Predicting Injury in Runners from the Physical Therapy Exam

We have previously written about the functional movement screen (FMS) and its' ability to predict injury although more recent research has called its' predictive ability into question.  The highest quality research on the FMS has occurred in NFL athletes or those training for the NFL combine.  The research demonstrates the predictive value of these tests may be less powerful in endurance athletes.  As the diagnostic utility of these 7 tests falls it requires the clinician to incorporate other data from the subjective and objective examination to determine an athlete's injury risk.  An important aspect of the FMS that should not be overlooked, regardless of an athlete's sport, is their emphasis on movement quality.  Poor movement patterns may be secondary to a loss of joint mobility, strength, coordination, or balance and can lead to injury if not corrected.  In a runner, a poor movement examination on the treadmill may indicate the need for gait retraining by a Physical Therapist.  

A recent article by Hotta et al. examined the ability of the FMS to predict injuries in 18-24 year old competitive male runners (J Strength Cond Res. 2015).  Each athlete was scored on the 7 examination items during the preseason then followed through the running season to determine the predictive ability of these 7 tests on the development of future injury.  Prior authors have reported a score of less than 14 indicating poor movement patterns is predictive of future injury.  Hotta et al. found this composite score had a low predictability for running injuries.  Conversely, two tests including the active straight leg raise and deep squat had high predictability for running injuries.  A runner with a poor score of these tests had a 10 times greater risk of injury during the season.  

This article continues on prior research indicating the complete 7 tests may not be appropriate for all sports and athletes.  Instead, specific examination tools like the overhead squat can be combined with gait analysis and other running specific examination tests for a more predictive injury screening.