While football can be safely enjoyed by the majority of people, some players have musculoskeletal or medical complaints that can limit their participation or, in some cases, make their participation unwise. High-intensity exercise does have a small but measurable acute risk of cardiovascular complications; therefore, mitigating this risk in susceptible individuals is important. As with elite players, a pre-competition medical assessment (PCMA) could be useful.
Not everyone needs a medical assessment before starting an exercise programme. This would be a clear possible barrier to becoming physically active. Unnecessary referrals to healthcare providers for screening can also lead to unnecessary medical follow-up and additional tests.
The American College of Sports Medicine (ACSM) has produced guidelines relating to exercise prescription. 14 They do not recommend a medical assessment for healthy adults. The need for a medical assessment is based on three factors:
- the individual’s current level of physical activity;
- the presence of signs or symptoms and/or known cardiovascular, metabolic, or renal disease;
- desired intensity of exercise.
Individuals who are relatively inactive, who have symptoms or signs suggesting a significant underlying medical condition or those who want to exercise at a very high intensity are more likely to require a medical assessment or PCMA.