Strength and fitness evaluations should not be included in a pre-season assessment!

Proposition for Debate - by Trish Formby and Sharlene Eadie

Contents

• Statement of the Topic
• Affirmative Argument by Trish Formby
• Negative Argument by Sharlene Eadie

Statement of the Topic

Strength and fitness evaluations should not be included in a pre-season assessment!

Affirmative Argument by Trish Formby

Sport Specific Assessment

Sport specific assessments are useful in providing information concerning an athletes ability to participate in sports and additional information can be gained on possible ways to improve performance and prevent injuries (Kibler et al 1988). Assessments are also often used to optimise training and in the selection of teams for competition (Kramer et al 1994).

It is important that the athlete is brought to optimal performance level before the season starts by identifying any deviations which are important to a specific sport. Identification of deficiencies may also provide the athlete with guidelines for training.

Generally, preseason assessments consist of measures of muscular strength, flexibility, balance and fitness testing. For a test to have predictive value it must incorporate some of the dynamic physical characteristics required for a particular sport (Zachazewski 1996).

This paper argues the point that strength and fitness should not be included as part of preseason assessment. Prior to presenting literature to support this case some definitions of measures of muscular performance and fitness testing will be covered.

Muscular Performance

Muscular Strength

The term muscular strength refers to the capacity of a muscle to develop active tension, irrespective of the specific conditions under which tension is measured (Sapega 1990).Komi (1996) however, defines strength as the magnitude of torque produced by a muscle or muscles in a single maximum isometric contraction of unrestricted duration.No single testing mode is obviously the best or most valid for testing strength and there is no proof that one particular testing mode has any more inferential capacity with regard to functional activity (Sapega 1990).

Muscular Work and Power

Muscular work is the measured as the ouput of mechanical energy calculated by the force exerted multiplied by the distance through which it is applied (Sapega 1990; Kannus 1994). It is inappropriate to refer to any measure of strength as power. Power refers to the rate of muscular work output and is expressed as the units of work per unit time (Sapega 1990). These parameters are directly related to ouput of muscular force and therefore offer little additional information about muscular performance. They can be excellently predicted from measures of peak torque (Kannus 1994).

Muscular Endurance

Muscular endurance relates to the quality of muscle that is the opposite of fatigue. It may be defined as the ability of contracting muscles perform repeated contractions against load (Kannus 1994) or the ability to delay the onset of fatigue ie. a decrease in force, work and output over time (Sapega 1990). There is no standarised testing protocol or definition for the assessment of muscular endurance.

Modes of Testing

Isometric testing typically involves a maximal voluntary contraction performed at specific joint angle against an unyeilding resistance (Wilson and Murphy 1996). Any mode of testing that limits or maintains the velocity of the body segment at a preselected, constant level is referred to as isokinetic muscular performance (Sapega 1990). The contraction may be concentic or eccentric and generally measures of peak torque are derived from this type of testing. Assessment of muscular strength can also be determined by variable resistance weight lifting and is determined by the amount of weight that can be lifted in a standardised manner either once or, more commonly ten times.

Fitness Testing

Fitness testing is aimed at enhancing the athlete and can be used for setting goals in the attainment of higher VO_{2 max} or anaerobic power output. Fitness tests can also be used to monitor and modify progress. Some fitness tests are used to rank athletes particularly when selecting teams.

True measures of VO_{2 max} require expensive equipment and submaximal tests have a large error factor associated with them.VO_{2 max} has largely been considered the �Gold Standard' predictor of maximal performance however VO_{2 max} tests can vary by +/- 11.2% ninety eight per cent of the time (Macfarlane 1991).

For ilete athletes who are well trained with similar VO_{2 max} values the anaerobic threshold may be a better measure of performance however anaerobic measures can only accurately be determined by using blood lactate sampling and expensive respiratory equipment.

The Argument Against Strength Testing

Strength testing as a prediction of injury

At the latest Football Conference Proceedings in Melbourne, Australia, 1998 Wise et al stated that one of the most common injuries in football are hamstring injuries. It was also stated that isokinetic tests have so far produced varying results with little, if any, correlation to hamstring injury.

Beach et al (1992) conducted a study to investigate the strength, flexibility and endurance of shoulder internal and external rotators in swimmers with shoulder impingement. They found no significant relationship to pain from the strength ratios however they did find a negative correlation with endurance ratios. These results infer that perhaps endurance ratios may be a better indicator of dysfunction than absolute strength measures.

