests that measure strength and power will provide a more comprehensive picture.
• Providing thorough training to assessors: Ensuring consistent scoring across different practitioners minimizes variability.
• Considering individual context: The FMS should be tailored to the individual’s specific needs and activity levels, acknowledging any pre-existing conditions.
• Using it as a screening tool, not a diagnostic tool: It should point to areas needing further investigation, rather than offering a diagnosis.

An asymmetrical score in the FMS indicates a difference in movement quality or capacity between the left and right sides of the body. For example, scoring a 3 on the right-side In-Line Lunge and a 1 on the left-side indicates a significant imbalance. This asymmetry highlights a potential weakness or instability on one side, increasing the risk of injury. This asymmetry often arises from prior injuries, muscle imbalances, or habitual movement patterns. The asymmetrical score necessitates a closer examination of the underlying cause through a thorough movement analysis to identify and address potential muscle imbalances or restrictions.

Movement limitations are strongly linked to injury risk. When the body compensates for restricted movement, it creates stress on other joints and tissues, increasing the likelihood of injury. For instance, limited ankle dorsiflexion during a squat might lead to excessive knee valgus (knees collapsing inward), putting stress on the ligaments and potentially leading to an injury. Addressing these limitations through corrective exercises can significantly reduce this risk by restoring optimal movement patterns and reducing the strain on susceptible areas. Think of it like a car with misaligned wheels – it’ll eventually wear down parts prematurely and increase the likelihood of a breakdown.

My approach to developing a corrective exercise program based on FMS results is systematic and individualized. It starts with identifying the movement limitations highlighted by the screen. Then, I prioritize addressing the lowest scoring movement patterns first, as these represent the most significant areas of concern. The program focuses on improving mobility, stability, and motor control of the restricted areas using exercises that target the underlying limitations. I begin with exercises that are easier to perform and progressively increase the challenge as the client’s capabilities improve. Throughout this process, I continuously monitor the client’s progress, adapting the program to address any changes or challenges that arise. The goal is not just to improve the FMS score but to enhance overall movement quality and reduce injury risk. This is a collaborative process, always ensuring the client’s feedback is integrated.

A movement limitation refers to a restriction in the range of motion or a deviation from optimal movement patterns, usually due to muscle tightness, joint stiffness, or other physical restrictions. This limitation is often correctable with targeted training. A movement impairment, however, is a more serious issue; it represents a dysfunction in the neuromuscular control and coordination of movement. This often requires more specialized intervention beyond basic corrective exercises, perhaps including physical therapy or other manual therapies. An example of a limitation would be tight hip flexors restricting a deep squat. An impairment would be a significant motor control issue affecting the coordination of multiple muscle groups needed for a proper squat, often related to neurological or systemic factors.

Movement compensation refers to the body’s strategy to achieve a desired movement when a primary muscle or joint is unable to function optimally. Think of it like a car with a flat tire; it can still move, but it will do so inefficiently, potentially damaging other parts of the vehicle. Similarly, in the human body, compensation can lead to overuse injuries, pain, and reduced performance.

For example, someone with weak gluteus medius muscles might compensate during a squat by leaning heavily to one side to maintain balance. This compensates for the lack of hip abduction strength, but it increases stress on the knee and low back, potentially leading to pain and injury over time. The implications of movement compensation are significant; they can range from decreased athletic performance and increased risk of injury to chronic pain and functional limitations in daily activities. Identifying and addressing these compensations is crucial for optimizing movement and improving health outcomes.

The Functional Movement Screen (FMS) is a valuable tool for assessing fundamental movement patterns. I integrate it into training programs by first administering the screen to identify movement limitations and asymmetries. This assessment informs my program design, ensuring I address any underlying weaknesses before progressing to more advanced exercises. For example, if the FMS reveals limitations in shoulder mobility and stability, I would incorporate mobility drills and exercises focusing on the rotator cuff muscles before adding overhead pressing movements. This approach minimizes the risk of injury and optimizes training effectiveness. After addressing limitations, I regularly reassess using the FMS to track progress and adjust the program accordingly, creating a dynamic and responsive training plan.

