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Pre-participation screeningneed of the hour

There are some untimely deaths of young athletes happening around the world - Dr Mahmoud Shehabullah - Sports medicine expert
Dr Mahmoud Shehabullah
Dr Mahmoud Shehabullah

A 36-year-old man died after collapsing while running the London Marathon recently.

Though the man, from south-east England, received immediate medical treatment and an ambulance arrived within three minutes but he died later in hospital. The runner became unwell between miles 23 and 24 of the 26.2-mile event.

There are some untimely deaths of young athletes happening around the world, says sports medicine expert Dr Mahmoud Shehabullah.

Q: Are we missing anything in pre-participation examination (PPE) of athletes or are we bit reluctant to the screening before joining sports?A: During my more than four decades of work in this part of the world, I come across thousands of athletes from national athletes/club athletes/amateur athletes and gymnasium fitness lovers.

Most of them don’t like the actual protocol of PPE but they want a shortcut to finish this screening going to GP and bring the physical fitness clearance.

However, in the real PPE there is no way of any shortcut. One must respect the PPE process religiously.

Q: Does PPE needs to be mandatory or just a routine?A: In the West, PPE is done at all school and educational institutions for those who wants to enrol in sports activities which is done mostly by the School Health Department.

During my study and training in Germany and Australia my dorm was in sports schools in Dortmund and Hostel in Queensland University in Brisbane and in Vichy National Pre-Olympic centre. I regularly noticed that pupils of Elementary Middle and High Schools specially those who wants to enroll in regular school sports, each and everyone must get the clearance from sports medicine PPE section. The process will take at least 3 to 4 days minimum to finish.

Q: How important is the pre-screening in present day sports?

A: Now a days every year there is someone fainted while playing and immediately medical team intervene in the ground and later found that either he had a cardiac arrest or a concussion etc.

So to be on the safer side it’s very important to go through this protocol.

Q: What is the main purpose of PPE?

A: The demand and objective of PPE is to ensure an athlete is physically/medically fit to participate to their sports of choice.

Q: Can you elaborate on your experience with pre-screening?

A: I used to do PPE with group of medics and paramedics specially with all national teams for the last four decades.

On that span of my career, many talented athletes were not allowed to participate because of medical issues with concern.

Sometimes any of the athletes’ family member sudden death occurs before the age of 35 without any accident.

Off late, Covid itself is a threat to human immunity. It did not spare anyone from child to adult and all ages. Nowadays you can see many elite athletes becoming Covid positive. Many 2020 top Olympic medal hopefuls were unable to take part due to it.

Post-Covid complications are also there. So one should be more cautious about screening in PPE. We can link this to many top cricketers missing the upcoming Twenty20 World Cup in Australia.

Q: Is there any shortcuts for PPE?

A: There is no shortcut in pre-participation screening for athletes to join sports.

Couple of times many sports officials and unqualified so-called medics confronted with me regarding the protocol of the PPE as there were no shortcuts before me to give clearance for some athletes to join sports.

In my long career in the field of sports medicine, I have never given any clearance to any athlete without completing the PPE protocol.

Dr Mahmoud had retired as the Senior Sports Medicine Physician at the Ministry of Culture, Sports and Youth after an eventful career spanning 40 years.

The Bangladeshi physician had special training from United States, United Kingdom and Australia along with the European Sports Medicine Commission and Cyprus on pre-participation screening for athletes.

What should be

included in PPE?n Personal history of illness

♦ Family history

♦ Physical examinations

♦ Cardiovascular symptoms

♦ Pulmonary symptoms

♦ Musculoskeletal symptoms

♦ Haematological symptoms

♦ Allergies

♦ Infection/Immunology

♦ Ear/Nose/Throat

♦ Eye, Dental

♦ Genitourinary

♦ Neurological

♦ Endocrine/Metabolic

♦ Mandatory tests


♦ HB & Ferretin levels


♦ Viral Hepatitis profile

♦ BMD bone marrow density

♦ Peak flow pulmonary function

♦ Body fat composition

♦ Isokinetic muscle testing

♦ Biomechnical analysis and gait assessment

♦ Urine analysis

Note: This is a summary and the actual format is quite elaborate.

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