Lower limb injuries are common in professional football and can cause time loss, impaired performance and a significant financial cost to a professional team. Screening tools, like the functional movement screen (FMS) are popular, however there is little evidence that those tools are valid and applicable.
The functional movement 9+ test consists of 11 exercise ‘tests’ designed to assess a player’s movement patterns. It was designed as a tool for clinicians to use to assess athletes with a view to predicting future lower limb injury. In general terms these tests assess a player’s stability, mobility and neuromuscular control. The exercises included in the test battery are: a deep squat, in-line lunge, shoulder mobility assessment, a trunk stability push-up, active hip flexion and diagonal lift, one-legged squat and deep one-legged squat, drop jump test, seated rotation and a straight leg raise.
This study followed 362 professional players, over a total of 508 player-seasons (216 played one season, 146 played two seasons).1. The participant’s score on the 9+ was collected along with prospective data relating to each player’s injury history and match and training exposure.
In total, at least one lower extremity injury was sustained by 203 (56%) of the 362 players. Thigh muscle strains were the most common injury type. There was no relationship found between the 9+ total score and the risk of sustaining a lower extremity injury (both overuse injury and acute injuries). This outcome was the same even when adjusted for other risk factors and site of injury. Subsequent analysis did not find any cut-off point that could be used to identify an at-risk player. Age, player position and season were however associated with a significant increased risk of lower extremity injury.
This study shows that the 9+ test does not appear to be a useful tool to predict those at risk of injury.
1 Bakken A, Targett S, Bere T, et al The functional movement test 9+ is a poor screening test for lower extremity injuries in professional male football players: a 2-year prospective cohort study Br J Sports Med 2018;52:1047-1053.