Fig. Schematic representation of data illustrating the relationship between external knee abduction moment (reported as Nm adjusted for body height and weight) and risk of ACL injury. Uninjured players are shown in grey, while athletes who went on to suffer an ACL injury during the season are shown in black. The dotted lines denoted in A, B and C illustrate three alternative cut-off values. Note that the relative proportion of injured (N=9) to uninjured athletes (N=196) is not to scale, as each injured athlete is depicted by a full-size figure. Is it possible to use screening tests to identify who is at risk for a sports injury—in order to address the deficit through a targeted intervention programme?! To validate a screening test to predict and prevent sports injuries, at least 3 steps are needed: First, a strong relationship needs to be demonstrated in prospective studies between a marker from a screening test and injury risk (step 1). Second, the test properties need to be examined in relevant populations, using appropriate statistical tools (step 2). Unfortunately, there is currently no example of a screening test for sports injuries with adequate test properties. Given the nature of potential screening tests (where test performance is usually measured on a continuous scale from low to high), substantial overlap is to be expected between players with high and low risk of injury. Therefore, although there are a number of tests demonstrating a statistically significant association with injury risk, and therefore help the understanding of causative factors, such tests are unlikely to be able to predict injury with sufficient accuracy. The final step needed is to document that an intervention programme targeting athletes identified as being at high risk through a screening programme is more beneficial than the same intervention programme given to all athletes (step 3). To date, there is no intervention study providing support for screening for injury risk. While predicting future injury risk through screening tests is unrealistic, a PHE or pre-participation examination can serve several other purposes. First and foremost, it includes a comprehensive assessment of the athlete's current health status, and, typically, it is the entry point for medical care of the athlete. As demonstrated by Bakken and colleagues, in a large cohort of professional football players, the majority of athletes presented with at least one current health condition and one in three with a musculoskeletal condition requiring some form of follow-up. Other potential benefits of regular health examinations include establishing rapport between the medical team and the athlete, reviewing medications and supplements to avoid inadvertent doping, establishing a performance baseline for the athlete in the healthy state, and, in some settings, to satisfy the medicolegal duties of care. Nevertheless, the IOC consensus statement concluded that large-scale population-based studies are needed to evaluate the components of history and examination that can be used to identify athletes at risk, intervene and change outcome, and recommended that programmes on PHEs be set up and conducted as research projects. But the point to be noted here is: to date, there is no screening test available to predict sports injuries with adequate test properties and no intervention study providing evidence in support for screening for injury risk. https://www.facebook.com/share/p/16jPpHzF6E/