Background
The Pre-Competition Medical Assessment (PCMA) battery is widely used to identify injury risks among athletes. This comprehensive set of Functional Performance Tests (FPTs) aims to evaluate risk factors for knee, ACL, hamstring, groin, and ankle injuries. Prior research suggests that factors such as general joint laxity, asymmetrical reach distances in balance tests, reduced hamstring-to-quadriceps (H:Q) strength ratios, and limited hip abduction range of motion may predict lower limb injuries. However, the predictive accuracy of these assessments remains debated, underscoring the need for rigorous validation in athletic populations.
Objectives
This study aimed to evaluate whether PCMA can effectively identify injury risk in university football players over multiple competitive seasons.
Study design
A prospective cohort study was conducted across three consecutive competitive seasons (2022–2025). A total of 120 university football players (63 male, 57 female) underwent pre-season assessments including the Y-Balance Test (YBT), isokinetic dynamometry for H:Q ratios, single-leg hop tests, Landing Error Scoring System (LESS), ankle dorsiflexion measurement, and hip strength evaluation. Injury surveillance was maintained throughout each season. Statistical comparisons were made between athletes who sustained lower limb injuries and those who did not, using independent t-tests and additional analysis testing the previous year’s scores against the subsequent season’s injuries.
Results
Over three seasons, 47 injuries were recorded among 98 athletes, with lower limb injuries constituting 51.1% of all injuries. In same-season analyses, the 2024–25 data revealed that injured athletes performed significantly greater in standing long jump distance (p = .015), Standing Long Jump % of Height (p = .020), bilateral hip abduction strength (Non-dominant side: p = .007; Dominant side: p = .046), and non-dominant Y-Balance Test adduction (p = .037). No significant differences were found in the 2022–23 and 2023-24 seasons. In the one-year lag analysis (2023–24 assessments identifying 2024–25 injuries), injured athletes demonstrated greater hip abduction strength in non-dominant side(p = .047), hip adduction strength in the dominant side (p = .010), and limb asymmetry in adduction (p = .014).
Conclusions
In conclusion, generic preseason assessments demonstrate limited utility for injury risk profiling in university football players. Any observed associations were inconsistent across seasons and often indicated superior performance among those subsequently injured. This counterintuitive pattern challenges deficit‑based screening models and may reflect prior injury adaptation or heightened exposure to intense demands rather than intrinsic vulnerability. Findings warrant caution due to the small sample of injured athletes and the multifactorial nature of injury, which involves training load, sport‑specific movement patterns, and fatigue not captured by isolated strength measures. These results highlight the need for more context‑sensitive screening protocols that account for positional demands, sex‑specific biomechanics, and load monitoring. Future research should prioritize the development and validation of tailored assessment batteries to enhance injury prevention strategies in football.
|
