Sport specialization's association with an increased risk of developing anterior knee pain in adolescent female athletes.

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Abstract

[Indexed for MEDLINE] 18. Phys Ther Sport. 2026 Mar 12;79:101913. doi: 10.1016/j.ptsp.2026.101913. Online ahead of print. Reliability and validity of a wall slide test for monitoring growth-related lower limb pain in elite youth footballers. Blanchard S(1), Holden S(2), Dadd L(3), Cumming S(4), Williams S(4). Author information: (1)Department of Health, University of Bath, Bath, UK; Manchester City Football Club, Manchester, UK. Electronic address: https://twitter.com/sjbphysio_sport. (2)School of Public Health, Physiotherapy and Sports Science University College Dublin, Dublin, Ireland; UCD Institute for Sport and Health, University College Dublin, Dublin, Ireland. (3)Department of Health, University of Bath, Bath, UK; Manchester City Football Club, Manchester, UK. (4)Department of Health, University of Bath, Bath, UK. OBJECTIVES: To develop and evaluate the reliability and validity of a novel Wall Slide Test for monitoring pain and knee flexion in youth athletes with growth-related lower-limb pathologies. DESIGN: Reliability and prospective longitudinal cohort study. SETTING: A Category 1 English Premier League football academy. PARTICIPANTS: Eighty-one male academy footballers aged 9-17 years with clinically diagnosed lower-limb pain conditions (including Osgood-Schlatter disease, patellofemoral joint pain, Sinding-Larsen-Johansson syndrome, and Sever's disease) and 45 asymptomatic controls. MAIN OUTCOME MEASURES: Pain at onset of loaded knee flexion (0-10 numerical rating scale), knee flexion range (cm), and a composite Wall Slide Test score. Reliability was assessed using intraclass correlation coefficients (ICC), standard error of measurement (SEM), and minimum detectable change (MDC). Validity was evaluated using mixed-effects models and receiver operating characteristic (ROC) analysis. RESULTS: Within-day reliability was excellent (ICC = 0.96-0.97). MDC values indicated meaningful detectable change (pain 0.74 points; range 9.1 cm). The composite score demonstrated good to excellent discriminative ability between symptomatic and asymptomatic players (AUC = 0.81-0.94). CONCLUSIONS: The Wall Slide Test is a simple, reliable, and valid field-based tool for monitoring pain and functional knee flexion in youth athletes, supporting clinical decision-making and longitudinal management. Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved. DOI: 10.1016/j.ptsp.2026.101913