What a Movement Screen (SFMA/FMS) Actually Tells Us

If you have ever been asked to do a deep squat, a lunge on a two-by-four, or a shoulder-reach test at the start of an assessment, you have met a movement screen. The two most common in our setting are the Functional Movement Screen (FMS) and the Selective Functional Movement Assessment (SFMA). Both are useful tools, and both are easy to oversell. It is worth being clear about what they tell us and, just as importantly, what they do not.

What these screens actually are

The FMS is a set of seven fundamental movement patterns, scored to flag limitations, asymmetries, and patterns that provoke discomfort. The original description, published across two papers in the International Journal of Sports Physical Therapy, frames it as a way to look at basic movement competency rather than a diagnosis of any specific structure.^1,2 The seven patterns include the deep squat, hurdle step, in-line lunge, shoulder mobility, active straight-leg raise, trunk stability push-up, and rotary stability. Each one asks a slightly different question about mobility, stability, and control.

The SFMA is its clinical cousin, used when someone already has pain. Instead of scoring for readiness, it works from top-level movements down toward the specific limitation, sorting whether a restriction is a mobility problem, a stability or motor-control problem, or a painful one. The point in both cases is the same: get a structured, repeatable look at how a person actually moves before deciding what to do about it.

What a screen is genuinely good for

Used well, a movement screen does three helpful things. First, it gives us a shared starting point. A squat that stalls at a certain depth or a straight-leg raise that is noticeably limited on one side is something we can measure now and re-measure later. Second, it guides exercise selection. If your rotary stability pattern falls apart but your mobility is fine, your program should look different than someone with the opposite finding. Third, it nudges us to think beyond the sore spot.

That last point matters to how we practice. A limited ankle or a stiff hip often shows up as a problem somewhere else entirely, which is the essence of regional interdependence, the idea that the body works as a linked chain rather than a collection of separate parts. A screen is one structured way to catch those links early instead of chasing pain from joint to joint.

Where the evidence says to be honest

Here is the part that gets glossed over in marketing. A movement screen is a weak standalone predictor of who will get hurt. A systematic review with meta-analysis in the British Journal of Sports Medicine looked at whether FMS composite scores predict future injury and found the evidence conflicting and the effect too small to recommend the screen as an injury-risk estimator on its own.³ A separate systematic review and meta-analysis in the American Journal of Sports Medicine reached a similar conclusion, reporting that the FMS composite score has limited value for predicting injury and questioning its use as a screening tool for that purpose.⁴

The reliability picture is more encouraging. Trained raters tend to agree reasonably well on scores, which means the screen measures something consistently. But consistency is not the same as prediction. A tool can reliably describe how you move today without being able to forecast whether you will roll an ankle in October. Injury risk is genuinely multifactorial, involving training load, sleep, previous injury, fatigue, and plain bad luck, and no single movement score captures all of that.

How we use it, then

Because the evidence is mixed, we treat a movement screen as one input among several, not a verdict. Practically, that looks like this:

• As a baseline, not a diagnosis. A finding is a starting question, not a label. A stiff pattern tells us where to look, not what is wrong.
• To prioritize, not to alarm. A low score does not mean you are fragile or that injury is coming. It helps us decide what to work on first.
• Alongside load history. How much you have been doing, and how quickly you ramped it up, usually tells us more about risk than any single movement test.
• As a re-test. The real value often comes from comparing a screen to itself a few weeks later to confirm a program is doing what we intended.

This balanced use fits how we think about evidence generally. Good clinical decisions come from combining the best available research with clinical judgment and the person in front of us, which is the heart of evidence-based practice. A movement screen earns its place in that process precisely because we are honest about its limits.

It also connects to a principle we lean on in rehab: there are no bad exercises, only too much too soon. A screen can help us choose a sensible entry point and a reasonable rate of progression, which is a far more useful job than pretending to predict the future.

References

1. Cook G, Burton L, Hoogenboom BJ, Voight M. Functional movement screening: the use of fundamental movements as an assessment of function - part 1. Int J Sports Phys Ther. 2014;9(3):396-409.
2. Cook G, Burton L, Hoogenboom BJ, Voight M. Functional movement screening: the use of fundamental movements as an assessment of function - part 2. Int J Sports Phys Ther. 2014;9(4):549-563.
3. Moran RW, Schneiders AG, Mason J, Sullivan SJ. Do Functional Movement Screen (FMS) composite scores predict subsequent injury? A systematic review with meta-analysis. Br J Sports Med. 2017;51(23):1661-1669.
4. Bonazza NA, Smuin D, Onks CA, Silvis ML, Dhawan A. Reliability, validity, and injury predictive value of the Functional Movement Screen: a systematic review and meta-analysis. Am J Sports Med. 2017;45(3):725-732.

Dr. Michael Minenna D.C., B.Sc., SFMA, FMS

Related care at Boreal Spine and Sport: How we manage sport injuries · Our chiropractic services.