Selecting corrective exercises requires careful consideration. First, I identify the specific movement limitation using the FMS or other assessments. Next, I determine the underlying cause – is it due to muscle weakness, tightness, or neuromuscular control issues? Then, I choose exercises that directly address the identified limitation. It’s crucial that exercises are safe, progressive, and specific to the individual’s needs. For instance, if someone demonstrates poor hip mobility, I might begin with simple stretches like the couch stretch or pigeon pose, progressively loading with dynamic movements such as hip circles, before finally progressing to more challenging exercises like deep squats. The exercises are always chosen based on the individual’s current fitness level and any existing injuries.

Assessing the effectiveness of corrective exercises involves a multi-faceted approach. I reassess movement patterns using the FMS or similar assessments at regular intervals, tracking changes in scores and observing qualitative improvements in movement quality. I also monitor clients’ reported pain levels and functional capacity, both subjective and objective markers of improvement. For example, if a client initially scored a 1 on the hurdle step test (indicating a significant limitation), I’d track their progress and expect to see an improvement in score and a decrease in reported pain or discomfort, alongside improvements in their daily activities like going up and down stairs. Furthermore, I use video analysis to track form improvements, ensuring exercises are performed correctly and safely. Any lack of progress would signal a need to adjust or modify the program.

Adapting the FMS for different populations requires a nuanced approach. For athletes, the FMS is used to identify movement limitations that may hinder performance and increase injury risk. I might use more advanced variations of the tests or incorporate sport-specific movements into the assessment. With older adults, modifications are crucial to ensure safety and account for age-related changes in flexibility, strength, and balance. I’d prioritize functional exercises that improve mobility, stability and reduce fall risk, potentially adapting the test positions to accommodate limitations while still gaining valuable insights into movement capabilities. Modifications might include using assistive devices or altering the range of motion required in some tests, always prioritizing safety and client comfort.

Beyond the FMS, I have extensive experience using other movement assessments, including the Selective Functional Movement Assessment (SFMA), the Overhead Squat Assessment (OSA), and various postural assessments. The SFMA, for example, provides a more detailed, pain-specific assessment and helps isolate the root cause of pain, guiding specific exercise prescription. The OSA focuses on the biomechanics of the overhead squat, useful in identifying weaknesses and compensations in the upper and lower body. My understanding of these various assessments enables me to create a holistic understanding of a client’s movement patterns and functional limitations and tailor a more comprehensive plan.

I use a combination of methods for documenting and tracking client progress. This includes using digital tools to record FMS scores, video analysis of movement patterns, and client self-reported data such as pain levels and functional capacity scores on standardized questionnaires. I regularly review this data to monitor improvements and adjust the program as needed. A well-maintained client file provides a comprehensive record of the progress made. This provides accountability for both myself and the client, allowing for continuous and data-driven improvement of their movement and overall health.

Communicating Functional Movement Screen (FMS) findings and exercise prescriptions requires a clear, concise, and client-centered approach. I begin by explaining the FMS in simple terms, emphasizing that it’s a tool to identify movement limitations, not a diagnostic test. I then present the results visually, using a score sheet and potentially photos or videos of their movement patterns during the assessment. I translate the numerical scores into clear language, highlighting any movement compensations or asymmetries observed. For example, instead of saying “Deep Squat score of 1,” I might explain, “During the squat, I noticed you were unable to maintain a neutral spine and your heels lifted off the ground, suggesting tightness in your ankles and/or hamstrings.” The exercise prescription is then tailored to address these specific limitations, focusing on improving mobility, stability, and strength. I explain the rationale behind each exercise, emphasizing the connection to their movement limitations. Furthermore, I provide written materials and home-exercise programs, ensuring clients understand how to perform the exercises correctly and safely.

