Force plates, skinfolds and 200 biomarkers: Every test a Premier League player does at start of pre-season
By
Geoff ScottTimes have changed.
Pre-season at a Premier League football club looks very different to how it did a decade ago.
Cardiac and concussion screening have become mandatory at Premier League clubs, and the level of detail in the testing of players when they return to their clubs is extraordinary.
Any idea what a force plate is? Or how about a NordBord? How much leeway are players allowed when it comes to their target body weight on day one of pre-season?
The start of the 2025-26 Premier League season is just one month away and over the past week or so, players have started reporting for the start of pre-season training.
To find out more about what those early days back at the training ground actually involve, we spoke to high-performance specialist and co-founder of Reload clinics, Geoff Scott, who worked in the Premier League for 20 years, most recently as head of medicine and sports science at Tottenham Hotspur.
Pre-pre-season
“When players leave at the end of the season,” Scott says, “they’re given a fitness programme to work on throughout the off-season and an ideal return weight. Most players’ contracts stipulate they get three weeks’ holiday a year, so the clubs will try to honour that.
“Generally, it will be recommended they get at least two weeks of complete downtime first, though; no football, and no gym training. During that time, they’re advised to keep themselves in good shape by doing general activities they’d normally like to do. Then they would start to ramp up by implementing a home exercise programme or running programme for the rest of their holiday.
“It’s become much more common in recent years for some players to work with private fitness coaches during the off-season. Any player can decide to do so and training camps are held in Spain, Portugal, Dubai and other places. It’s fairly structured and the companies organising them will communicate with the club and report back on the work done.
“Most teams will have a six-week pre-season, though it can vary depending on whether they’re an international player or playing in tournaments like the Club World Cup (CWC) this summer. At Tottenham, we tended to let internationals have three weeks off after their last game, even if that meant they’d return to the club slightly later. That’s impossible in the CWC situation, though, so that’s a new thing clubs are dealing with.”
Pre-season
“The first day back is nearly a full day of medical testing. At Tottenham, we had a schedule with up to 16 stations on it that each player would work their way around, including everything from blood tests to power testing and even dental and optometry screens.”
Blood screen
“The club doctor assesses any current illnesses or concerns they’ve had through the off-season, and players undergo a full blood screen that looks at hundreds of different markers to see if there’s anything abnormal about their blood. The club will have a database of that player going back in history, so you are comparing everything to how it looked before they went away, looking for any changes, any signs of infection, inflammation or other conditions, so you get a precursor to any future problems.
“That blood screen will also include a nutritional screen, looking at about 200 different biomarkers (including ions, vitamins and minerals) to check they’re at the right levels. We would tend to do this around four times per year, but it’s an expensive test, so not every club can do that. If something is not at the right level, you can modify their diet to try to amend it — if you can’t do that through food, then with supplements.”
Nutritional screen
“Players’ weight and height are checked (clubs like players to come back within a kilogram of the target weight they were given at the end of the previous season). They will also do a body composition assessment, either using a DEXA scanner or a skinfold test with callipers that measure the thickness of subcutaneous fat at specific sites on the body. This is also a chance to talk to the player about their plans for the season and what they need to do to reach optimal body composition for them, whether it’s gaining muscle mass or losing body fat.”
Concussion baseline test
“This is a computer-based cognitive screening test that measures their reaction speeds, memory, and how fast they can complete certain tasks on a computer. Their score is then marked as their ‘normal’ or baseline. A concussion can have an impact on reaction times and memory, so if they suffer one during the season, they repeat that test as part of their return to play — you must return to baseline levels or very close to them before you can play again.
“This test came in around 10 years ago and computer-based baseline testing is now mandatory under Premier League rules.”
Cardiac screening
“An external cardiologist would do an electrocardiogram (ECG) and an echocardiogram. An ECG involves attaching electrodes to the skin to detect the heart’s electrical signals. It tells us about your heart rate and rhythm and can help to diagnose and monitor various heart conditions. The echocardiogram is a type of ultrasound scan that allows us to assess the heart’s structure, function, and blood flow.
“Different divisions will have different requirements here, but in the Premier League, both tests are done. All new signings undergo a baseline test and each pre-season, their cardiac screen will be compared against that level. It’s relatively unusual to find any variations, but it’s not entirely rare either. Sometimes you’ll pick up an abnormality that’s developed over the previous year and it’s a chance to check that out and make sure everything is safe for that player before they continue training again.”
Musculoskeletal testing
“The physiotherapists will go through several musculoskeletal tests, making sure they’re aware of any problems the player has. This is all bed-based, so the player will lie down while the physio works through each joint to see if there are any tendons that are thickened, any joints that have swelling, are painful or lack range of motion, or any ligaments that are lax. They’ll work through joint by joint and see if they find anything abnormal from that player’s baseline.
“Pre-season is a chance to pick up any minor problems so you can ensure you work on them through the season to stop them becoming major problems.
“Depending on the club’s protocols, they can add in more detailed ultrasound testing of tendons, particularly the Achilles and patella tendons, which can be a source of longstanding problems. Any thickening or neovascularity that is detected around the tendons indicates that a problem is either already there or might develop in time.”
Cont..
