Pre-Participation Physical Examination

Introduction

Physical exercise is a pillar of a healthy lifestyle throughout the lifetime, and all healthcare practitioners advocate involvement in sports and leisure. All healthcare care experts advise physical exercise and involvement in sports due to their multiple health benefits. Physical exercise, sports, and leisure are essential for adolescents and people of all ages to maintain a healthy lifestyle, foster appropriate growth and development, avoid chronic illness and alleviate stress. These advantages of sport and leisure involvement have significant consequences for public health, although the injury risks must also be addressed. Success must focus on enjoyment while building a balance between physical fitness, psychological wellness, and lifetime learning for a healthy and proactive lifestyle.

Tests Given to Prevent or Diagnose Medical Issues in Athletes

The preparticipation physical examination (PPE) and factors for assessing safe participation in sports and detecting disqualifying conditions are vital to the safety of athletes. To safeguard all parties, the sports medical community must explore creating a standard procedure for administering PPE in light of the ongoing increase in sports involvement at all stages and the increased incidence of unexpected deaths documented in organized athletics. Most unexpected fatalities in male basketball and football athletes have been related to congenital or inherited cardiovascular abnormalities (Vaňova et al., 2022). Each participant should undergo a full medical and family history, neurologic screening, visual testing, orthopaedic screening, functional movement screening and general health screening.

Medical and Family History

An individual’s medical history must be collected and analyzed. A comprehensive medical history identifies the first sports participation-related issues and serves as the foundation of the preparticipation physical examination (Datoc et al., 2020). During the medical history part of the PPE procedure, most conditions needing further assessment or limitation are recognized. Preparticipation Physical Evaluation has established a historical form that focuses on the most significant areas of interest for sports participation. Particularly, inquiries on family and medical history, as well as cardiovascular disease risk factors, should be addressed. A favorable answer to any of these concerns must be validated, and if required and justified, more examination should be undertaken based on additional questioning.

Neurologic Screening

Athletes who report a prior neck injury must undergo a thorough neck assessment. The athlete should be checked for neurologic signs and symptoms and have a complete range of neck motion, excellent neck flexion and extension ability, and symmetrical lateral flexion strength. Arms, hand, and leg symptoms should induce cervical radiographs, particularly flexion-extension views. Any suspicion of cervical stenosis should elicit additional investigation, including radiographic examinations. A player with prior history of neurapraxia while engaging in sports may be approved for action if they are pain-free and has full motion range and strength. If the athlete has a history of transitory or recurring quadriplegia, cervical radiography examinations are necessary before the clearance.

Visual Testing

In sports where visual acuity is essential, such as baseball, basketball, and soccer, visual performance is a significant aspect of achieving greatness. The purpose of sports vision is to train the athlete’s optical coordination and acquire knowledge of the needed motor responses, which are what the eyes tell the body to perform or how the body must respond to a certain visual input. Possessing the ability to utilize peripheral vision is advantageous for the player and the team. In cricket, for instance, peripheral awareness training is crucial. If the batsman focuses his eyes entirely on the ball, he is most likely to be caught or bowled out eventually.

Orthopaedic Screening

Musculoskeletal disorders are the most common cause of sports participation restrictions. Most often afflicted is the knee, followed by the ankle. Consequently, every PPE should have a musculoskeletal component. The orthopaedic screen should be employed to detect problems that would make engagement in sports dangerous, considering the sport for which the participant is being examined, and to support conditioning regimens for injury prevention. Authorization for involvement must depend on the injury’s severity and nature and the sport’s regulations. Participation in exercises that do not touch the damaged region may be feasible. Additionally, protective padding, tape, or bracing may enable the athlete to participate safely. In addition to identifying athletic participation restrictions, the physician should recommend suitable strength and conditioning exercises.

The first element of orthopaedic PPE is a thorough history of past injuries and operations. Prior musculoskeletal damage would be a significant risk factor for re-injury. Any history of injury, strain, fracture, sprain, or undiagnosed localized edema or discomfort should be included on the orthopedic history form. A detailed history will uncover roughly 75% of the issues that impact athletes and may result in sport limitation (Datoc et al., 2020). If the athlete reports a prior injury, the assessing physician must question the precise treatment protocol and rehabilitation after the incident. This will help the physician determine whether a follow-up assessment, rehabilitation, or limitations are necessary. To guarantee the accuracy, athletes should be urged to undertake the medical history.

Functional Movement Screen (FMS)

The FMS, in addition to other instruments, has shown good to exceptional inter-rater and intra-rater validity in identifying abnormalities in motion patterns and motor function that are associated with injury risk, and has garnered much interest in recent years. It focuses on seven essential movement patterns, including balance, mobility, and stability, which mirror fundamental concepts of proprioception and kinesthetic perception. Each component consists of a distinct movement pattern that tests the body’s kinetic operation. For instance, Kolodziej and Jaitner (2018) revealed that the aggregate FMS score indicates injury concerns in amateur male football players. The FMS has been acknowledged as the most common field-based injury screening instrument for detecting athletes at risk.

