Musculoskeletal Screening

Dr. Kirill Micallef Stafrace

Vice-President European Federation of Sports Medicine Associations (EFSMA)

Objectives of this Talk:

MSK screening concepts
NOT full MSK screening
Stress the variability and adaptability of a
screening process

Why MSK screen?

Identify past and current injury, which can lead
to specific exercise prescription aimed at
managing the condition and preventing further
injury
Highlight inter-athlete differences - direct
conditioning training programs to be set for
various levels of fitness, indicate parameters
required for the exercise and encourage the lower
level athlete to strive to higher levels of
participation
Determine physical changes over time, which
is particularly important in the growing athlete
and athlete participating in long hours of
training/competition

Assist exercise prescription for musculoskeletal

conditioning - effective physical conditioning
involves measurement, review and modifications to
exercise training programs involving sport science
and sport medicine.
http://www.ausport.gov.au/sportscoachmag/safety/pre-season_screening_and_injury_prevention

May help to predict performance

Medico-legal issues

Pre-participation Physical Examination (PPE)

Sport requirements, international or national
Club requirements
Military requirements
All differ in the rationale behind holding a PPE
of which MSK screening is just one aspect

Practicalities
Equipment- examination table (portable?),
goniometer, tape measure, recording sheet, MSK
measurement kits e.g. FMS
Time-varies but usually around 30min per athlete
Location- clinic, training area, gym?
Flexible approach-priorities between athletes
Post-screen procedure-what to do with the results

Tailoring your screening protocol

-VITAL aspect as it determines how effective the screening will be
What are the athletes main
action?

Intra-test reliability
Repeatability

What are you looking for?

Personal experience
Inter-test reliability-keep it simple
with clear protocols.

Scheduling the screening

Ideally 6-8 weeks before start of
training to give time to take corrective
action
Can prioritise remedial strategies
Can seek treatment for specific injuries
Gives you time to repeat screen

What do we look for?

Joint and muscle ranges of motion (ROM)
Indicators of movement control and stability
Postural and movement alignment, and
proprioceptive balance.
Previous injuries/surgery

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Examples-General
FMS Screening
Trialled by US military and
various sports
http://www.functionalmovement.com/

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FMS is a series of 7 movements that evaluate a

soldiers mobility and stability
Places an athletes body in extreme positions to
discover limitations
Scored 0-3 for total of 21 points
Lower scores indicate more prone to injury

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American Academy of Family Physicians

-generic medical PPE

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Sport Specific

http://www.sarugby.co.za/boksmart/pdf/BokSmart%20-%20Musculoskeletal%20Assessment%20for%20Rugby%20Players.pdf

http://www.dublingaagamesdevelopment.ie/wp-content/uploads/FunctionalScreeningGAA.pdf

http://www.rowingaustralia.com.au/docs/nrce_musculo-screening-2009.pdf

http://www.zeitschrift-sportmedizin.de/artikel-online/archiv-2015/heft-6/the-pre-participation-examination-in-sports-efsmastatement-on-ecg-for-pre-particpation-examination/