FUNCTIONAL MOVEMENT SCREEN SCORING SHEET
DATE: ______________ NAME: ___________________________________ AGE: _______ LEVEL: ____________________
TEAM/SCHOOL: ________________________________ HEIGHT: __________ HAND DOMINAANCE: R L
SPORT/POSITION: ______________________________ WEIGHT: __________ LEG DOMINANCE: R L
TEST SCORE DYSFUNCTION GRADING CRITERIA III GRADING CRITERIA II GRADING CRITERIA I
1. Deep Squat 3 2 1 0 >Upper torso is parallel with >Upper torso is parallel with >Tibia and upper torso are not
tibia or toward vertical tibia or toward vertical parallel
TOE TOUCH TEST: Able >Femur below horizontal >Femur below horizontal >Femur not below horizontal
Not able >Knees aligned over feet >Knees aligned over feet >Knees not aligned over feet
>Dowel aligned over feet >Dowel aligned over feet on a >Lumbar flexion noted
2X4
2. Hurdle Step 3 2 1 0 >The hips, knees & ankles >Alignment is lost between >Contact with foot & hurdle
remain aligned in the sagital hips, knees & ankles >Loss of balance at any time
Inches: ____________ plane >Movement in the lumbar
>Minimal Movement in the spine
Left Leg Up 3 2 1 0 lumbar spine >Dowel & hurdle do not remain
>Dowel & hurdle remain parallel
Right Leg Up 3 2 1 0 parallel
3. In-Line Lunge 3 2 1 0 >Minimal to no torso >Movement noted in torso >Loss of balance at any time
movement >Feet do not remain in sagital
Inches: ____________ >Feet remain in sagital plane plane on the 2X6
on the 2X6 >Knee does not touch 2X6
Left Leg Forward 3 2 1 0 >Knee touches 2X6 behind the behind the heel of front foot
heel of front foot
Right Leg Forward 3 2 1 0
4. Shoulder Mobility 3 2 1 0 >Fists should be within one >Fists should be within one >Fists fall greater than one and
Distance (tip of middle finger to L top: ____ hand length and a half hand lengths a half hand lengths
distal crease): ____________ R top: ____
IMPINGEMENT TESTS SCORE 6.5=9.75, 6.75=10.1, 7.0=10.5,
__________Left 3 2 1 0 7.25=10.86, 7.5=11.25, 7.75=11.63, 8=12,
__________Right 3 2 1 0 8.25=12.38, 8.5=12.75, 8.75=13.1, 9=13.5
5. Active Straight Leg Raise 3 2 1 0 >Malleoi resides between mid- >Malleoi resides between mid- >Malleoi resides below mid-
thigh and ASIS thigh and mid-patella patella
L: ______
R: ______
6. Trunk Stability Push Up 3 2 1 0 >Males perform 1 repetition >Males perform 1 repetition >Males unable to perform 1
with the thumbs above head with thumbs in line with the rep with hands in line with chin
PRONE PRESS UP TEST >Females perform 1 repetition chin >Females unable to perform 1
____________ with thumbs in line with the >Females perform 1 rep with rep with thumbs in line with
chin thumbs in line with the clavicle clavicle
7. Rotary Stability Quadruped 3 2 1 0 >Performs 1 unilateral rep >Performs 1 diagonal rep while >Unable to perform diagonal
while keeping torso parallel to keeping torso parallel to board repetitions
KNEELING LUMBAR board >Knee & elbow touch in line
FLEXION TEST >Knee & elbow touch in line with the board
________________ Left Up 3 2 1 0 with the board
Right Up 3 2 1 0
Total Score Tests 1-7: ____________/21 Initials of Tester: ___________________ Revised 4/15/11
FMS SCORING CRITERIA
DEEP SQUAT
FMS
Upper torso is parallel with tibia or toward vertical | Femur below horizontal
Knees are aligned over feet | Dowel aligned over feet
Upper torso is parallel with tibia or toward vertical | Femur is below horizontal
Knees are aligned over feet | Dowel is aligned over feet | Heels are elevated
Tibia and upper torso are not parallel | Femur is not below horizontal
Knees are not aligned over feet | Lumbar flexion is noted
The athlete receives a score of zero if pain is associated with any portion of this test.
A medical professional should perform a thorough evaluation of the painful area.
Excerpted from the book, Movement: Functional Movement Systems—Screening, Assessment, Corrective Strategies
Copyright © 2010 Gray Cook.
HURDLE STEP
3
FMS
Hips, knees and ankles remain aligned in the sagittal plane
Minimal to no movement is noted in lumbar spine | Dowel and hurdle remain parallel
Alignment is lost between hips, knees and ankles | Movement is noted in lumbar spine
Dowel and hurdle do not remain parallel
Contact between foot and hurdle occurs | Loss of balance is noted
The athlete receives a score of zero if pain is associated with any portion of this test.
A medical professional should perform a thorough evaluation of the painful area.
