Q&A Time! What Would I Take First, the FMS or the SFMA?

I got asked this a few times in the past few weeks, so instead of answering it over and over again, I thought I'd make a blog post of it. What would you suggest taking first (or both), the FMS or the SFMA?

Let's start with the order I took the courses in. I took the FMS level 1 first, then 5 months later took the SFMA level 1. After taking the FMS, I was left with, now what? It certainly was easy enough to implement, but I had to buy extra equipment to grade someone. The FMS testing kit is not expensive, but it is an added cost for those on a budget. Since it is merely a screen, and not an assessment, the information you get as a novice to the entire FM System is not as much as you get from the SFMA.

The SFMA is for clinicians, this typically includes PTs, ATCs, DCs and sports MDs or DOs. If you're a clinician who wants to streamline your evaluation, by all means, I highly recommend the SFMA.

It will help you look at the body from head to toe in a very systematic way. You will find motion dysfunction and motor control issues where you may have not thought to look. This case I wrote about last summer is a great example of using the SFMA.

Keep in mind that the SFMA is a method of assessment, you still need tools in your bag to treat what you find, whether it's "joint or tissue" dysfunction or motor control issues. Many of the questions coming from our particular class was "what would you do if...." That is beyond the scope of a 2 day course on assessment. However, being an assessment, and not a screen, it does lead you to conclusions like posterior chain tissue extensibility or motor control issue with rolling patterns. These mechanical diagnoses lead you to treatment and it works well as a reliable system of classification according to some unpublished research by Dr. Voight, one of the system's founders.

The FMS is a series of movements taught to anyone (instead of only clinicians), mostly in the fitness industry, but clinicians should learn it as well. Gray Cook uses it around discharge planning, at least discharge from care, but they may stay on for performance training or to further work on motor control issues. Someone may have all special tests negative, full ROM and strength, and still not be cleared on the FMS. The goal of the FMS, is not to get a perfect score, but to get symmetrical 2's in the least and at least one 3 (perfect score). The research they are going on is in looking at normative movement across the lifespan and seeing very little variation in individuals without significant neuro or ortho issues. It also suggests that individuals with injuries had movement asymmetry; with the FMS, you are looking at teasing out asymmetry.

It also helps with communication/referral for those in the fitness industry who are using it to screen their clients. I think as clinicians, we are missing out on a big potential referral source if you are not communicating regularly with your patients after they leave, or with the local fitness centers that they may be attending, or you could refer to.

So to go back to the question, I would say for clinicians, SFMA first, and FMS second. Both have their uses, but for the ortho/sports patients who are not in your practice solely for performance, the SFMA is the way to go.