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7 is that time of the year where teams are busy preparing for the start of the season. 7oday we will be discussing pre-competition medical assessment.
%efore players start participating in any sport, they should be medically examined to ensure that they are physically fit to cope with the demands of training and playing. 7herefore, medical assessments aimed at risk factor and disease detection are generally advocated by physicians and sports organisations. 7he aims of the pre-competition assessment are to prevent harm and to identify potentially significant medical conditions that might make playing football dangerous.
$ very small number of individuals have unknown or undiagnosed heart conditions, such as congenital cardiomyopathy, and may be at risk as exercise might trigger the manifestation of their disease or at least of associated symptoms like cardiac arrhythmia and might, in the worst case, cause sudden cardiac death. 7his small part of the population should be identified in order not to expose a player to any disproportionate risk.
The FIFA pre-competition medical assessment (PCMA) divides the medical history into three sections: general, orthopaedic, and cardiovascular.
7KH JHQHUDO PHGLFDO KLVWRU\ covers the personal and family history of a player and includes standard questions on general health like allergies and medication use. It should include questions aimed at detecting risk factors manifested through any suspicious symptoms in the past and present, particularly with respect to exercise. It has been suggested that a proper medical history alone may identify or at least lead to a suspicion of up to 75 per cent of the problems that affect athletes.
2UWKRSDHGLF KLVWRU\ .nowledge of the medical history of the musculoskeletal system may help to identify risk factors for injury. 7he player should be asked about previous injuries, especially those leading to a time-loss of more than four weeks, and about any operations on the musculoskeletal system. It should be determined whether the player suffers from any current complaints, aches or pains whether there are known diagnoses and what treatment is applied for these.
&DUGLRYDVFXODU KLVWRU\ $ny cardiac assessment in football should be performed by a sufficiently trained, experienced and skilled physician to reliably identify the clinical symptoms and signs associated with critical cardiovascular disease in sport. 7he athlete should be asked about the presence of exertional chest pain or discomfort, syncope periods of unconsciousness or near-syncope, irregular heartbeats or palpitations, and the presence of shortness of breath or fatigue out of proportion to the degree of exertion. )amily history is of great importance in identifying players at risk.
*HQHUDO SK\VLFDO H[DPLQDWLRQ +eight, weight, head and neck, lymph nodes, chest, heart and lungs, abdomen, blood vessels, skin, and the nervous system were examined.
/DERUDWRU\ ([DPLQDWLRQ Included full blood count, blood sedimentation rate, electrolytes, lipids, blood sugar, uric acid, creatinine, iron, ferritin, liver en]ymes, and urine analysis.
$ -lead resting can identify hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiopathy dysplasia. )or conduction anomalies, the resting electrocardiogram E&G is even the decisive diagnostic tool. $ stress E&G records the heart rhythm during exercise.
7his can be useful when the patient’s symptoms are particularly present during football exertion. It is also one of the most common tests used to identify cardiac ischemia ± generally in older patients suspected of coronary heart disease. )urthermore, it assesses heart rate blood pressure changes during exercise and detects exercise-dependent arrhythmia.
(FKRFDUGLRJUDP 7wo-dimensional transthoracic echocardiography is an important tool for diagnosing much cardiac pathology. :hile being a cornerstone in the diagnosis and follow-up of hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiopathy dysplasia, it can also detect other relevant abnormalities possibly responsible for S&D in young athletes, such as left ventricular dysfunction, valvular heart disease and aortic root dilatation. /et’s thank those teams who do P&M$ for all their players, it’s a good thing to do.
7ill next week I love you all, God bless you.