In March 2009, the International Olympic Committee assembled an expert group listed above to discuss the current state of the art of the pre-participation health evaluation aiming to provide recommendations for a practical elite athlete Periodic Health Examination (PHE), as well as to outline the need for further research.
The PHE can serve many purposes. The PHE includes a comprehensive assessment of the athlete’s current health status and risk of future injury or disease and, typically, is the entry point for medical care of the athlete. The PHE also serves as a tool for periodic health evaluation and monitoring in athletes.
In a narrow sense, the main purpose of the PHE is to screen for injuries or medical conditions that may place an athlete at risk for safe participation. Athletes may be affected by conditions that do not have overt symptoms and that can only be detected by periodic health evaluations.
The PPHE may serve other purposes than just screening athletes for future health problems. One obvious goal is to ensure that current health problems are managed appropriately and, ultimately, to determine whether an athlete is medically cleared to engage in a particular sport or event. Even elite athletes with easy access to medical care do not always seek medical attention for injuries or disease, despite having significant symptoms.
Some silent conditions are common and, although not severe from a health perspective, may influence sports performance. Periodic health evaluations and ongoing monitoring represent an opportunity to diagnose and manage such conditions. They also provide an opportunity to identify conditions that are barriers to performance.. Another important function of periodic health evaluations is that they allow the athlete an opportunity to establish a relationship with the health personnel who will be involved in providing continuing care.
Finally, the PHE also represents an opportunity to look for characteristics which may put the athlete at risk for future injury or disease. Depending on the sport and the age, ethnic origin and gender of the athlete, it may be prudent to include an assessment of specific risk factors in the PHE.
The final paper will include specific paragraphs on cardiology, non-cardiac medical conditions, concussion, dental injuries, musculoskeletal injuries and issues specific to women. The paper will be published simultaneously in seven major sport medicine journals and will include evidence base and recommendations for the PHE content, as well as recommendations for further research in this field. Finally, in the Appendix, a common history and physical examination form will be provided.
It is hoped that the practical recommendations provided in the document will form a starting point for future research to advance our understanding of this important step toward protecting the health of the elite athlete.
The group did not take any position as to whether PHE should be recommended as compulsory for participation in elite sport. That is for the relevant sports authorities to decide.