Potential Evidence of the Value of the Functional Movement Screen Regarding Injury Probability
As I enter the profession of Athletic Training I have been charged with overseeing the care of the student athletes at a small Junior/Senior High School in a rural farming and lumber town. This presents with a number of unique challenges and opportunities, none of which are entirely unanticipated. Of course there is nothing like reality to teach one lessons, even in anticipated situations. One of my goals upon entry to this environment was to perform both SCAT 5 and FMS screens on every student athlete starting with football. Football, as a point of necessity, was the first portion of my patient population to complete these pre-screens. As of yet I have not had to utilize the SCAT 5 baselines, however the FMS appears to have become indicative of injury and as such will be a useful return to play metric as I rehabilitate patients.
On a football roster of 18, the 3 injuries that have produced practice and performance time loss at this point in the season have been among the three student athletes with the lowest aggregate FMS scores during pre-screening with scores of 9 (anterior rotator cuff/labral injury) 10 (MCL sprain) and 11 (MCL sprain). Evidence suggests that functional movement (1,2) and the FMS may be predictive of injury risk in a variety of athletic populations.(3,4,5) However, this has not been validated in secondary school populations.(6,7) Evidence also points to a correlation between greater risk of injury and age in secondary school populations.(6,7) This would be a consistent finding given evidence suggesting that the greatest predictor of injury is previous injury.(7,8) Consistent with findings suggesting that older secondary school student athletes sustain injury more often than their younger counterparts, (8) in the cases presented above, the patients are in grade 11, 12, and 12.
As the seasons progress I will continue to utilize the FMS as a pre-screen for return to play purposes and monitor potential correlations between injuries that produce practice and/or performance time loss and lower aggregate scores on the FMS. It will also be useful to note any correlations between individual movement screen scores within the FMS and type of injury sustained. In the cases above, the anterior shoulder injury scored a 1/1 on shoulder mobility (SM), and both MCL injuries scored 1/1 on the active strait leg raise (ASLR). These three data points have provided an interesting practice based glimpse into the potential efficacy of the FMS as a predictive model and a possible opportunity to contribute to the growing body of research in this area.
References
1. Cook G, Burton L, Hoogenboom B. Pre‐Participation screening: The use of fundamental movements as an assessment of function—part 1. North Am J Sports Phys Ther. 2006; 1(2):62‐72.
2. Cook G, Burton L, Hoogenboom B. Pre‐Participation screening: The use of fundamental movements as an assessment of function—part 2. North Am J Sports Phys Ther. 2006; 1(3):132‐139.
3. Kiesel K, Plisky JP, Voight ML. Can serious injury in professional football be predicted by a preseason functional movement screen? North Am J Sports Phys Ther. 2007; 2(3):147‐158.
4. Chorba RS, Chorba DJ, Bouillon LE, Overmyer CA, Landis JA. Use of a functional movement screening tool to determine injury risk in female collegiate athletes. North Am J Sports Phys Ther. 2010; 5(2):47‐54.
5. Garrison M, Westrick R, Johnson MR, Benenson J. Association between the Functional Movement Screen and injury development in college athletes. Int J Sports Phys Ther. 2015; 10(1):21‐28.
6. Bardenett SM, Micca JJ, DeNoyelles JT, Miller SD, Jenk DT, Brooks GS. Functional Movement Screen normative values and validity in high school atheltes: can the FMS be used as a predictor of injuyr. Int J Sports Phys Ther. 2015; 10(3):303-308.
7. Turbeville SD Cowan LD Owen WL Asal NR Anderson MA. Risk factors for injury in high school football players. Am J Sports Med. 2003; 31(6):974‐980.
8. Emery CA Meeuwisse WH Hartmann SE. Evaluation of risk factors for injury in adolescent soccer: Implementation and validation of an injury surveillance system. Am J Sports Med. 2005; 33(12):1882‐1891.