Functional Movement Screen

Functional Movement Screen Sports Medicine

In today’s world, calling something a “screen” inevitably conjures images of tablets, monitors, TVs, and LCD, but functional movement screen (FMS) is quite different. It’s an early-detection system primarily used for runners and athletes that uses seven key tests to measure physical strength and coordination. It is, in the words of its founder, Lee Burton, “designed to help identify movement pattern dysfunctions, thereby helping create the best possible interventions.”

FMS works by isolating flawed movement patterns, providing the patient with the knowledge needed to retrain his or her body to move properly. The seven movement patterns tested, each of which is ranked on a scale of 0 to 3 (from least capable to most capable), gauge not only the mobility but also the stability of the ankles, spine, hips, knees, and even shoulders.

The seven tests include:

  • The deep squat, in which the patient holds his or her arms in place while squatting. Here the physician is looking for twisted heels or other tell-tale signs of asymmetry.
  • The hurdle step, in which the patient is asked to step over a hurdle of moderate height. Here the physician is primarily gauging your ability to balance and the strength of your core.
  • The in-line lunge, in which you lunge forward with one hand near the neck and the other near the lower back. Here the physician will scan for eversion or inversion of the feet or an inability to balance.
  • Shoulder mobility, which consists of trying to place both hands behind your back at the same time. The physician will check for symmetry and to see how close together your hands are.
  • The active straight-leg raise, in which the patient raises one leg towards the sky, while lying prostrate, without bending the knee. Here the physician will check the angle of your leg and alignment of your ankles.
  • The trunk stability pushup, in which you perform a pushup whilst keeping your hands aligned with your forehead or chin. The physician will be on the lookout for hyper-extension of the spine.
  • And, finally rotational stability, in which you lower yourself to the ground, raise your right arm and leg, and touch your right elbow to your right knee; then repeat with the left half of your body. The physician will check for symmetry and elbow/knee alignment

Together these seven tests allow you and your physician to appraise your body’s movements before training to lower the risk of injury during the training period. Once dysfunctions have been uncovered, the two of you can work together to develop a workout regimen to retrain your body before moving into the next phase of training. FMS is recommended for both beginning and advanced runners to enhance exercise and prevent movement dysfunction.

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

image

Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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