The Efficacy of Lower-Limb Screening Tests in Predicting PlayerLoad Within a Professional Soccer Academy.

CONTEXT: Training exposure has been associated with injury epidemiology in elite youth soccer, where lower-limb musculoskeletal screening is commonly used to highlight injury risk. However, there has been little consideration of the relationship between lower-limb screening and the loading response to soccer activities. OBJECTIVE: To quantify the efficacy of using screening tests to predict the loading elicited in soccer-specific activities and to develop a hierarchical ordering of musculoskeletal screening tests to identify test redundancy and inform practice. DESIGN: Correlational. SETTING: Professional soccer club academy. PARTICIPANTS: A total of 21 elite male soccer players aged 15.7 (0.9) years. INTERVENTION: Players completed a battery of 5 screening tests (knee to wall, hip internal rotation, adductor squeeze, single-leg hop, and anterior reach) and a 25-minute standardized soccer session with a Global Positioning System unit placed at C7 to collect multiplanar PlayerLoad data. MAIN OUTCOME MEASURES: Baseline data on each screening test, along with uniaxial PlayerLoad in the mediolateral, anteroposterior, and vertical planes. RESULTS: Stepwise hierarchical modeling of the screening tests revealed that dominant leg knee-to-wall distance was the most prevalent and powerful predictor of multiplanar PlayerLoad, accounting for up to 42% of variation in uniaxial loading. The adductor squeeze test was the least powerful predictor of PlayerLoad. Of note, one player who incurred a knee injury within 3 weeks of testing had shown a 20% reduction in knee-to-wall distance compared with peers, and elicited 23% greater PlayerLoad, supporting the hierarchical model. CONCLUSIONS: There was some evidence of redundancy in the screening battery, with implications for clinical choice. Hierarchical ordering and a concurrent case study highlight dominant leg knee-to-wall distance as the primary predictor of multiaxial loading in soccer. This has implications for the design and interpretation of screening data in elite youth soccer.