Excerpted from the book, Movement: Functional Movement Systems—Screening, Assessment, Corrective Strategies
Copyright © 2010 Gray Cook.
INLINE LUNGE
FMS
Dowel contacts maintained | Dowel remains vertical | No torso movement noted
Dowel and feet remain in sagittal plane | Knee touches board behind heel of front foot
Dowel contacts not maintained | Dowel does not remain vertical | Movement noted in torso
Dowel and feet do not remain in sagittal plane | Knee does not touch behind heel of front foot
Loss of balance is noted
The athlete receives a score of zero if pain is associated with any portion of this test.
A medical professional should perform a thorough evaluation of the painful area.
Excerpted from the book, Movement: Functional Movement Systems—Screening, Assessment, Corrective Strategies
Copyright © 2010 Gray Cook.
SHOULDER MOBILITY
3
FMS
Fists are within one hand length
Fists are within one-and-a-half hand lengths
1
Fists are not within one and half hand lengths
The athlete will receive a score of zero if pain is associated with any portion of this test.
A medical professional should perform a thorough evaluation of the painful area.
Clearing Test
Perform this clearing test bilaterally. If the individual does
receive a positive score, document both scores for future
reference. If there is pain associated with this movement,
give a score of zero and perform a thorough evaluation of
the shoulder or refer out.
Excerpted from the book, Movement: Functional Movement Systems—Screening, Assessment, Corrective Strategies
Copyright © 2010 Gray Cook.
ACTIVE STRAIGHT-LEG RAISE
FMS
Vertical line of the malleolus resides between mid-thigh and ASIS
The non-moving limb remains in neutral position
Vertical line of the malleolus resides between mid-thigh and joint line
The non-moving limb remains in neutral position
Vertical line of the malleolus resides below joint line
The non-moving limb remains in neutral position
The athlete will receive a score of zero if pain is associated with any portion of this test.
A medical professional should perform a thorough evaluation of the painful area.
Excerpted from the book, Movement: Functional Movement Systems—Screening, Assessment, Corrective Strategies
Copyright © 2010 Gray Cook.
TRUNK STABILITY PUSHUP
3
The body lifts as a unit with no lag in the spine
FMS
Men perform a repetition with thumbs aligned with the top of the head
Women perform a repetition with thumbs aligned with the chin
The body lifts as a unit with no lag in the spine
Men perform a repetition with thumbs aligned with the chin | Women with thumbs aligned with the clavicle
1
Men are unable to perform a repetition
with hands aligned with the chin
Women unable with thumbs aligned with the clavicle
The athlete receives a score of zero if pain is associated with any portion of this test.
A medical professional should perform a thorough evaluation of the painful area.
Spinal Extension Clearing Test
Spinal extension is cleared by performing a press-up in the pushup
position. If there is pain associated with this motion, give a zero and
perform a more thorough evaluation or refer out. If the individual does
receive a positive score, document both scores for future reference.
Excerpted from the book, Movement: Functional Movement Systems—Screening, Assessment, Corrective Strategies
Copyright © 2010 Gray Cook.
ROTARY STABILITY
FMS
Performs a correct unilateral repetition
Performs a correct diagonal repetition
Inability to perform a diagonal repetition
The athlete receives a score of zero if pain is associated with any portion of this test.
A medical professional should perform a thorough evaluation of the painful area.
Spinal Flexion Clearing Test
Spinal flexion can be cleared by first assuming a quadruped
position, then rocking back and touching the buttocks to the
heels and the chest to the thighs. The hands should remain in
front of the body, reaching out as far as possible. If there is pain
associated with this motion, give a zero and perform a more
thorough evaluation or refer out. If the individual receives a
positive score, document both scores for future reference.
Excerpted from the book, Movement: Functional Movement Systems—Screening, Assessment, Corrective Strategies
Copyright © 2010 Gray Cook.
The Functional Movement Screen
Scoring Sheet
NAME DATE DOB
ADDRESS
CITY, STATE, ZIP PHONE
SCHOOL/AFFILIATION
FMS
SSN HEIGHT WEIGHT AGE GENDER
PRIMARY SPORT PRIMARY POSITION
HAND/LEG DOMINANCE PREVIOUS TEST SCORE
RAW FINAL
TEST SCORE SCORE COMMENTS
DEEP SQUAT
L
HURDLE STEP
R
L
INLINE LUNGE
R
L
SHOULDER MOBILITY
R
L
IMPINGEMENT CLEARING TEST
R
L
ACTIVE STRAIGHT-LEG RAISE
R
TRUNK STABILITY PUSHUP
PRESS-UP CLEARING TEST
L
ROTARY STABILITY
R
POSTERIOR ROCKING CLEARING TEST
TOTAL
Raw Score: This score is used to denote right and left side scoring. The right and left sides are scored in five of the
seven tests and both are documented in this space.
Final Score: This score is used to denote the overall score for the test. The lowest score for the raw score (each side)
is carried over to give a final score for the test. A person who scores a three on the right and a two on the left would
receive a final score of two. The final score is then summarized and used as a total score.