How Athletes can be Helped After Suffering a Career-Ending Injury

Negative feelings, mood disorders, re-injury anxiety, diminished confidence, and restlessness are potential psychological reactions to an injury. These psychological reactions may affect the mental health and recuperation of an athlete. When athletes have a first injury, they may experience negative feelings such as despair, denial, rage, frustration, and despair (Bescoby, 2022). Athletes may become more severe if they do not address these emotional responses. Clinicians must recognize that these emotional responses accompany injuries and are an integral component of the psychological processing of athletes during the beginning of injury and throughout therapy. Beyond physical functioning, injuries may significantly influence the quality of life of an athlete, increasing their chance of getting mental health issues, including anxiety and depression.

While high-performance athletes seem to have the potential to amass riches throughout their sports careers, it is essential to understand that sporting careers are typically brief and that players may be forced to quit unexpectedly early due to injury or deselection. Financial literacy may aid everyone, particularly high-performance athletes, in achieving quality of life and financial sustainability (Hong & Fraser, 2021). Financial literacy may aid athletes in achieving long-term financial security; following a career-ending injury. Due to their lack of financial knowledge, athletes might be susceptible to financial loss or troubles. As most high-performance athletes begin their professions at a young age, they have little opportunity to learn financial planning abilities such as budgeting and decision-making.

By fostering supportive settings, sports organizations can assist players better in integrating their athletic personalities with their daily lives. Hong and Coffee (2018) examined transition programs in 19 nations where they found that most of them provided career counseling through psychological support, academic guidance, career planning, and work preparation. Practice, travel, and competition can leave athletes with little time for extracurricular pursuits. Thus, sports organizations may play a key role in assisting the transitions of transgender athletes. Sports organizations should give players opportunities to acquire transferrable life skills. Since athletes may be susceptible to drug misuse, suicidal thoughts, and feelings of isolation and loneliness, which may result in painful transitions, sports organizations can assist by offering psychological support.

Injury Prevention Measures

It is important for athletes to have enough rest and recovery to reduce their risk of injury. Athletes can restore their energy reserves of muscle glycogen and fully hydrate themselves by resting and recovering for the appropriate period before competing at their highest level. It is easier for the body to sustain an injury when it has been overworked and is exhausted. The body can make itself stronger and better equipped to deal with the demands of physical exercise when it is provided with an adequate amount of rest and recovery time. In addition, getting enough rest, maintaining a healthy diet, and stretching regularly are significant contributors to preventing injuries.

As a consequence of injuries sustained by players during athletic activities, government, national health, and public health organizations establish safety guidelines to identify dangers and protective equipment necessary in certain sports, especially action or contact sports, to limit injury risk. Athletes who compete professionally or for pay are covered by occupational health and safety regulations. When participating in a sport, it is advisable to get expert guidance on the necessary safety equipment. When a cricketer, boxer, or hockey player gets struck by a speeding ball or racquet or suffers stress fractures from the repeated blunt force in martial arts, facial bone fractures are prevalent. Face shields and batting helmets are used to prevent such injuries.

Strength training and strength exercises have been integral to sports conditioning for decades. It positively influences speed, strength, stamina, agility, and muscular mass. Every sport will profit from improving speed, stamina, agility, and physical endurance. Injury prevention is nonetheless an often-overlooked advantage. Strength training is an essential element of any injury prevention or treatment program. Strength training enhances the strength of tendons, muscles, and even ligaments and bones. Stronger tendons and muscles assist in maintaining the body’s normal alignment and protect the joints and bones during movement or trauma. Due to the strain exerted on them during training, the bones get denser, and the ligaments become much more flexible and better absorb stress during dynamic motions.

Conclusion

Physical activity is a foundation of a healthy lifestyle throughout the lifespan, and all healthcare practitioners urge participation in sports and leisure. Each athlete should receive a comprehensive medical and family history, neurologic screening, vision testing, orthopaedic screening, functional mobility screening and general health assessment. After suffering a career-ending injury, players should be granted financial help and mental health support from sponsors and sports organizations. Ultimately, there are various preventive measures that may be put into place to lessen the chance of injury in sports. These include; giving appropriate rest and recuperation time between workout sessions, regular strength and conditioning initiatives and providing well-maintained equipment and facilities.

References

Bescoby, C. (2022). Shifting the spotlight: Mental health of injured athletes. Sports Injury Bulletin. Web.

Datoc, A., Horne, K., & Golden, C. (2020). Sport-related concussion and risk for suicide in athletes. Aggression and Violent Behavior, 54, 101413. Web.

Hong, H. J., & Coffee, P. (2018). A psycho-educational curriculum for sport career transition practitioners: Development and evaluation. European Sport Management Quarterly, 18(3), 287-306. Web.

Hong, H. J., & Fraser, I. (2021). ‘My sport won’t pay the bills forever’: High-Performance athletes’ need for financial literacy and self-management. Journal of Risk and Financial Management, 14(7), 324. Web.

Kolodziej, M., & Jaitner, T. (2018). Single Functional Movement Screen items as main predictors of injury risk in amateur male soccer players. German Journal of Exercise and Sport Research, 48(3), 349-357. Web.

Vaňova, N., fatima, G., Zenuch, P., & Fedacko, J. (2022). Cardiovascular screening of athletes: implications in reducing the risk of sudden cardiac deaths. Web.

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