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BMJ Open Sport Exerc Med. 2018 May 30;4(1):e000376. doi: 10.1136/bmjsem-2018-000376. eCollection 2018.

Musculoskeletal examination in young athletes and non-athletes: the Finnish Health Promoting Sports Club (FHPSC) study.

Author information

Tampere Research Center of Sports Medicine, Tampere, Finland.
UKK Institute for Health Promotion Research, Tampere, Finland.
Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
Clinic for Sports and Exercise Medicine, Helsinki, Finland.
Paavo Nurmi Centre & Unit of Health and Physical Activity, University of Turku, Turku, Finland.
Department of Sports and Exercise Clinic, Oulu Deaconess Institute, Oulu, Finland.
Center for Life Course Health Research, University of Oulu, Oulu, Finland.
Medical Research Center, University of Oulu and University Hospital of Oulu, Oulu, Finland.
Kuopio Research Institute of Exercise Medicine, Kuopio, Finland.
Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.
Department of Psychology, University of Jyväskylä, Jyväskylä, Finland.



To determine the inter-rater repeatability of a musculoskeletal examination and to compare findings between adolescent athletes and non-athletes in Finland.


In this cross-sectional study, a musculoskeletal examination assessing posture, mobility and movement control was carried out by a sports and exercise medicine physician on 399 athletes aged 14-17 years and 177 non-athletes. Within 2 weeks another sports and exercise medicine physician repeated the examination for 41 adolescents to test the inter-rater repeatability.


In total, 10 of the 11 tests performed had at least moderate inter-rater reliability (κ ≥0.4 or percentage agreement >80%). Athletes more often than non-athletes had one shoulder protruded (8.0% vs 4.0%, OR 2.81, 95% CI 1.16 to 6.81). Forty-six per cent of athletes had good knee control in the two-legged vertical drop jump test compared with 32% of non-athletes (OR 1.99, 95% CI 1.29 to 3.06). Athletes had better core muscle control with 86.3% being able to remain in the correct plank position for 30 s compared with 68.6% of non-athletes (OR 2.70, 95% CI 1.67 to 4.36). In the deep squat test, good lumbar spine control was maintained only by 35.8% of athletes and 38.4% of non-athletes.


A basic musculoskeletal examination is sufficiently reliable to be performed by trained physicians as a part of a periodic health evaluation. Shortfalls in mobility, posture and movement control are common in both athletes and non-athletes. These deficits could have been caused by sedentary behaviour, monotonous training, or both.


adolescent; athlete; motor control; movement control; movement/physiology; musculoskeletal examination; observer variation; periodic health evaluation; postural balance/physiology; reproducibility of results; testing

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