Medical Checkup

Medical Checkup

Mitsutoshi Hayashi

Mitsutoshi Hayashi

Doctor of Medicine, specialist in the Japanese Society of Rehabilitation Medicine, specialist in the Japanese Society of Orthopaedic Surgery, specialist in the Japanese Society of Rheumatology, staff to strengthen JOC, and sports physician certified by the Japan Sports Association

Doctor’s Ediction

Specialists in physical management, such as doctors and trainers, conduct medical checkup. This is mainly a body check of the athletes.


Medical checkups are health checkups for athletes before exercise. These checkups are useful not only for health management, but also for the prevention of sports injuries. In addition to acute (sudden) injuries, many chronic disorders are caused by overuse. However, the diagnosis is difficult because players often remain in pain (due to a lack of awareness of the injury). Therefore, the significance of individual medical checks for athletes is high.

What is a medical checkup?

This is mainly a body check of the athletes, conducted by a physical management specialist, such as a doctor or trainer. Questionnaires are the most important checklist and are available not only at hospitals but also at sports sites. The doctor checks the current problem (site of pain), previous injury, previous sport history (including level of competition, training time, and position), previous treatment (such as surgery), current position, previous sport history, dominant hand (dominant foot), muscle tightness, joint laxity (body stiffness), alignment of the lower extremities, range of motion, tender points, and muscle strength. The location of the injury may vary depending on whether the person is junior or adolescent, recreational, or competitive. When necessary, doctors can examine height, weight, blood pressure, and pulse (athletes may have a slow pulse), blood (peripheral blood, such as anemia), biochemistry (such as blood sugar and liver function, cholesterol, and uric acid levels), urine (such as sugar in the urine and protein in the urine), X-rays (such as the heart and lungs, seen on chest X-rays), electrocardiograms (such as abnormal heart rhythms at rest), and exercise electrocardiograms (such as pulse changes during exercise on a treadmill or exercise bike). Athletes are characterized by an unexpectedly higher incidence of anemia (iron deficiency) than the general population.

Practice of checkup

In Japan, medical checks at public medical institutions are mandatory once a year for national team-level athletes. The content is broadly divided into internal medicine and orthopedics (see above). At the spring-summer National High School Baseball Tournament held in Koshien Baseball Stadium, an X-ray check of the elbow joint is mandatory for pitchers. If an abnormality is found, the doctor’s order to stop will be applied.

Checkup methods and characteristics by sport

Various types of sports are characterized by the duration of game, contact sports, and the need for unique actions (such as pitching and shoulder pain) that can cause injuries. The problem is that exercise pain is more common than spontaneous pain, so the examiner needs to check to induce the expected specific disorder (pain).
Marathon: Lower extremity, particularly knee disability checks, Achilles tendon inflammation, shin splints, lower extremity alignment, plantar aponeurosis, and sports anemia checks.
Football (soccer): hip joint flexibility, Osgood-Schlatter disease of the knee (growth period), knee meniscus injury, history of ankle sprain, and checking for low back pain (e.g., trunk flexibility).
Volleyball: Tall athletes are more likely to be scouted because the body does not come into direct contact with the other players, and it accounts for much of the athletic population. They often have Marfan syndrome -like elements (blurred vision, long extremities, emaciation, cardiovascular abnormalities). It is a sport in which is easy to generate characteristic disorders for each action, such as lumbar, knee, and ankle joint failures by jump landing, shoulder and elbow injury by the attack and serve (Photo 1), finger failure by a pass (Photo 2), shoulder and elbow failures by receiving, Achilles tendon fracture (inflammation). Particularly in jumper’s knee (Photo 3), checking the characteristic tender points in the lower part of the patella and checking the quadriceps muscle flexibility are helpful.
Swimming: Check for shoulder disorders (fluctuation and impingement), knee meniscus disorders, pes anserine bursitis, medial collateral ligament inflammation (breaststroke knee ), and low back pain in addition to ears (e.g., otitis media), and eyes (conjunctivitis).
Baseball: Check shoulder disorders by throwing (front, side, back), presence of absence of pain on the mediolateral side of the elbow represented as baseball elbow, and ankle sprain, low back pain, etc.

Medical Check2

Photo: He was a right-handed ace attacker on the volleyball team. The right shoulder joint external rotation muscle force was decreased on the medical checkup. Scapular nerve palsy resulted in infraspinatus muscle atrophy.

Medical Check 3

Photo: Fracture within the DIP joint. The thumb was sprained but actually also fractured.