It has been documented that in one study that overuse injuries were the most common injuries in soccer (Ekstrand and Gillquist 1983) and that muscle strength did not correlate with injury. Rather, players who were less flexible and displayed muscle tightness were more susceptible to injury. Overuse injuries have also been commonly reported in other sports such as tennis (Kibler 1988) and swimming ( Beach et al 1992) and athletes often display tightness in the musculo-skeletal system.

Kibler (1997) quotes a case where deficiencies in an athlete of a professional standard caused by injury the previous season were picked up in the preseason, too late for correction. Kibler (1997) also notes that weight work is commenced by the athlete prior to the preseason therefore strength testing may be more beneficial during this time to allow for specific programmes to be implemented and for musculo-skeletal adaptations to occur.

Sapega (1990) noted that many early studies indicating a correlation between muscle strength and injury were retrospective and therefore biased due to the effects of injury rather than causes. As an example Jonhagen et al (1994) measured hamstring torque eccentrically and concentrically as well as flexibility in sprinters injured in one of the two previous seasons. The sprinters with a history of injury were weaker than their uninjured counterparts only at lower velocities but also displayed significantly less flexibility. It is worth noting that all athletes were competing again at the time of the study in spite of the deficits detected.

Prospective studies of strength deficits related to injury are scarce but available however one cannot conclusively attribute injury to the strength measures. Orchard (1997) found an association between hamstring injury and weakness in a prospective study of footballers. Flexibility of the hamstrings was also evaluated using a sit and reach test which does not isolate hamstring length and found no correlation to injury however Knapik et al (1991) found a reduction in preseason strength and flexibility associated with athletic injury as did Kibler (1988) in relation to tennis injuries. These studies emphasise other contributing factors to injury which may be largely ignored or measured so grossly so as not be clinically useful.

Strength testing as a measure of performance and readiness to return to sport

As an indicator of performance, muscle strength tests have yielded varying results. Strength tests are most often open chain, single plane, one joint tasks which have little resemblance to sport specific requirements (Zachazewski 1996).Viitasalo (1982) found no correlations between maximal strength and vertical jump height in elite volleyball players but did find that vertical jump was a good predictor of jump height in actual games, important for spiking and blocking. These results were shared by Genuario (1980) who also found no correlation between isokinetic strength testing and vertical jump and Kramer et al (1994) found no correlation between quadriceps strength and performance in rowers. Anderson et al (1991) also found a lack of correlation between strength measures and a 40 yard dash, agility run and vertical jump in athletes of five different sports.

Strength measures are often used as indicators of readiness to return to sport after injury. Lephart et al (1992) investigated selected measures of physical and functional capabilities in anterior cruciate deficient athletes and their correlations with athletic ability. Results suggested that peak torque ratios of quadriceps and hamstrings were not related to the functional capacity of subjects and may not therefore have a great influence on the ability to return to sport. They concluded that functional performance tasks may be better used as criteria for returning to competition. Banff et al (1998) advocate the 12 metre timed hop test as the best predictor of overall knee function and as an indicator to return to sport following ACL reconstruction.

It cannot be denied that strength is important for optimal performance however peak torque is not necessarily related to functional capacity ( Lephart et al 1992) and strength deficits should really be addressed prior to preseason. Improvements in strength may take up to 8 weeks due to neural and physiological adaptation. Perhaps then, athletes should be allowed adequate time to gradually increase strength prior to preseason. An increase in strength will not automatically transfer to other tasks hence more time is required for this to occur. Therefore these tests may be more appropriately performed prior to preseason and functional tests indicative of performance be used to assess athletic ability during the preseason. This is important too in the athlete who has been injured during the previous season as many overuse injuries occur during the preseason (Eksrand and Gillquist 1983) although it should be remembered that some athletes involved in asymmetrical sports will display differences from side to side (Kannus 1994).

The Argument Against Fitness Testing

It is often difficult to measure fitness in sports which require the involvement of aerobic and anaerobic systems as well as high levels of technical skill and mental acuity and studies have shown that traditional standardised tests of cycle or treadmill ergometry are poor indicators of performance in sport (Chin et al 1995). Although used regularly their specific value with repect to various sports is questionable (Minkoff 1982). For many sports involving non-rhythmic movements sport specific testing may be impossible or only perfomed using elaborate and expensive eqipment (Chin et al 1995). Kibler (1988) supports the theory that sport specific or activity specific testing is more appropriate to testing the athlete.

