The modern full back developed in response to the “winger” – these players don’t really exist any more, although you will hear the word used.
The winger would run down the touchline with the ball, go past anyone in his way and then cross the ball into the penalty area for the centre forward to head or kick into goal.
The full back was tasked with preventing this, either by tackling the winger as he ran, by blocking the cross and stopping it reaching the centre forward, or as the position developed, by forcing the winger onto his inside foot, making him take an inside line and cut in towards the box, making him use his weaker foot and limiting the effectiveness of his crossing.
The combination of skills for a full back at this time were that he should have most of the qualities of a good centre half (although usually he would not be expected to make as many tackles or be as good at heading the ball) and if he had a little more pace than the average defender, so much the better.
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As the game developed, wingers began to adapt their style of play. Rather than staying wide and crossing from the touchline, they would purposely cut in closer to the penalty area, leaving the full back behind them. It became popular for these players to play on the opposite flank to where they would have before, so a left footed player would play on the right and could then cut in on his left foot, presenting a danger at the heart of the defence.
At around the same time, full backs began to be used in a more attacking style themselves. As the winger was now looking to cut in towards the penalty area, there was space behind him for a full back to over-lap. Eventually, full backs ended up playing more like traditional wingers, and crossing became an important part of their game, too. This was something that came from analysis of Brazilian football, where players like Roberto Carlos had grown as attacking wide players who played from a deep role.
The evolution of the “wing back” was related to this development. Certain managers realised that the full back-cum-winger could be employed further forwards as part of a five man midfield if a third centre back was dropped in behind. This is the ultimate manifestation of the modern full back, the wing back is essentially both attacker and defender, he has pace and the ability to take the ball past players, but he also needs to be defensively solid and to track back to give width to his defence when out of possession. Most sides who employ wing backs will ensure that when one pushes forwards, the other tends to stay a little further back.
(The need for the third centre back was largely dropped when some began using a holding midfielder who could drop into the back line when needed and act as the third defender.)
Full back is in some ways the least glamorous position, but great full backs are very rare. And yes, there have been great teams who did not have great full backs. Manchester United’s Gary Neville won almost every trophy in the game at full back, but was a technically very limited player. He would struggle with the attacking responsibilities of modern full backs.
How important is the full back? I would say it depends on the team. A poor team with a world class full back is probably not going to see a lot of benefit from him. A world class team with a poor full back is definitely going to feel the cost of a better player in that role.