Can you have an optimal Y Balance Test or Functional Movement Screen score and still have increased risk of injury?

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Recently, I tested a player in professional sports who had the following Y Balance Test and Functional Movement Screen scores.

Move2Perform Report High YBT Low FMS

Test 1 Graph

 Move2Perform Report High YBT low FMS

 

If you will notice, his Y Balance Test Lower Quarter scores were great – symmetrical and above the risk cut point for his gender, sport, and competition level. But his Functional Movement Screen was riddled with fundamental movement pattern deficits and asymmetries. This a classic example of why both tests are necessary for a more complete profile of the athlete’s motor control of body weight.

In an unpublished analysis of 1490 athletes/active individuals, we found 677 (45%) passed the Y Balance Test Lower Quarter and of those 677 that passed, 243 (35%) failed the FMS. So, if you only use the Y Balance Test Lower Quarter, you will miss about 16% of the athletes who are at risk of injury.

However, consider another athlete on the same team:

Move2Perform Report low YBT good FMS

Test 2 Graph

 Move2Perform Report Good FMS poor YBT

As you can see with this player, his FMS score was good (no zero’s or one’s). While he may possess movement competence as demonstrated by the Functional Movement Screen, he has deficits in his motor control capacity as measured by the Y Balance Test Lower Quarter. But with an anterior reach asymmetry and a composite score below his peers (other professional baseball players), he is at risk of injury. His dynamic left/right imbalance and decreased performance at his limit of stability is a substantial risk factor for injury.

If we go back to the analysis of the 1490 athletes/active individuals, we found that 535 (35%) passed FMS and of those 535 that passed, 253 (47%) failed the Y Balance Test Lower Quarter.  If you just use the FMS, you will miss about 17% of the total number of athletes who are at risk injury.

Thus, it is important to use both the Functional Movement Screen and Y Balance Test for a more complete profile of the athlete as well as the most robust injury risk prediction (see Lehr et al 2013). Or at a minimum, establish basic motor control competency with the Functional Movement Screen first, then move on to the Y Balance Test.

What do you think?

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6 Comments:

  • By Joe Miller 26 Apr 2014

    Starting with the approach of the whole (FMS) and the drilling down to the specific (LE Y-balance) makes sense. Just like when we examine someone, we ask general questions and then get more specific or use more sensitive test to screen then more specific to fine tune. Athletes can easily compensate and in my experience they can hide faults well till the time they break.

  • By Phil Plisky 26 Apr 2014

    Great analogy Joe! It is so important to know what your goals of testing are (e.g. return to sport, pre-season injury prevention, pre-performance enhancement program, etc.) and which domain you are testing (e.g. motor control competency, motor control capacity, speed, agility, power, etc.).

  • By Adam Kelly, ATC 26 Apr 2014

    Phil,
    I really enjoyed this post! However, it leaves me with a question regarding the direction that the system would take you for cases like the aforementioned basketball player. Would you work on ASLR and/or SM, balance training, try to break down more indepthly with something like the SFMA? Perhaps you would work to bring the mobility tests to symmetrical 3s then build from the ground up? Just curious what your thoughts are.

    Best,

    Adam Kelly, ATC

  • By Phil Plisky 28 Apr 2014

    Great question! For the first case (the one with the optimal Y Balance Test Lower Quarter), I would start with the Functional Movement Screen and work with the most primitive patterns with one’s and/or asymmetry (i.e., correcting the rotary stability and trunk stability push up pattern). Only if they had pain, a recent injury, or multiple injuries in the past year, I would look at it more depth from the medical perspective with the SFMA.

  • By Adam Kelly, ATC 28 Apr 2014

    Thanks for the reply! However I guess I should have clarified better that I was curious about the case where the FMS was acceptable but the YBT-LQ scores were subpar? Thanks for responding!

  • By Phil Plisky 28 Apr 2014

    Ahh….for case of a passing FMS and poor YBT, I would check closed chain dorsiflexion and work on shoulder mobility and ASLR from a corrective perspective. If dorsiflexion was clear, I would take them through a balance progression breathing —> rolling (segmental and hard) –> resisted quad diagnonals –> half kneeling chops/lifts –> Single leg deadlift. In addition, would have them progress through the get up. In my opinion, if dorsiflexion is clear, this person could also be part of a group type injury prevention program (e.g., FIFA 11+, SportsMetrics, or Santa Monica PEP)

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