Kibler et al (1988) used the Sharkey step test to evaluate maximal VO₂ levels by heart rate recovery in junior tennis players. Results indicated high aerobic and anaerobic fitness in players not necessarily related to extra training apart from regular tennis training. This would indicate that information gained from this type of testing may not be useful and therefore unnecessary. The same study also revealed the majority of injuries in tennis are overuse, related to inflexibility and muscle imbalance which has been previously discussed.

Viitasalo (1982) stated that maximal anaerobic power was not correlated to success in volleyball players and Chin et al (1995) moved away from traditional fitness testing to develop a model for the sport specific requirements of badminton stating that standardised cycle ergometry was not sufficient for the prediction of successful performance. He suggested that aerobic and anaerobic requirements for sports such as badminton, squash and tennis depended on the the length and nature of the rally. Even using a sport specific field test  moderate correlations (r = 0.65) to rank order of players was found concluding that other factors such as skill, agility and visual acuity were more indicative of performance although the test provided a reasonable assessment of fitness.

Tumilty et al (1987) found moderate correlations between peak oxygen uptake and total work for rowers on an ergometer (r= 0.51). He also found that repeated testing showed variability in results in even a few weeks especially at the beginning of training during the preseason which may be a good reason for not testing during this period of great variability.

Minkoff (1982) also investigated cardiovascular fitness of hockey players over a period spanning the preseason and competitive season. Measures of VO_{2 max} and anaerobic and aerobic threshold as determined by an incremental treadmill test showed little change throughout the season possibly due to the fact that VO_{2 max} reaches a plateau with training beyond which levels remain fairly inflexible for long periods. Minkoff (1982) also found no apparent relationship of success to VO_{2 max} ratings and concluded that anaerobic measurements may be a better measure of function. Macfarlane (1991) suggests that athletes who have reached a plateau in their fitness should concentrate on skill development. This refinement of skill and technique should surely occur in the preseason.

As for strength training, many athletes will begin work on their aerobic capacity prior to preseason and may benefit from testing at this stage to determine a baseline measure.

O'Connor et al (1995) showed that anxiety levels increase with maximal exercise testing and that repeated testing does not alleviate anxiety, concluding that tests of this kind are associated with negative feelings. Athletes may see these tests as a potential reason for exclusion from sport whereas sport specific testing may be a truer measure of success. coaches should not select teams based purely on physiological teasting where motivation and skill are largely ignored. It is also important that the error factor associated with exercise testing is reported to the athlete because false negative reports may have a disasterous effect on the individual.

Clinical Implications

Measures of fitness and strength may well be important factors associated with optimal performance however the athlete must be allowed adequate time to correct deficits and promote transfer of strength to other skills. This should occur prior to the preseason so that an ordered approach to maximal performance can be attained during the preseason.

The equipment required for extensive strength and fitness testing may not always be available to the clinician and therefore tests of function which may be performed with minimal equipment may be more appropriate to the athlete particularly during the preseason when the emphasis is on fine tuning.

Physiotherapists are aware that many injuries occur as a result of poor biomechanics and weak stabilising muscles which cannot be effectively evaluated via strength measures, vastus medialis and multifidus to name a couple. Other components, such as proprioception have been shown to influence injury incidence and physiotherapists are also aware that lower back dysfunction may lead to hamstring injuries.

Generally a lack of specificity to particular sports and the error factors associated with both strength and fitness testing must be taken into account before these measures can be used to accurately predict performance.

Conclusion

To summarise the points made above, strength testing has not conclusively been able to predict injury during sport nor has it conclusivley been correlated with functional performance. In the ACL injured athlete return to sport has been more highly correlated with functional testing rather than strength testing. Similar reports have been made of fitness testing pertaining to the lack of correlation with performance.

Many overuse injuries which occur during the sporting season and during preseason may be related to inadequate flexibility which also requires attention. Overuse injuries are also associated with fatigue and therefore perhaps a fatigue index measure would be more appropriate than absolute strength testing.

Preseason fitness testing does not take in to account the mental state required for competition , level of skill required to be a successful athlete or the team effort required for some sports. Athletes often see preseason tests in a negative light, as a process to exclude them from participation and it has been shown that anxiety levels rise prior to assessment. Testing performed prior to preseason would possibly be seen as positive because the athlete has adequate time to improve measures.

Although both measures are useful as part of a full assessment of the athlete I believe that measures of strength and fitness should be performed prior to the preseason so that the athlete can address deficits in those areas with specific conditioning programmes and concentrate on skill aquisition and refinement during the preseason ready for competition.

