The popularity of team sports has mushroomed in the last two decades at the amateur and professional level. As a consequence of this dramatic surge in participation we are seeing an  increase in the incidence of injuries regardless of sport.

In the last decade or so the drive to decrease the incidence and severity of sport injury has been given much attention in the medical field.  Health Care Providers have implemented or suggested many strategies (i.e. proper conditioning, improved skills and techniques, equipment and environment, pre-participation examination) to help lower the incidence of injuries.  Current literature reveals that if such strategies are implemented, there can be a drastic decrease in the incidence and severity of sport related injuries.  This can also lead to improved performance, hence making the sport more enjoyable for the participant.

Of  the above mentioned injury strategies, the Pre-Participation Examination(PPE) should be the front line of defense.  Implementation of the Pre-Participation Exam concept into the sporting team program is a prudent, initial and effective step in the drive to decrease injuries and improve performance. It should be noted that in addition to injury prevention, the PPE has several other benefits, namely: identification of strengths and deficiencies in athletic abilities (i.e. conditioning, biomechanical faults, asymmetries, and congenital disorders).

Overall, this type of  athletic profiling can help determine whether the athlete is fit to participate fully, or on a limited level, in a selected sport.  In addition, by correcting the deficiencies discovered in the examination, athletic performance can be improved and the frustration level decreased when the etiology of poor performance is unclear.  The pre-participation exam has several components most of which must be addressed if the outcome is to be successful.

The components of the Pre-Participation Examination are:
· Medical history
· Physical examination
· Musculoskeletal examination
· Muscle balance
· Flexibility, Strength, Power and Endurance
· Orthopedic and neurologic
· Gait assessment
· Physiological Profile
· Aerobic and anaerobic capacity
· Isokenetic Testing

The PPE for each sport will vary depending on the biomechanical and physiological characteristics of that sport.  For example, consider the sport of Track and Field.

Track and Field is a very physically demanding sport. The skills required are actually that of sprinting, running, walking, pushing, jumping, hopping and throwing.  Consequently Track and Field athletes should place emphasis on the power, speed, relative strength, anaerobic, aerobic and flexibility components of fitness.  In addition the nature of the sport determines the body part where the majority of the injuries will occur, primarily affecting  the lower extremities and low back.  Most of these injuries are of the overload type ( e.g. tendinitis, strain, muscle tear or stress fracture ) or traumatic in nature (e.g. ankle and knee sprains or severe ligament tears).

Poor flexibility, muscle strength imbalances and muscle weaknesses in the trunk, shoulder complex, and hamstring/quad complex are common findings in Track and Field injuries.  For example, it is known that proper balance in the abdominal and back muscles are crucial in maintaining trunk stability.  Accurate synchronization of the thigh and lower leg power, strength, and flexibility is especially important in determining proper balance during sprinting movements.  For instance, if there are weaknesses or muscle imbalances in the thigh, knee stabilization capacity can be severely compromised in movements such as running and jumping, predisposing the athlete to severe ligament (ACL, MCL) tears and sprains.

The Pre-Participation Examination can offer exceptional benefits to a Track and Field athletes based on the facts mentioned above.  Such an exam will help identify weaknesses and imbalances in the musculoskeletal system and determine body adaptations which would have taken place from participating in other sports in the off season.  The PPE will also aid in making recommendations for pre -season reconditioning.  The examination protocol must be simple, comprehensive and easy to implement and above all, conducted by personnel with the appropriate skills and training.