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Introduction

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What price screening the elite athlete? Dutch national Ruud van Nistelrooy “failed” his screening examination with Manchester United in April 2000. Within days, he ruptured his ACL training with a leading Dutch club. We hope the clinician got a cut of the cost-saving to Manchester United! (At the time average player salaries were £409000 per season.)

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Screening the competitive sportsperson is an important component of the sports medicine team’s job. It involves taking a comprehensive history, performing a complete examination, and utilizing additional tests if appropriate. Screening differs from a pre-participation examination (Chapter 61) in that it is oriented toward both health and performance.

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Aims of screening an elite sportsperson

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The screening of high performance sportspeople has a number of aims.

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  1. Ensure optimal medical health:

    1. Recognize previously undiagnosed medical problems, such as cardiac disorders, exercise-induced asthma, anorexia nervosa, Marfan syndrome, depression.

    2. Assess the status of known medical problems (such as asthma, diabetes, epilepsy).

    3. Identify family history of inheritable medical disorders.

  2. Ensure optimal musculoskeletal health:

    1. Assess any current injury.

    2. Assess the deficit(s) resulting from any previous injury.

    3. Identify unrecognized injury.

  3. Optimize performance:

    1. Obtain information that will help improve factors that may affect performance (i.e. physical characteristics such as strength and joint range) as well as more holistic factors (such as nutrition, psychology, biomechanics).

  4. Injury prevention:

    1. Assess the presence of any predisposing factors to future musculoskeletal injury.

  5. Baseline data collection:

    1. Establish clinical baselines on musculoskeletal tests that can be used for reference during any future rehabilitation.

    2. Establish functional baselines that can be used for reference as part of any testing prior to return to play post-injury.

    3. Establish medical baselines (including blood tests, psychological testing, etc.) that can be used for reference while monitoring general health throughout the year.

    4. Establish accurate medical records on medications and vaccinations so appropriate future planning can occur.

  6. Develop professional relationship with sportsperson.

  7. Education.

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Additional benefits of screening

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There are a number of advantages of screening the sportsperson in addition to the abovementioned aims. Screening provides an opportunity for the sportsperson to be examined by a physician, sometimes for the first time in many years. Young sportspeople are usually healthy and rarely seek assistance from a medical practitioner. The athletic screening may be the first time that a physician has listened to the sportsperson’s heart since birth. It may be the first time the sportsperson’s blood pressure has been measured or urine has been tested.

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The screening process gives the clinical team an opportunity to develop a relationship with the sportsperson that may stand them in good stead in the future. A knowledge of the sportsperson’s personal details, including family, job, and other personal habits, may provide useful information in the future management of the sportsperson.

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Screening also gives the opportunity for the clinical team to offer advice regarding the prevention of ...

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