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ART-939: Functional Movement Screening for Tennis — The FMS

Executive Summary

The Functional Movement Screen (FMS) is a standardized assessment tool that evaluates seven fundamental movement patterns to identify mobility limitations, stability deficits, and left-right asymmetries. Originally developed by Gray Cook and Lee Burton, the FMS was designed to predict injury risk and performance potential in athletes. For tennis players, the FMS is particularly valuable because the sport's repetitive, unilateral nature creates predictable movement asymmetries that the FMS can detect before they become injuries. By identifying these movement dysfunctions and prescribing targeted corrective exercises, players and coaches can address the root causes of pain and inefficiency rather than merely treating symptoms.

The Seven FMS Tests

The FMS evaluates seven movement patterns, each scored on a scale of 0 to 3:

  • 3: The movement is performed correctly without compensation.
  • 2: The movement is performed with some compensation or dysfunction.
  • 1: The movement cannot be completed, even with compensation.
  • 0: The movement produces pain (regardless of quality).

The seven tests are:

1. Deep Squat

The athlete holds a dowel overhead with arms fully extended, feet shoulder-width apart, and squats as deeply as possible while keeping the heels on the ground and the chest up. This test evaluates bilateral mobility of the hips, knees, and ankles, as well as shoulder mobility and thoracic extension. A score of 2 indicates that the athlete can squat deeply but with some compensation (e.g., heel lift, forward lean, or knee valgus). A score of 1 indicates inability to achieve depth even with compensation.

2. Hurdle Step

The athlete steps over a hurdle (set at the height of the tibial tuberosity) with one leg while maintaining an upright torso and the other leg extended straight ahead. This tests single-leg stability, hip mobility, and dynamic balance. It is particularly relevant for tennis because the single-leg stance and step pattern mimics the loading phase of a serve or the push-off for a wide ball.

3. In-Line Lunge

The athlete stands with one foot on a line and the other foot behind, then lowers into a deep lunge while maintaining an upright torso. This tests hip mobility, ankle dorsiflexion, and trunk stability in a split stance. The in-line lunge directly relates to the lunge position used in many groundstrokes and the loading phase of the serve.

4. Shoulder Mobility

The athlete reaches one hand over the shoulder and the other behind the back, attempting to touch the fingers together. The distance between the hands is measured. This test evaluates shoulder internal and external rotation range of motion, which is critical for the serve and overhead. Tightness or asymmetry in shoulder mobility is one of the most common FMS deficits in tennis players.

5. Active Straight-Leg Raise

The athlete lies on the back and raises one leg as high as possible while keeping the other leg straight and flat on the ground. This tests hamstring flexibility and the ability to disassociate the lower body from the pelvis. A score of 2 indicates that the leg can be raised to the mid-thigh or higher but not to the ankle. Poor hamstring flexibility is a known risk factor for hamstring strains and lower back pain.

6. Trunk Stability Push-Up

The athlete performs a push-up with the hands aligned with the chin (men) or forehead (women) and attempts to push up as a single unit (no "snaking" or segmental movement). This tests core stability and the ability to transfer force through the trunk without energy leakage. A score of 2 indicates that the athlete can perform the push-up but with some trunk compensation.

7. Rotary Stability

The athlete is on hands and knees, then lifts one arm and the opposite leg while maintaining a stable trunk. This tests multi-planar trunk stability and the ability to resist rotation — the exact function of the core during tennis strokes. A score of 2 indicates that the athlete can perform the movement but with some trunk compensation.

Scoring Interpretation and the Tennis Context

A perfect FMS score is 21 (7 tests × 3 points). Research suggests that a score of 14 or below is associated with a significantly higher injury risk. For tennis players, the interpretation should be nuanced:

  • Asymmetries: A 1-point difference between left and right on any test is considered an asymmetry. Given the unilateral nature of tennis, asymmetries are common and often reflect the dominant-side adaptation. However, asymmetries can also indicate compensatory movement patterns that increase injury risk.
  • Pain: A score of 0 on any test (pain during movement) requires immediate attention. Pain during a fundamental movement pattern is a red flag that should be evaluated by a medical professional before continuing high-level training.
  • Shoulder mobility: Shoulder mobility deficits are extremely common in tennis players due to the repetitive overhead demands. A score of 2 or below on the shoulder mobility test should trigger a shoulder mobility and rotator cuff assessment.
  • Deep squat and hurdle step: These tests are particularly relevant for tennis because they assess the hip and ankle mobility needed for the low athletic stance, the split step, and the loading phase of strokes.

Corrective Exercise Selection Based on FMS Results

The FMS is not just an assessment; it is a roadmap for corrective exercise. The general principle is: correct the lowest-scoring test first, address asymmetries before total scores, and prioritize mobility before stability.

Deep Squat Score of 1 or 2

  • Common dysfunction: Limited ankle dorsiflexion, limited hip mobility, or poor thoracic extension.
  • Corrective exercises: Ankle dorsiflexion mobilizations (knee-to-wall stretch), hip flexor stretches, thoracic spine foam rolling, and goblet squats with a heel lift.