References

Anderson MA, Gieck JH, Perrin D, Weltman A, Rutt R and Denegar C (1991)

The relationships among isometric, isotonic and isokinetic concentric and eccentric quadriceps and hamstring force and three components of athletic performance. Journal of Orthopaedic and Sports Physical Therapy 14(3):114-119

Banff M, Godfrey J, Beard D and Breckenridge J (1998)

Which clinical performance test best indicates a patient's readiness to return to full sporting activities following ACL reconstruction. Proceedings of: Football Australasia: Melbourne: Royal Australasian College of Surgeons

Beach ML, Whitney SL and Dickoff-Hoffman SA (1992)

Relationship of shoulder flexibilty, strength and endurance to shoulder pain in competitive swimmers. Journal of Orthopaedic Sports and Physical Therapy 16(6):262-268

Chin M, Wong A, So R, Siu O, Steinager K and Los D. (1995)

Sport specific fitness testing of elite badminton players. British Journal of Sports Medicine 29(3):153-157

Eksrand J (1982)

Soccer Injuries and their Prevention. Linkoping: Linkoping University

Genuario SE and Dolgener FA (1982)

The relationships of isokinetic torque at two speeds to the vertical jump. Research Quarterly 51(4):595-598

Jonhagen S, Nemeth G and Eriksson E (1994)

Hamstring injuries in sprinters: The role of concentric and eccentric hamstring muscle strength and flexibility. American Journal of Sports Medicine 22(2):262-266

Kannus P (1994)

Isokinetic evaluation of muscular performance: Implications for muscle testing and rehabilitation. International Journal of Sports Medicine 15:S11-18

Kibler WB, McQueen C and Uhl T (1988)

Fitness evaluations and fitness findings in competitive junior tennis players. Clinics in Sports Medicine 7(2):403-416

Lephart SM, Perrin DH, Fu FH, Gieck JH, McCue FC and Irrgang JJ (1992)

Relationship between selected physical characeteristics and functional capacity in the anterior crucuate ligament-insufficient athlete. Journal of Orthopaedic Sports and Physical Therapy 16(4):174-181

Minkoff J (1982)

Evaluating parameters of a professional hockey team. American Journal of Sports Medicine 10(5):285-292

O'Connor PJ, Petruzello SJ, Kubitz KA and Robinson TL (1995)

Anxiety responses to maximal exercise testing. British Journal of Sports Medicine 29(2):97-102

Sapega A (1990)

Current concepts review : Muscle performance evaluation in orthpaedic practise. Journal of Bone and Joint Surgery 72A(10):1562-1574

Viitasalo J (1982)

Anthropometric and physical performance characterisitcs of male volleyball players. Canadian Journal of Applied Sport Science 7(3):182-188

Wise PR, Lew PC and Connor BT (1998)

Hamstrings in AFL football. In Proceedings of Football Australasia: Melbourne: Royal Australasian College of Surgeons.

Zachazewski J, Magee D and Quillen W (1996)

Athletic Injuries and Rehabilitation. Philadelphia: WB Saunders Company.

Negative Argument by Sharlene Eadie

Introduction

A paucity of specific literature exists on this controversial topic. Previously, we have relied on anecdotal information as to why strength and fitness evaluations are included in pre-season assessments.

Background Knowledge

Strength and fitness are broad terms. For the purpose of this discussion, these terms have been defined as follows.

Muscular Strength

Refers to the capacity of a muscle for active development of tension, irrespective of the specific conditions under which this tension is measured (slow or fast contractile velocity, or shortening or lengthening contraction). No single testing mode (isometric strength, slow speed dynamic strength or fast speed dynamic strength) is the best or most valid for measuring strength (Sapega 1990). Aside from this, strength must be quantified somehow.

Special functional requirements for an athlete make one type of strength of more interest than another, but in general, all modes of expression of muscular strength bear a direct quantitive relationship with one another (Sapega 1990).

Clinical tests that measure strength evaluate the capacity of a patient's musculature to develop maximum voluntary tension. Muscular work is defined by Sapega (1990) as the output of mechanical energy by an externally applied force multiplied by the distance through which it is applied. Muscular power refers to the rate of muscular work output. Measurements of work and power are useful for the assessment of timed bouts of work.

Fitness

Fitness is a broad term, which when reviewed in the literature, covered the ATP-CP, anaerobic and aerobic systems, flexibility, agility, anthropometry, strength and power.

