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Musculoskeletal examination in young athletes and non-athletes: the Finnish Health Promoting Sports Club (FHPSC) study
  1. Kerttu Toivo1,2,
  2. Pekka Kannus1,2,
  3. Sami Kokko3,
  4. Lauri Alanko4,
  5. Olli J Heinonen5,
  6. Raija Korpelainen6,7,8,
  7. Kai Savonen9,10,
  8. Harri Selänne11,
  9. Tommi Vasankari2,
  10. Lasse Kannas3,
  11. Urho M Kujala3,
  12. Jari Villberg3,
  13. Jari Parkkari1,2
  1. 1 Tampere Research Center of Sports Medicine, Tampere, Finland
  2. 2 UKK Institute for Health Promotion Research, Tampere, Finland
  3. 3 Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
  4. 4 Clinic for Sports and Exercise Medicine, Helsinki, Finland
  5. 5 Paavo Nurmi Centre & Unit of Health and Physical Activity, University of Turku, Turku, Finland
  6. 6 Department of Sports and Exercise Clinic, Oulu Deaconess Institute, Oulu, Finland
  7. 7 Center for Life Course Health Research, University of Oulu, Oulu, Finland
  8. 8 Medical Research Center, University of Oulu and University Hospital of Oulu, Oulu, Finland
  9. 9 Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
  10. 10 Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
  11. 11 Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
  1. Correspondence to Kerttu Toivo; kerttu.toivo{at}


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

Methods 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.

Results 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.

Conclusion 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.

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

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  • Funding This study was financially supported by the Finnish Ministry of Education and Culture (major, grant number: 6/091/2011) and Ministry of Social Affairs and Health (minor, grant number: 152/THL/TE/2012).

  • Competing interests None declared.

  • Ethics approval The study was carried out in conformance with the Declaration of Helsinki. A positive statement from the Ethics Committee of Health Care District of Central Finland was received (record number 23U/2012).

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Patient consent Not required.

  • Contributors All authors contributed to study conception and design. SK and JP coordinated and managed all parts of the study. KT carried out the literature search. SK and JV conducted data collection and performed preliminary data preparations. KT and JV conducted data analyses, and all the authors contributed to the interpretation of data. KT, PK and JP wrote the first draft of the paper, and all authors provided substantive feedback on the paper and contributed to the final manuscript. All authors have approved the submitted version of the manuscript. JP is the guarantor.

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