I always check for understanding by asking questions and encourage clients to ask questions. I believe in shared decision-making, involving clients in choosing exercises they feel comfortable with and can integrate into their lifestyle. Follow-up sessions are crucial for monitoring progress and making necessary adjustments to the program. This collaborative and educational approach ensures that clients are actively involved in the process, improving compliance and outcomes.

Addressing client concerns regarding the FMS is vital for building trust and ensuring a positive experience. Many clients are apprehensive about being assessed, particularly if they have pre-existing injuries or limitations. I address these concerns by creating a safe and supportive environment. I start by emphasizing that the FMS is not about judgment, but rather about identifying movement limitations to help them improve their overall movement quality and reduce the risk of injury. I explain the assessment process step by step, answering any questions they might have about each movement pattern. If a client expresses pain or discomfort during the assessment, I immediately stop and address the issue, adjusting the assessment or recommending alternative movements as needed. I also highlight the benefits of improved movement – increased performance, reduced pain, and improved overall health – to help them see the value in the process. Building rapport, showing empathy, and demonstrating professionalism are key components of putting clients at ease. I might share success stories from past clients to reinforce the effectiveness of the FMS and the positive changes they experienced.

I once assessed a client with severe osteoarthritis in her knees. The standard FMS deep squat was impossible for her to perform without significant pain. Instead of abandoning the assessment, I modified my approach using a functional movement screen that assesses the specific movements important for her daily activities. I focused on assessing her ability to perform functional movements like rising from a chair, stepping over an obstacle, and getting into and out of a car. I used a modified deep squat variation where she performed the movement with support from a chair to assess her joint mobility and stability within the limitations of her condition. This allowed me to identify her movement compensations specific to her condition and tailor an exercise program focused on improving knee stability and strength without exacerbating her osteoarthritis. This demonstrated the importance of adapting the FMS to individual needs, avoiding unnecessary pain and providing a personalized and effective assessment.

Common movement compensations I observe include:

• Foot and ankle compensations: Limited dorsiflexion (ability to bring toes towards shin) often leads to heel lift during squats and lunges. Address this with ankle mobility exercises such as calf stretches and dorsiflexion exercises.
• Hip compensations: Limited hip extension can lead to lumbar extension (arching of the lower back) during squats and lunges. I address this with hip mobility exercises, such as hip flexor stretches and glute activation exercises.
• Shoulder compensations: Limited shoulder mobility can lead to improper posture and compensatory movements during overhead movements. Addressing this involves improving shoulder mobility through exercises such as shoulder rotations and thoracic spine mobility drills.
• Lumbar spine compensations: Excessive lumbar flexion (rounding of the back) is frequently observed in movements like the torso twist and often indicates a lack of core stability and/or hamstring tightness. I address this with core strengthening exercises and hamstring flexibility work.

Addressing compensations involves a multi-faceted approach. It’s not simply about stretching tight muscles but also strengthening weak ones. A crucial element is the integration of corrective exercises designed to restore proper movement patterns. These exercises might include foam rolling, static and dynamic stretches, and strengthening exercises targeting the muscles involved in the compensation.

Motor learning principles are fundamental to effective functional movement training. I apply these principles by focusing on:

• Stages of learning: Understanding the cognitive, associative, and autonomous stages of motor learning allows me to structure training progressively, starting with simple exercises and gradually increasing complexity. This ensures that the client develops proper motor control and coordination before progressing to more challenging movements.
• Practice conditions: Varied practice, where exercises are performed in different contexts and situations, is crucial for enhancing motor learning and making movements more robust and adaptable.
• Feedback: Providing both intrinsic (internal feedback the client feels) and extrinsic (external feedback from me) feedback is essential. I utilize cues and demonstrations to enhance the client’s understanding of the desired movement pattern. I also utilize video feedback, which has proven to be particularly effective in demonstrating proper form and identifying areas for improvement.
• Transfer of training: I design exercises that not only address specific movement limitations but also translate to improved performance in everyday activities. This focus on transfer ensures that the learning is relevant and functional.

