Movement Chapter 5: Functional Movement Systems and Movement Patterns

This is a chapter 5 summary of the book “Movement” by Gray Cook.

In this chapter, Gray outlines the interconnectedness of the tests and outlines all of the different breakouts. The movements will be demonstrated in later chapters.


There are seven movements with different clearing examinations.

1)      Deep squat

2)      Hurdle step

3)      Inline lunge

4)      Shoulder mobility

5)      Active straight leg raise (ASLR)

6)      Trunk stability pushup

7)      Rotary stability.

The first three movements are often called the big 3, as they are functional movements that check core stability in three essential foot positions. The remaining four are considered fundamental movement patterns.  Often these patterns are attacked before the first three.

These screens can also be broken up into those that check symmetry and asymmetry:

Symmetrical patterns

  • Deep Squat
  • Trunk stability pushup.

Asymmetrical patterns

  • Hurdle step
  • Inline lunge
  • Shoulder mobility
  • ASLR
  • Rotary stability.

The way we work the FMS is by first attacking asymmetrical patterns before straight patterns, and primitive patterns before functional patterns.

The FMS is scored on a four point ordinal scale with the following scoring criteria:

3 – Complete pattern

2 – Complete pattern with compensations/deviations

1 – Incomplete pattern

0 – Painful pattern.

There are also three clearing tests that are either positive or negative for pain.

1)      Impingement clearing test (shoulder mobility)

2)      Prone pressup (trunk mobility)

3)      Posterior rocking (rotary stability)

The FMS works by creating several filters to catch for compensations and problems.

1)      Pain – Signal to a problem.

2)      Decreased movements – Even though these movements go less than full ROM, compensations can be caught with multi-joint movements.

3)      Asymmetry

4)      Intentional redundancy to reduce error; consistent findings implicate mobility issues, inconsistent finding implicate stability issues.


The SFMA is not talked about in much detail in this chapter, but here are the top tier assessments:

1)      Cervical spine patterns.

2)      Upper extremity movement patterns

3)      Multi-segmental flexion (MSF)

4)      Multi-segmental extension (MSE)

5)      Multi-segmental rotation (MSR)

6)      Single leg stance (SLS)

7)      Overhead deep squat

From here each component has different breakouts. I have updated these as much as possible based on the recent SFMA course that I have attended.

Cervical breakouts

Active/passive supine flexion → active OA flexion→ active/passive cervical rotation → C1-C2 rotation → extension

Upper extremity breakouts

Active/passive prone patterns → Supine reciprocal patterns → Active/passive 90/90 internal/external rotation → Active/passive shoulder extension and abduction→ Active/passive elbow extension→ Active lumbar-locked extension

MSF breakouts

1 leg forward bend→ Long sit toe touch → ASLR→ PSLR → Rolling → Prone rocking → Supine knee to chest (KTC)

MSE breakouts

SPINAL: backward bend → single-leg backward bend→ prone pressup→ active/passive lumbar-locked (Internal rotation [IR]) → prone on elbows unilateral extension-rotation

LOWER EXTREMITY: FABER → Modified Thomas test → Prone active/passive hip extension → rolling

UPPER EXTREMITY: Unilateral shoulder backward bend → Supine lat stretch with hip flexed/extended → lumbar-locked (external rotation [ER]) extension-rotation unilateral → active/passive Lumbar-locked (IR) extension-rotation unilateral

MSR breakouts

SPINAL: Seated rotation → lumbar-locked (ER/IR) active/passive rotation-extension → prone on elbows unilateral rotation-extension

HIP: Seated active/passive ER & IR → Prone active/passive ER & IR

TIBIA: Seated active/passive ER/IR

SLS breakouts

Vestibular/core: clinical test for sensory interaction balance (CTSIB)→ Vestibular shake test → half-kneeling narrow base → rolling → quadruped diagonals

Ankle: Heel walk/toe walk → Prone passive dorsiflexion/plantarflexion→ Seated active/passive inversion/eversion

Overhead deep squat breakouts

Interlocked finger behind neck squat → Assisted deep squat → half-kneeling dorsiflexion→ Knee to chest holding shins → knee to chest holding thighs


Upper & lower prone to supine and supine to prone