Accounting for multiple injuries does not improve the Functional Movement Screen (FMS™) as a tool to identify injury risk among English Premier League academy football players: a 3-season prospective cohort study

ABSTRACT Purpose: The aim of the present study was to investigate the relationship between FMS™ score and non-contact injury while accounting for participant exposure and multiple injuries to the same player. Materials and methods: Sixty-four players were screened during the preseason period with non-contact injuries and exposure time recorded prospectively for the entirety of three consecutive seasons (2014/15, 2015/16 and 2016/17). One-hundred and eighteen player-season observations were included in the analysis. Generalized estimating equations (GEE) were utilized to explore associations between FMS™ composite, individual sub-test scores, the number of sub-test asymmetries and non-contact injury. Results: The FMS™ composite score demonstrated a likely trivial (IRR: 1.05 95%CI: 0.94–1.17) association with non-contact injury. The number of individual sub-test asymmetries and all of the sub-test scores (with the exception of the hurdle step, IRR: 1.58 95%CI: 0.99–2.52) demonstrated unclear associations with non-contact injury. Conclusions: No associations with non-contact injury were observed for the FMS™ composite score, individual sub-test scores or the number of sub-test asymmetries, even when accounting for exposure and multiple injuries to the same player. Practical implications: The FMS™ composite score is likely not useful for injury risk stratification, nor are the individual sub-tests or the number of asymmetries.