Preseason physical examination for the prevention of sports injuries

The importance of the preseason physical examination and preparticipation evaluation of sports candidates is highlighted because it constitutes one of the few occasions in which the physician can actively prevent sports injuries from occurring. As exercise participation continues to increase on a world-wide basis, an understanding of the goals and objectives of such a pre-exercise evaluation are important. The need is not for a standard evaluation form, but for a consistent understanding of adjusting the evaluation to the age of the candidate, the type of sport to be engaged in and the anticipated level of competition. Essentials of any evaluation are musculoskeletal, cardiovascular and psychological examinations. Examinations should have clearly defined objectives, and factors determining the type of evaluation include: prospective athlete; contemplated exercise programme; and motivation. Different types of implementation are individual examinations, locker room technique and the station technique, each with advantages and disadvantages. A pre-exercise evaluation should always occur before any anticipated change in level of school or competition with an interval or intercurrent history and physical examinations occurring at regular intervals. It is important that examinations take place before the commencement of a sports season so previous injuries and problems can be dealt with; timing is vital. Contents of a pre-exercise physical examination should include history, a physical examination, laboratory testing and additional specific screening evaluations. Finally, assessment of the pre-exercise evaluation and injury prediction will aid physicians in preparticipation evaluations.