Research Review By Kevin Neeld©

Date Posted:

December 2009

Study Title:

Can Serious Injury in Professional Football be Predicted by a Preseason Functional Movement Screen?

Authors:

Kiesel K et al.

Author's Affiliations:

ProRehab PC, Evansville, IN; Belmont University, Nashville, TN

Publication Information:

North American Journal of Sports Physical Therapy 2007; 2(3): 147-158.

Background Information:

Football has one of the highest injury rates of all sports. In order to prevent sport-related injuries, it is necessary to have an in-depth understanding of the specific risk factors associated with an injury. While a plethora of football injury risk factors have been identified (e.g. previous injury, body composition, muscle flexibility, etc.), it is likely that a combination of many physical parameters are influential in predisposing an athlete to injury.

As a result, it is logical to assume that a battery of tests assessing symmetrical and asymmetrical movement patterns, and joint mobility and stability relationships will be predictive of football-related injuries (and to logically extrapolate, other sports).

The purpose of the current investigation was to determine if a relationship existed between a football player’s score on the Functional Movement Screen (FMS) and the odds of that player suffering an injury during the subsequent season.

Pertinent Results:

  • The average (SD) FMS score for all participants was 16.9 (3.0) out of a possible 21.
  • The difference in FMS score between those players that suffered an injury (14.3) and those that did not (17.4) was statistically significant (p < 0.05).
  • The authors determined that a FMS score of 14 “maximized the specificity and sensitivity of the test”, meaning that this was the best value to use as a cut-off point. A score above 14 meant it was not very likely the athlete would get injured.
  • There was over an 11-fold increased likelihood of injury if an athletes scored less than 14.

Clinical Application & Conclusions:

The FMS has increased in popularity in recent years, but it requires proper clinical study to evaluate its utility. This was a great exploratory study examining the relationship between an assessment geared around functional movement and subsequent injury risk. Not surprisingly, there was in fact a significant relationship between FMS score and injury risk, with a score of 14 emerging as the “magic number” below which injury risk is drastically increased.

The strength of the FMS is that it assesses fundamental movement patterns used in all sports and in everyday life. While the results of this study cannot be applied to all populations (see Study Limitations below), it is likely that relationships do exist between total FMS scores and left-right asymmetries and injury risk in all populations. Health and fitness professionals should begin to employ the FMS with their clients to develop their own normative data and injury predictors.

Study Methods:

A strength and conditioning specialist for a professional football team (NFL) tested all the players that attended the team’s training camp on the Functional Movement Screen (FMS), which includes 7 tests to identify mobility and stability limitations and side-to-side asymmetries in range of motion and motor control. The 7 tests were: Deep Squat; Hurdle Step; In-Line Lunge; Shoulder Mobility; Active Straight Leg Raise; Trunk Stability Push-Up; and Rotary Stability Test (essentially a cross-crawl). For more information on the FMS, visit: www.functionalmovement.com, or there are many examples on You Tube if you search for it..

Players were defined as injured if they were placed on the injured reserve and missed at least three weeks of competition. Data analysis techniques were utilized to determine if there were statistical differences in the total FMS score between players that suffered an injury and those that did not, as well as to determine a specific FMS score cut-off point that would be most predictive of a player suffering an injury.

Study Strengths / Weaknesses:

  • This study had a few notable limitations. Because this study was conducted on only one team, it is unclear whether the results are applicable to all teams in the National Football League or if the results were biased to the particular participants.
  • Similarly, the results of this study cannot be extended to all levels of football or of athletes of other sports, as injury rates and risk factors are likely to differ amongst these populations.
  • Lastly, the injury definition of being on the injured reserve list for at least three weeks likely underrepresented significant injuries that weren’t severe enough to sideline a play for three weeks.

Additional References:

  1. Cook G et al. The use of fundamental movements as an assessment of function - Part I. NAJSPT 2006; 1: 62-72.
  2. Cook G et al. Pre-participation screening: The use of fundamental movements as an assessment of function - Part 2. NAJSPT 2006; 1: 132-139.
  3. Meeuwisse WH. Assessing causation in sports injury: A multifactorial model. Clin J Sport Med 1994; 4: 166-170.