These are a set of tests conducted on an athlete to ensure they are safe to participate in any form of physical activity. The aim is to detect possible medical illnesses that may be catastrophic to an athlete when they engage in any exertional physical activity. This in Football was introduced by FIFA in the 2006 world cup where an 81% response rate showed that a standardized physical assessment in possible and since every team has to conduct them prior to competition.
The composition of the PCMA include a medical history, physical examination and investigations
Medical History: It aims to pick up current illnesses and risks that may predispose one to adverse health
events and guides further investigation
Physical Examination: A head to toe examination of body systems to pick out any physical impairment or assess for injuries. The examination may be guided also by the history and usually the major systems of importance which are but not limited to the heart (cardiovascular system), the lungs (respiratory system), bones, joints, muscles (musculoskeletal system).
Investigations: aimed at screening the athlete and further look at any problems found during history and physical assessment. They are usually conducted by the Team physician and physiotherapist.
The standard tests include:
1. Chest X-ray (looks at the lungs),
2. 12 lead resting electrocardiogram/ECG (looks at the heart) if available and stress ECG if available and when indicated – to look at structural or electrical abnormalities of the heart such as
Hypertrophic cardiomyopathy which may lead to sudden collapse or sudden cardiac death on the field. It also has or requires an athlete specific interpretation.
3. Echocardiogram/ECHO – Is an ultrasound scan around the heart done and is indicated when there are boarder line or abnormal changes that are pathological on the athlete ECG.
4. Blood tests (Full blood count and iron stores, urea & electrolytes, Liver function tests, lipid profile) – and any indicated tests based on prior assessment
5. Body composition assessment: body weight, height, Body mass index (BMI), fat percentage
Other useful tests if available include:
1. Lung function tests – to check lung function in terms of capacity and their recoil ability.
2. Other Test may be conducted by the Biokineticist, Physical/strength and conditioning coach along with the sports scientist (if available) include the Biomechanical status of the athlete and Exercise stress testing (VO2 max – to check your oxygen consumption).
They are conducted at the start of each season or towards a major competition to ensure the participating athletes are ready to compete. Some of the tests may be conducted as the season progress depending on the indication (injury, illness etc.) such as the physical exam and ECG.
Any hospital government or private offer these tests. The team must ensure a system is place for its athletes to be able to conduct these tests.
They are not 100% effective but they pick majority of those abnormal cases that may be catastrophic to an athlete performance. The one (1) life that will be saved by detection of abnormalities from these tests fat outweighs the cost associated with running this test. Hence it is important to conduct them
diligently and not put any athlete at risk by being negligent and overlooking them.
The BFA Medical committee will going forward ensure these tests are done in structures under the BFA and spot checks are to be done for evaluation of these tests independently. The aim is to protect the greatest stakeholder in the athlete.