For example, if a client struggles with hip extension during a squat, I start with simple exercises like glute bridges, progressing to more complex variations. Throughout the process, I provide detailed feedback and use varied practice conditions, helping the client master the movement and transfer it to more functional activities like walking or running.

Muscle imbalances identified through the FMS are addressed by a comprehensive approach that integrates several strategies. First, I carefully analyze the FMS results to pinpoint specific muscles involved in the compensations. This might involve assessing range of motion, muscle strength, and movement patterns. Then, I design an exercise program to address these imbalances. This often involves a combination of:

• Flexibility and mobility work: Stretching and mobility drills targeting tight muscles identified during the assessment. Examples might include static stretches for tight hamstrings, dynamic stretches for hip mobility, or foam rolling to address muscle adhesions.
• Strength training: Exercises to strengthen weak muscles identified as playing a role in the compensations. This may include bodyweight exercises, resistance band exercises, or weight training exercises depending on the client’s fitness level.
• Activation exercises: Exercises aimed at improving neuromuscular control and activating specific muscles. These are often incorporated into warm-ups or are performed before the main strength training exercises.

For example, if a client exhibits limited hip extension, the program might include hip flexor stretches, glute activation drills (like glute bridges), and strengthening exercises (like squats or deadlifts). Progress is carefully monitored, and adjustments are made as needed to ensure the program remains effective and safe.

Active range of motion (AROM) refers to the range of motion a person can achieve using their own muscle power, while passive range of motion (PROM) is the range of motion achieved with external assistance, such as from a therapist or a stretching device. Both AROM and PROM are important in FMS. AROM reveals the client’s ability to actively control movement, highlighting limitations in muscle strength, neuromuscular control, and flexibility. PROM assesses joint mobility limitations, which might be due to structural limitations (like joint stiffness) or soft tissue restrictions (like muscle tightness). A discrepancy between AROM and PROM can provide valuable insights. For example, a client might have good PROM in their hip but poor AROM, indicating weak hip extensor muscles or poor neuromuscular control.

In the FMS, AROM is assessed during functional movement patterns. For example, in the deep squat, the AROM reveals how well the client can control their movement through the full range of motion. PROM is often assessed indirectly, by observing limitations in AROM and then potentially using manual palpation or other techniques to further explore the limitations. Comparing AROM and PROM helps identify if joint stiffness is the primary cause of movement limitations or if neuromuscular control is a significant contributing factor. This information allows for a more targeted exercise program designed to address the root causes of movement dysfunction.

Proprioception, or the body’s awareness of its position in space, is fundamental to functional movement. It’s our internal GPS, allowing us to smoothly and efficiently execute movements without consciously thinking about every detail. Without proper proprioception, even simple actions become challenging and increase the risk of injury.

Assessing proprioception within the context of a Functional Movement Screen (FMS) isn’t done with dedicated tests like a Romberg test, but is implicitly evaluated throughout the seven fundamental movement patterns. For example, during the Deep Squat assessment, we observe the athlete’s balance, the symmetry of their movement, and their ability to maintain proper posture. Any deviation from ideal form might indicate impaired proprioception. A person with poor proprioception might struggle to maintain balance, exhibit excessive swaying, or demonstrate asymmetric movement patterns, indicating a potential need for intervention focused on improving their body awareness.

We also look for compensatory movements. If someone compensates by leaning heavily on their hands during the hurdle step, it suggests that they lack the proprioceptive awareness to maintain proper alignment and stability during a single-leg stance. In summary, the FMS assesses proprioception indirectly by observing the quality of movement execution within the seven movement patterns.

Individual factors are paramount in FMS implementation. Ignoring these factors can lead to inaccurate assessments and ineffective programming. Age significantly impacts joint mobility, muscle strength, and neurological function. A 70-year-old’s FMS score shouldn’t be directly compared to a 25-year-old’s. Medical history is critical; a client with a prior knee injury may demonstrate compensations during the in-line lunge that don’t reflect general movement dysfunction, but rather, a protective mechanism. Similarly, fitness level dictates the intensity and progression of any intervention plan. A highly trained athlete will require different programming than a sedentary individual.

