A movement screen loads several joints in one task and records how the task is solved. That is a genuinely useful thing to know — and it is a narrower thing than screens are often asked to deliver.
What a screen detects
In a kinetic chain, when one link cannot meet the demand, the movement does not stop — another link absorbs the deficit. Screens make that substitution visible, which is exactly what an isolated joint measurement cannot do.
| Observation | What it suggests | What it does not establish |
|---|---|---|
| Heels lifting in a squat | Ankle dorsiflexion demand not met | That the ankle is the restricted structure |
| Knees moving medially | Hip control demand not met | Which muscle group is responsible |
| Trunk leaning forward | Hip mobility or trunk control | The origin of either |
| Side-to-side difference | A unilateral difference exists | Whether it is mobility or control |
The third column is the part that gets dropped. A screen produces hypotheses; confirming one requires measuring the joint in question — see Range of Motion Measurement.
The seven patterns of the Functional Movement Screen
The best-known screening battery uses seven movement patterns, ordered so that mobility and stability demands increase progressively. Several are performed on both sides and scored separately.
| # | Pattern | Primary demand |
|---|---|---|
| 1 | Deep squat | Ankle, knee and hip working together; shoulder and thoracic mobility |
| 2 | Hurdle step | Single-leg stability with movement at the opposite hip |
| 3 | In-line lunge | Trunk control on a narrow base, hip mobility |
| 4 | Shoulder mobility | Combined shoulder girdle range, performed bilaterally |
| 5 | Active straight-leg raise | Lumbopelvic control and posterior chain extensibility |
| 6 | Trunk stability push-up | Trunk moving as one unit under load |
| 7 | Rotary stability | Cross-pattern control, performed bilaterally |
The battery also includes **clearing tests** — brief provocation manoeuvres for shoulder impingement and spinal extension and flexion. If one of them provokes pain, the associated pattern is scored zero regardless of how well the movement was performed.
How scoring works
| Score | Meaning |
|---|---|
| 3 | Pattern completed without compensation |
| 2 | Pattern completed, with compensation |
| 1 | Pattern cannot be completed as defined |
| 0 | Pain during the movement — no performance score is assigned |
Zero is not the bottom of a performance scale; it is a **stop signal**. A painful pattern leaves the scope of screening and moves to detailed clinical assessment. Bilateral patterns are scored per side, and the lower side is what carries into the total — which is one reason the total conceals more than it reveals.
Why composite scores are not risk scores
The most consequential misuse of movement screening is treating a total score as a prediction of injury. The predictive value of composite screening scores has been questioned repeatedly in systematic reviews, and using one as a standalone risk figure is not supported by the evidence.
This does not make screening useless. It makes the output different from what a risk score implies: a screen tells you which patterns warrant closer assessment, not how likely someone is to get hurt.
Why asymmetry outranks the total
On bilateral tasks, the difference between sides is often more informative than either value, because the reference becomes the person rather than a population average.
Two people can produce the same total while one has evenly distributed scores and the other a clear unilateral drop. Those are different clinical situations, and a total does not distinguish them. Raw scores should therefore be recorded side by side rather than summed.
Conditions that change what a screen means
- **Pain during the task.** The pattern then reflects avoidance, not capacity. Screening stops and the region moves to detailed assessment.
- **Unfamiliarity with the movement.** Someone who has never performed the task can look identical to someone restricted.
- **Rater variation.** Observational scoring differs between clinicians; video reduces the gap and makes later comparison possible.
- **Footwear and surface.** A raised heel masks ankle findings; these conditions belong in the record.
What follows a positive finding
- If pain was present, the screen stops and the region is assessed in detail.
- A low-scoring pattern is followed up by measuring the joints it implicates, actively and passively.
- An asymmetry is examined side by side: is it mobility or control?
- Exercise targets the restriction producing the compensation, not the compensation itself.
- The screen is repeated under the same conditions — otherwise there is nothing to compare.
- What are the 7 functional movement screening tests?
- Deep squat, hurdle step, in-line lunge, shoulder mobility, active straight-leg raise, trunk stability push-up and rotary stability. The order raises mobility and stability demands progressively, and several are performed and scored on both sides.
- How is functional movement screening scored?
- Each pattern is scored 0 to 3: three for completion without compensation, two with compensation, one when the pattern cannot be completed as defined, and zero when the movement provokes pain. Clearing tests can also reduce a pattern to zero. Bilateral patterns are scored per side.
- What does a movement screen actually tell you?
- It shows how a person solves a multi-joint task and where compensation appears. That indicates which regions warrant closer assessment. It does not identify the structure responsible, which requires targeted measurement and clinical examination.
- Do movement screens predict injury?
- The predictive value of composite screening scores has been questioned in systematic reviews, and a total score should not be used as a standalone injury risk figure. Screening indicates where to assess further; it does not calculate risk.
- Why does asymmetry matter more than the total score?
- Because the reference becomes the person rather than a population average. Two people with the same total can have very different profiles — one evenly distributed, the other with a clear unilateral drop — and a total does not distinguish them.
- Can a screen be interpreted if the patient has pain?
- Not in the usual way. If pain limits the task, the observed pattern reflects avoidance rather than capacity. The appropriate response is to stop screening that pattern and assess the region in detail.
Sources
- Cook G, Burton L, Hoogenboom B. Functional Movement Screening — structure and scoring rationale of screening batteries.
- Systematic reviews on the predictive validity of movement screening composite scores — discussion of limitations.
- Magee DJ. Orthopedic Physical Assessment. Elsevier — regional assessment and compensation patterns.