Different sports, depending on their durations and intensities, require the activation of specific energy systems, strength and skills (McArdle et al 1996). The objective analysis of athletic performance is an important aspect in the planning of individual training programmes. The athlete's progress may be gauged by fitness assessments. These measurements reflect the overall performance of the athlete and overall effectiveness of the training programme (Telford 1980). Contributing to the overall performance are physical fitness, skill and psychological states. Measurement of these components provides an indication of how the athlete produces the overall performance. Therefore, examination of the athlete's strength and weaknessess enables training programmes to be refined and for the athlete's progress to be monitored. (Telford 1980).

The Pre-season Assessment: Why do we do it?

Pre-season assessments are conducted for the following reasons:

Performance Monitoring

Pre-season assessments allow for performance monitoring throughout and at the end of the season to assess the progress of different physiological variables required for a specific sport throughout the season. Therefore, training regimes can be guided (Pickard and Pyke 1981).

Set Training Regimes

Specific training regimes can be set to meet the specific demands of the sport and to address strength or fitness deficits that may have been detected in pre-season assessment. Therefore, training can be guided throughout the season (Telford 1980).

Assess Injury Potential

This is beneficial in previenting injury and reducing time loss due to injury (Orchard et al 1997).

Assess the athlete's health status

(McArdle et al 1996).

To provide feedback to the athlete in order to avoid a potential career ending injury.

This will result in an improvement in the athlete's motivation to achieve goals set (Gurray et al 1985).

The pre-season assessment is helpful for the athlete, physiotherapist, physician and coach to monitor progress. Information collected from pre-season assessment provides a useful baseline for comparison with mid or end of season testing. It also allows for planning of a training programme specific to the particular fitness/strength area of the sport that is necessary to address in order to prevent injury and to enhance performance.

New Knowledge

Assessment of Injury Potential

It has been discussed in the literature, that pre-season strength and fitness assessments are useful in injury prevention (Gurray et al 1985, Knapik et al 1991, Orchard et al 1997, Waller et al 1994).

Orchard et al (1997) were able to demonstrate in their study of elite AFL players that the rate of hamstring muscle injuries in the football team decreased after a protocol was introduced to correct pre-season deficits (determined by pre-season assessments), to avoid time loss due to injury.

It has been suggested by Waller et al (1994) that many rugby injuries are preventable. A prospective cohort study, called the Rugby Injury Prevention Program, was designed to examine the risk and protective factors for rugby injury. 344 subjects completed a pre-season questionnaire and the pre-season physical assessment. It was found to be useful in detecting possible injuries, areas of concern for strength and fitness improvements in order to enhance performance.

Gurray et al (1985) conducted a study where pre-season health, strength and fitness evaluations were performed on 40 professional baseball players to assess for levels of conditioning and potential for injury. Screening identified many players with problems or potential problems. Test findings resulted in at least one training or lifestyle recommendation in each player tested. Body composition, muscular endurance, flexibility and aerobic capacity were the parameters tested.

Knapik et al (1991) reported that it has been assumed for a long time that specific strength and flexibility imbalances may be associated with athletic injuries. These authors conducted a study which demonstrated that specific strength and flexibility imbalances are associated with lower extremity injuries in female athletes. 138 females were tested over 3 years. Flexibility was measured with a goniometer at lower extremity points and strength KF/KE measured with Cybex 11 dynamometer at 30 and 180 degrees/sec. Results indicated that lower extremity injuries accounted for 80% of all injuries. It is therefore imperative to perform a pre-season assessment to avoid this.

Roetert et al (1995) conducted a study where normative data specific to tennis were developed. They postulated that by testing junior players early in their careers, physical training programmes can be implemented to strengthen weaknesses and lessen the risk of injury. A total of 465 boys and 428 girls completed the test protocol consisting of; flexibility - using the sit and reach test, chest, shoulder and upper limb endurance - by the number of push ups performed in 60 seconds, abdominal strength and endurance - by the number of sit ups performed in 60 seconds. A hand grip dynamometer was used to measure hand grip strength. Lower body power was evaluated by maximum vertical jump performance. Aerobic endurance was measured by timing a one and a half mile run. They concluded that coaches and players can determine which fitness areas need to be improved for athletes on an individual basis. Specific training programmes can then be designed based on an athlete's fitness testing results. Proper interpretation of the fitness testing data base results can lead to an easy way to determine the relative position of a given fitness score in the distribution. Weaker areas will be recognised for the purpose of injury prevention and performance enhancement.

Setting Specific Training Regimes and Monitoring Performance

In order to achieve appropriate training prescription, the major factors leading to training improvement such as initial fitness level, intensity, duration, frequency and type of exercise need to be considered (McArdle et al 1996).

