WTF is “Load Management"?

Since the turn of the century, the San Antonio Spurs are the winningest team in the NBA. No doubt, a lot of their success can be attributed to having had a bevy of current and future Hall of Famers on their rosters. But perhaps no single person has been more influential in their success than head coach (and famous curmudgeon) Gregg Popovich.

Under Popovich, the Spurs have run off a stretch of 18 straight 50-win seasons and 22 consecutive playoff appearances. Obviously, Popovich is a brilliant basketball strategist; you don’t win that many games by accident. But his brilliance appears to extend off the court, too -- specifically, to the human body and its need for rest and recovery. (Note: he likely also has the help of a world-class sports medicine team.)

Case in point: in 2012 Popovich famously rested his four best players on the night of a nationally televised game. It was an unfortunate decision for fans around the country who were stuck watching the Spurs’ B-squad. Although the Spurs ended up losing the game, the move proved to be the right one for them in the long-run. They won the championship that season.

The Two Most Common Misconceptions about the FMS

Over the past three years as part of my PhD, I’ve been researching the relationship between movement and injury. A recent Twitter discussion reminded me that people on either side of the great FMS social media debate are still confused. I figured I’d put my research efforts to good use to clear up a couple of common misconceptions.

Misconception #1: The FMS composite score can predict injury.

When the FMS first became popular in the late 2000s, its creators touted it as an injury prediction tool [1,2]. The trouble was, at the time they had zero scientific evidence to back that claim up.

It turns out scoring low on the FMS does increase a person’s risk of injury slightly [3,4], but it doesn’t guarantee it. In other words, while low scores are associated with injury, the FMS does not predict injury on an individual basis. Big difference [5].

Specifically, when the FMS is conducted on a large group of people, as in a scientific study, we tend to see a lot of false negatives (people who score high but still get injured).

The fact that the FMS can’t predict injury actually isn’t that surprising. There’s no one thing that predicts injury [6]. This is because injuries aren’t caused by just one factor. Instead, they’re the result of a complicated web of interrelating factors -- a web that’s different for every person based on the types of activities they do [7].

Bittencourt NFN, et al. Br J Sports Med 2016;50:1309–1314.