Hurdle Step Score of 1 or 2

  • Common dysfunction: Poor single-leg balance, limited hip mobility, or compensatory trunk lean.
  • Corrective exercises: Single-leg balance drills, hip mobility work (90/90 stretches, pigeon pose), and step-downs with a focus on controlled movement.

In-Line Lunge Score of 1 or 2

  • Common dysfunction: Tight hip flexors, limited ankle dorsiflexion, or poor trunk stability.
  • Corrective exercises: Hip flexor stretches, ankle mobilizations, and lunge variations with a focus on upright posture.

Shoulder Mobility Score of 1 or 2

  • Common dysfunction: Internal rotation deficit (common in overhead athletes), tight posterior shoulder, or poor thoracic extension.
  • Corrective exercises: Sleeper stretches, cross-body shoulder stretches, thoracic spine mobility work, and internal rotation stretches with a band.

Active Straight-Leg Raise Score of 1 or 2

  • Common dysfunction: Tight hamstrings or poor pelvic control.
  • Corrective exercises: Supine hamstring stretches with a strap, single-leg deadlifts (light), and pelvic tilt exercises.

Trunk Stability Push-Up Score of 1 or 2

  • Common dysfunction: Poor core stability or compensatory movement patterns.
  • Corrective exercises: Dead bugs, planks with a focus on neutral spine, and push-up progressions (from knees, then full push-up with a dowel on the spine).

Rotary Stability Score of 1 or 2

  • Common dysfunction: Poor multi-planar trunk stability or compensatory rotation.
  • Corrective exercises: Bird dogs, pallof presses, and rotational medicine ball throws with a focus on controlled movement.

Integrating the FMS into a Tennis Program

The FMS should be performed:

  • Pre-season: As a baseline assessment to identify movement dysfunctions before the training load increases.
  • After injury: As a return-to-play assessment to ensure the athlete has restored fundamental movement patterns before resuming full training.
  • Periodically (every 4-6 weeks): To track progress and identify new dysfunctions that may have developed.

Corrective exercises based on FMS results should be performed daily (10-15 minutes) until the movement dysfunction is resolved. Once the FMS score improves to a 3 (or the asymmetry is corrected), the corrective exercise can be reduced to 2-3 times per week for maintenance.

Limitations of the FMS

The FMS is a screening tool, not a diagnostic tool. It identifies movement dysfunctions but does not identify the specific tissue or structure causing the dysfunction. A low FMS score should prompt a more detailed assessment (by a physical therapist or athletic trainer) to determine the underlying cause. Additionally, the FMS has been criticized for its subjective scoring and its imperfect predictive validity. It is best used as one component of a comprehensive assessment that includes sport-specific movement analysis, strength testing, and injury history.

Diagnostic & Training Matrix

Observation Failure Result Corrective Strategy
Deep squat score of 1 or 2 Limited hip/ankle mobility or thoracic extension Poor low stance, compensatory back pain Add ankle mobilizations, hip flexor stretches, and goblet squats
Shoulder mobility asymmetry Internal rotation deficit from serving Shoulder pain, reduced serve velocity Add sleeper stretches, thoracic mobility, and internal rotation stretches
Hurdle step asymmetry Poor single-leg stability on one side Uneven movement, injury risk on weaker side Add single-leg balance drills and hip mobility work
Active straight-leg raise score of 1 Tight hamstrings Hamstring strain risk, lower back pain Add supine hamstring stretches and single-leg deadlifts
Rotary stability score of 2 Poor multi-planar trunk stability Energy leakage in strokes, trunk fatigue Add bird dogs, Pallof presses, and controlled rotational throws
Pain (score of 0) on any test Underlying tissue pathology Potential serious injury Refer to medical professional for evaluation

Practical Application: "The FMS-Triggered Prehab Routine"

Perform this routine daily (10-15 minutes) based on your FMS results. It addresses the most common movement dysfunctions in tennis players.

  1. Thoracic spine foam rolling (2 minutes): Roll the upper back to improve thoracic extension and rotation.
  2. Ankle dorsiflexion mobilization (2 minutes): Knee-to-wall stretch, 30 seconds each side, 2 repetitions.
  3. Hip flexor stretch (2 minutes): Half-kneeling hip flexor stretch, 30 seconds each side, 2 repetitions.
  4. Sleeper stretch (2 minutes): Internal rotation stretch for the shoulder, 30 seconds each side, 2 repetitions.
  5. Dead bug (2 minutes): 10 repetitions per side, focusing on a neutral spine and controlled movement.
  6. Pallof press (2 minutes): 10 repetitions per side, 10-second hold each repetition.

This routine takes approximately 12 minutes and addresses the movement patterns most relevant to tennis. Perform it before training or as a standalone session on rest days. Re-test the FMS every 4-6 weeks to track your progress. When your scores improve, your movement quality improves — and with it, your performance and injury resilience.