High Number of Medical Conditions Detected in Elite Athlete Periodic Health Evaluations, But Only Mild Consequences

Abstract

Objective: To evaluate the number of medical conditions detected by periodic health evaluations (PHEs) in elite athletes, and their consequences for management and medical clearance.

Design: Retrospective design.

Participants: Elite athletes of various sports in a high-performance program in The Netherlands, in the period between 2009 and 2020.

Interventions: The PHEs consisted of a questionnaire, general and musculoskeletal physical examination, laboratory blood test, electrocardiogram, pulmonary function testing, and (cardiopulmonary) exercise test.

Main outcome measures: We extracted and analyzed the medical conditions that led to advice, clinical follow-up, further diagnostic investigation or treatment, and the medical clearance status of the athlete (clearance, temporarily no clearance, or permanently no clearance).

Results: We included 721 PHEs of 451 elite athletes. We found 1389 medical conditions that led to advice (n = 923, 66%), clinical follow-up (n = 124, 9%), further diagnostic investigation (n = 190, 14%), treatment (n = 132, 10%), or sports restriction (n = 20, 1%). Only 20 cases (3%) led to temporarily no medical clearance. After further investigation or treatment, no permanent sports restriction was imposed on any of the athletes.

Conclusions: We found a high number of medical conditions detected with a PHE in elite athletes. However, the vast majority of detected conditions were mild, with consequences limited to preventive advice and follow-up. The yield of PHE to detect (potentially) severe pathological conditions seems low. Clinical relevance of PHE in elite athletes and potential future health benefits remain unclear.