Medical Check 4

Photo: In a medical checkup of elite junior high school players, the typical tender part of the lower pole of the patella was recognized.

Procedures of medical checkup

Examine the upper extremity (shoulder, elbow, and finger) initially in a sitting or standing position, then regions of back, and examine the hip, knee, and ankle joint in a supine position, and finally examine the lower back, heel-buttock distance, and Achilles tendon in a prone position, to cover the entire body. Exercise is prescribed in consideration of the problems noted above.

Yasuhiro Nakajima

Yasuhiro Nakajima

Head coach of Shonan Bellmares Sports Club Triathlon Team, Head coach of Triathlon Team of Nippon Sport Science University, and Chairman of the Japan Triathlon Union Multi-sports Committee

Trainer’s Edition

Condition check

Medical checks are expensive, and because of the environment and other problems, they cannot be done often. Simple, routine checks allow you to manage your physical condition between medical checkups. For this reason, the trainer section introduces routine checks. It not only prevents chronic injuries and overtraining, but also prevents injuries due to poor concentration.

Conditioning diaries

Training diary

It is recommended that you first have a training diary. It is possible to find out not only the results of the training, but also the relationships between the content, intensity, time, distance, etc. and fatigue level and physical condition.
Because it is important to keep the diary correctly and continuously, it is recommended to evaluate simply by circling or filling in numerical values without feeling burdensome on a daily basis.
Refer to the following items and methods to arrange the coaches and players for easy sharing of information.

It is also important to quantify the amount as much as possible and make continuous comparisons possible. They can also be aggregated over a period of time and compared to athletic performance to assist in conditioning for contests and games. The goal of this condition check is to routinely check that the training load is adequate and that recovery from fatigue is uneventful. Elevation of heart rate on awakening, rapid weight loss, or loss of appetite may be noticeable if fatigue accumulates or the person feels sick. You need to watch carefully. These training diaries help athletes manage their own physical condition and must be submitted to a coach or trainer at specific time intervals, such as weekly intervals, if not daily, to gain an understanding of the situation.


I think you are using stretching for warm-up and cool-down, and this stretching can also be used as a condition check. Without adequate recovery from fatigue, flexibility tends to decrease. In addition to stretching the muscles on a regular basis, stretching the hamstrings, for example, ensures that the person checks for flexibility, such as the position of the tip of the hand. If the person feels less flexible than usual, it is recommended to increase duration and number of times of stretching and do partner stretching carefully. In particular, the area where the injury has occurred and the area where fatigue is likely to accumulate should be checked.

Anemia, POMS, etc.

Blood tests for detection of anemia and psychological tests may be conducted as a part of medical checkup but they could also be conducted as medical checkup in a field level. In endurance-type sports, such as those of long-range terrestrial athletics, iron deficiency anemia has a major impact on competitive performance. Early detection and early response are important for iron deficiency anemia because recovery is time consuming. The trainers may need to have the athletes undergone regular blood tests in partnership with their nearby health care providers. Hemoglobin alone can be easily measured at a sports site without a blood sample.
There exists POMS, a tool to grasp the psychology. POMS is a test in which the six factors of tension, depression, anger, energy, exhaustion, and confusion can be measured at the same time, and the person’s mood and emotion are measured over time, which is very helpful in grasping the person’s condition at any given time.

Check by a coach or trainer

In addition to the above items, it is important for coaches and trainers to recognize changes in athletes’ conditions as a result of their daily speech and actions. For example, the athlete’s condition can be ascertained through such things as an athlete’s step, and facial expression on morning walk during a training camp, and the expression and attitude of the athlete when meeting up unintentionally.
As I mentioned on the training diary, it is important to do it continuously in the conditioning check. In addition, it is a comprehensive assessment that considers not only physical, but also technical and spiritual aspects. We believe that it is possible to demonstrate good performance by changing the content, intensity, time, etc. of the training according to the evaluation.


Condition Check 1

Even casual stretching can be self-checked by evaluating the distance between the hands and toes and the sensation of muscles.


Condition Check 2

The angle of the leg rise may get inclined when the flexibility of the posterior thighs, lower legs, and buttocks are reduced. t


Condition Check 3

Make sure to keep the distance between the ground, the shoulders and knees, and the lower back becomes unsteady, etc. in mind. If the shoulder floats more than usual, the chest may be inflexible, and the buttocks and hips may be less flexible if the knees float more than usual.

Anterior aspect of the thigh

Condition Check 4

Whether the heel reaches the buttocks or, if the heel sticks, raise the knee upward to prevent the back from inverting. Check the distance between the ground and the knee.