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.
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