Knowledge of the athlete's fitness level can be useful in quantifying training regime, performance improvement and assessing potential injuries. It also enables aims and objectives for pre-season and throughout the season to be set. This will give the athletes incentive if they know the specific performance goals to meet the training objectives.

It has been discussed in the literature that further research needs to be conducted to define sport specific strength and fitness testing for different sports. Whilst specificity is essential in testing the elite athlete, Telford et. al. (1987) believes it is favourable to test generally with the Tri-level Profile. These authors believe that specific test tend to be influenced by training status, whereas the Tri-level Profile tends to be influenced more by the individual's natural endowments. Therefore, there maybe potential to identify talent in an athlete that has not been discovered.

Some literature has shown to be skeptical as to the value of general fitness and strength tests that are not specific to the sport in question. Telford et al (1987) state that the value of these general and simple assessments is the ability to monitor individual gains in response to training. The Tri-level Profile provides and objective record of progress which enables a general and quick evaluation of the effectiveness of training methods on the energy systems. It also provides motivation for the athlete (Telford et al 1987).

General fitness testing pre-season allows for an assessment of overall functional capacity of the central circulation (McArdle et al 1996). It is important to determine baseline central fitness prior to setting goals in training which enhance aerobic capacity of specific muscle groups (McArdle et al 1996). After pre-season aerobic assessment there are two factors important in formulating an aerobic training programme. Firstly, the training must provide a sufficient cardiovascular overload to stimulate increases in stroke volume and cardiac output (McArdle et al 1996). This ventral circulatory overload can be assessed by general fitness tests as central circulatory training will improve stroke volume and cardiac output. Secondly, the central circulatory overload should be accomplished by exercising the sport specific muscle groups to enhance their local circulation (McArdle et al 1996). However, when assessing aerobic fitness post season, the same general test may be used to assess aerobic fitness improvement. Specificity of testing is required when performance is to be evaluated (Chin et al 1995). For such sports involving non-rhythmic movements, such as, badminton, handball and squash, sport specific testing may be impossible or may be performed only with the help of elaborate and expensive technical equipment. This conclusion has prompted further research on possible means of obtaining valid estimations of the competition fitness of athletes in specific sports.

Sport specific laboratory tests, such as, rowing ergometry for rowers or cycle ergometery for cyclists, are specific to the task, however, do not have the capacity to forecast performance in competition. A study by Chin et al (1995) investigated the physiological response of elite badminton players in a sport specific test. Badminton, at the elite level, requires a combination of the aerobic and anaerobic systems and the involvement of these systems depends on the nature of the rally (short/long) and game duration (short/ long match). Apart from the demands of high levels of technical skill and mental acuity, essential requirements for badminton fitness are stamina, speed, endurance, strength and physical agility. Twelve Hong Kong national badminton team players performed a field test on a badminton court. Six light bulbs were connected to a programming device causing individual bulbs to light up in a given sequence. The players were instructed to react to the flashes by running towards them and triking shuttles mounted in the vicinity of the bulbs. Exercise intensity was controlled by altering the interval between successive lighting (Chin et al 1995). These authors concluded that the intensity of the test simulated the requirements of the actual game energy expenditure of the Hong Kong badminton players exercising at close to their anaerobic threshold. The results also showed that an estimate of fitness can be derived from measurements involving exercise closely resembling that which is specific for the sports activity in question. Improved training advice and guidance may result from this study (Chin et al 1995).

A similar study of pre-season test specificity was conducted in elite squash players by Chin et al (1995). Maximum oxygen uptake was measured using a continuous treadmill running test. A sports specific test was also performed in a squash court. A high correlation was found between the field test data and the ranked playing ability of subjects in a previous study by Steininger and Wodick (1987), using the same testing equipment method and protocol. The maximum heart rate values and lactate values showed that the players were under maximum load during the field test. Overall, the test data provide a good baseline and reference for coaches, sports physiologists, physiotherapists and future investigators to improve the performance of squash teams in international competition.

Clinical Implications

Pre-season assessment allows physiotherapists to test for deficits in strength and different aspects of fitness. Feedback can be made to the athlete, physician and coach regarding advice on how to avoid injury and how to maximumise performance. The physiotherapist may advise a coach of a specific training programme for an athlete based on pre-season assessment findings. Pre-season assessments may also create more scope for physiotherapy services.

Conclusion

Strength and fitness evaluations are necessary in pre-season assessments for the following reasons:

• