preparticipation – SEMS-journal

sports and youth preparticipation sports medicine team management

Lower limb in the preparticipation examination (PPE)

This article described the clinical examination of the lower extremity during a pre-participation screening in regard of sports ability, presence of injuries and musculoskeletal disorders as well as predisposing risk factors for injuries and prevention. It divided into global static and dynamic testing but also isolated analysis of joint function.

sports injury shoulder & elbow preparticipation

Elbow examination in the athlete

The elbow is a frequently underestimated and commonly misunderstood joint, leading to a considerable amount of clinical problems. A large part of this due to the largely overlapping and often unspecific symptoms of various diseases and injuries. A better understanding of elbow symptoms and the clinical exam of the elbow is the key to unlocking elbow pathology. This paper reviews a comprehensive and concise exam of the elbow that can easily be employed in a primary care sports medicine setting.

preparticipation shoulder & elbow

Shoulder examination in the athlete

The shoulder is the second most commonly injured joint in Sports Traumatology. A thorough clinical examination is mandatory for a strategic therapy regime. A standardized and, importantly, gentle and pain sparing, physical examination not only builts the basis for above mentioned, yet also provides a base in the doctor-patient relationship. The following guideline is meant to aid in these regards. Nonetheless, clinical experience is of utmost importance in combination with a correct physical examination. Hence, if hesitation is present about the diagnosis or treatment, there should be no hesitation in consulting an expert.

sports injury spine preparticipation

Clinical examination in back pain

Back pain has become one of the most frequent sports-related health problems. Up to 80% of the Swiss population experience at least one episode per year up to several times per week. It affects athletes of all age groups and all levels of activity equally. The causes of acute and chronic back pain are plentiful, but can be easily appreciated with a thorough and comprehensive history, concise clinical examination, and adequate imaging.

sports and youth growth maturation preparticipation sports injury

What are the key elements of youth sports orthopaedics examination?

Young competitive athletes are particularly at risk during puberty. Growth plates and apophyses are reduced in their stability by hormone influence. Epiphyses can slip, apophyses can tear out. Therefore, a regular examination of those athletes is important. The examination should focus on muscular asymmetries, or reduced range of motion of a joint. Shortened muscles have to be recon as a risk factor for apophysitis. Dysbalances of the musculature are mainly found in the trunk area. Training plans should be adapted to the increased vulnerability.

exercise is medicine cardiology sports and society sports medicine preparticipation

Pre-participation Evaluation for Screening of Health Risks in Leisure and Young Competitive Athletes

There seems to be a lack of consensus among medical associations, professional sports bodies and medical professionals about when pre-participation evaluations (PPE) are indicated and how they should be designed. Although it is generally accepted that the primary purpose of the PPE is the identification of cardiovascular disease and risk factors for sudden cardiac death in competitive athletes, there is an ongoing debate on which methods are most apt in the screening process. Furthermore, the need of PPE has been questioned all together in leisure or hobby athletes.

sports medicine cardiology team management preparticipation

Regional differences of sudden cardiac death in sports. Experiences from German and Swiss registries

Sudden death of an athlete is the most devastating medical event in sports. While accidents account for more than 50% of these cases, sudden cardiac deaths (SCD) are less frequent (approx. 15%), but the leading medical cause of deaths. The risk depends on age, sex, ethnicity, type of sport and sport level. There are large variations in the methods of registration of SCD in recreational and competitive sports. This must be taken into account when interpreting reported incidences and causes. High data quality in registries is a prerequisite for meaningful preventive strategies (e.g. ECG screening and safety at sports facilities).

sports medicine cardiology team management preparticipation

The International (Seattle) Criteria

Through continuous improvement of diagnostic accuracy of ECG criteria for athletes sensitivity as well as specificity have grown so much that foregoing this screening tool is not feasible anymore. The most updated guidelines, the so-called “International (Seattle) Criteria” globally exhibit the most important reference publication, currently. The criteria were created with the purpose that particularly “non-cardiologists” should be able to use them before clearly pathological findings lead to further follow-up examinations at a specialist. On the other hand, physiologic ECG findings should not prompt expensive further evaluations, as it used to happen quite frequently.

sports medicine cardiology team management preparticipation

Recommendations for cardiovascular evaluation in athletes – a viewpoint

Traditionally, cardiovascular screening has been recommended mostly for competitive athletes younger than 35 years. The perception that only young competitive athletes at top level are at increased risk, has changed in the last years. Theoretically, we advocate a voluntary cardiovascular screening for all athletes who exercise vigorously, independent of their competitive status, and age. Although, this should be based on an individual estimation of the athlete’s risk. Physical examination, medical history and an ECG should be the baseline investigations for all athletes.

exercise physiology sports and youth preparticipation sports medicine cardiology performance

Cardiopulmonary exercise testing in children and adolescents

In cardiopulmonary exercise testing with children and adolescents, age specific protocols are used together with tools adjustable to their body dimension and development. Assessing weight, height und pubertal stage is a prerequisite for the interpretation of every test. Indications for exercise testing are airway symptoms and findings limited performance, chronic diseases, planning of trainings and scientific studies. The more tests are standardized and used on a large scale, the more normal values are available to compare individual results. However, the interindividual variability of measured values is high, depending as much from the developmental stage of the individual as from protocols, tools and the performing laboratory.