Load test

The stress test during a sports medical examination is usually carried out including ECG and lactate measurement on a bicycle ergometer. Several factors can be tested. Pathological changes in blood pressure that occur under stress can be excluded, cardiac arrhythmia can be detected before and during stress, circulatory disorders of the heart muscle due to physical exertion become visible, and physical performance is determined.

Basically such a stress test is carried out with a Conconi step test. The cardiovascular examinations also include ultrasound examinations of the carotid artery, leg arteries and leg veins. Pathological changes and tendencies should be detected as early as possible in order to take action against them.

Ultrasound of the carotid artery can determine the risk of arteriosclerosis and possible calcifications, constrictions and deposits. The examination of leg arteries and veins also involves the determination of calcifications, constrictions and leg vein thromboses. A pulmonary function examination should provide information on whether the respiratory system is functioning properly or whether abnormalities are occurring. In the case of already existing diseases, this examination is used as a control. In addition, diseases caused by stress such as asthma can be detected.

Examinations of the internal organs

Now comes the examination of the internal organs. An ultrasound of the abdominal organs should be performed to detect abnormalities in the abdominal organs (liver, kidney, gallbladder, pancreas, spleen, bladder and prostate/uterus. The thyroid gland is examined, checked for size and examined for abnormalities.

The examination methods for the internal organs also include a large blood count, in which many different parameters are examined. Liver metabolism, protein, amino acid and homocysteine metabolism, kidney values and cholesterol levels are also examined. Iron metabolism, mineral content and trace elements, a urine test and a stool test for blood also play an important role in covering all aspects.

The examination methods of the sensory organs are primarily an eye test and a neurological examination. These examination methods are very comprehensive and sports medical examinations can also be carried out that do not include all these measures. Alternatively, there is also the possibility to carry out the stress test on a treadmill ergometer or rowing ergometer, depending on which device is available and which exercise one would prefer to do.

In addition to the stress analysis, it is often recommended to perform a spiroergometry. Spiroergometry is a breathing gas analysis and examines oxygen uptake, carbon dioxide release, etc. This allows the performance to be better understood and displayed.

How exactly such a sports medical examination is carried out is briefly described here. First the examination begins with a family and personal anamnesis. This means that attention is paid to conspicuous features caused by hereditary factors and previous events, which would not be recognized in this way.

Previous illnesses, injuries and disabilities also play an important role. The timeliness of vaccinations is checked and new vaccinations are prescribed if necessary. Daily habits, such as medication intake, smoking behaviour, alcohol consumption and drug abuse are surveyed in order to obtain a comprehensive picture of the athlete.

Further questions about personal sports activities are also included. These include sports that have been practiced so far, possible breaks, competitions and whether new sports should be tried out. In particular, the training plan of the last twelve months can be relevant for a sports medical examination and should therefore be given in weekly training hours (WTS) if possible.

Exercises that have been completed, best performances and maximum weights should also be stated when taking the medical history.To determine further body data, the next step is to undress. Then body measurements such as height, weight, hip circumference, abdominal circumference and chest circumference, leg and arm length, seat height and lower leg length are determined. In addition, biometric analysis is carried out, especially for adults, to determine body fat, muscle distribution and training, water balance and calorie consumption at rest.

As a rule, a large blood count should be taken, although further examinations will only be determined from the results of the blood count. An examination of visual acuity should be carried out in any case and hearing should also be included in the examination. Subsequently, further tests such as resting ECG, blood pressure measurement, spirometry, dental status examination, thyroid palpation, listening to lung and heart murmurs, artery and vein examinations and muscle reflexes can be performed. The order in which they are carried out varies from one sports physician to another and plays only a minor role.