Consider a 50-year-old client with a history of lower back pain. During the FMS, we might observe limited torso rotation in the Rotary Stability test. This limitation might stem from past injury or simply from years of sedentary behavior. We must differentiate between a true movement dysfunction and pain avoidance behavior before devising an appropriate intervention strategy. We adjust the testing and programming based on their capabilities and medical limitations, always prioritizing safety and individual needs.

The FMS provides a roadmap for programming. A low score on a specific movement pattern points to areas needing immediate attention. For instance, a poor score in the Hurdle Step might indicate weakness or limited mobility in the hip and ankle, impacting balance and potentially predisposing the individual to injury. This would inform our program to include specific mobility drills for the ankle and hip, as well as strengthening exercises for stabilizing muscles in the hip and core.

Strength training should focus on correcting identified weaknesses. For example, poor performance on the Deep Squat may necessitate exercises targeting the quadriceps, hamstrings, and glutes. Flexibility exercises address limited range of motion detected in specific movement patterns. Plyometrics would be introduced gradually after appropriate foundational strength and mobility are established to ensure proper force absorption and reduce injury risk. The FMS allows for a systematic and individualized approach, ensuring that training is targeted and effective.

Common FMS errors often stem from improper technique or assessment procedures. These include incorrect scoring, failure to identify compensatory movements, overlooking pain, and lack of understanding of movement principles. An examiner may misinterpret a movement variation as a true movement dysfunction, leading to unnecessary modifications in the program.

For instance, a common error is failing to distinguish between pain and limitation. If a client experiences pain during a movement, it indicates a problem requiring attention and possibly medical referral, rather than simply scoring them based on range of motion. Another is not recognizing compensatory movements, which mask the underlying issue. For example, excessive lumbar flexion during a squat might mask weakness in the hip extensors. Proper education and adherence to standardized procedures are crucial in minimizing these errors.

The FMS is a powerful tool for tracking progress in rehabilitation. By reassessing the client periodically, we can monitor improvements in movement quality and identify potential setbacks. For example, a client recovering from a knee injury might show improved scores on the in-line lunge and hurdle step over time. However, a sudden decrease in scores could signal a re-aggravation of the injury or the development of compensatory movements, requiring a reassessment of the rehabilitation plan.

This iterative process of assessment and adjustment is crucial for optimal outcomes. Let’s say a client shows improvement in their shoulder mobility after weeks of focused flexibility work but is still struggling with the Active Straight Leg Raise (ASLR). Re-evaluating their ASLR could reveal limitations in hip flexor mobility that previously weren’t addressed, enabling the focus to shift and ensure comprehensive rehabilitation.

Ethical considerations in administering the FMS include informed consent, confidentiality, maintaining professional boundaries, and accurate interpretation of findings. Clients must fully understand the purpose of the assessment, the limitations of the test, and how the results will be used. Their privacy must be protected, and their sensitive information kept confidential. Moreover, examiners should not exceed their scope of practice and seek appropriate medical advice when necessary.

It’s crucial to be sensitive to the client’s comfort levels. The assessment needs to be conducted in a respectful manner, and clients should feel empowered to express concerns or stop the assessment at any time. Misinterpreting findings or making unqualified medical diagnoses can also cause harm and have ethical implications. Proper training and ongoing professional development are vital in mitigating these risks.

Continuing education is essential for staying current with best practices and advances in the field of Functional Movement Assessment. The understanding of movement science is constantly evolving, with new research regularly informing our approaches to assessment and intervention. Moreover, continuing education helps improve the accuracy of assessments, reducing the likelihood of errors. It also keeps professionals updated on emerging techniques, technologies, and treatment modalities.

Staying abreast of the latest research on movement patterns, injury prevention, and rehabilitation techniques ensures professionals can adapt their assessment and treatment strategies to meet diverse needs and improve client outcomes. It also strengthens the credibility of the professional, allowing them to provide the most advanced and evidence-based care possible.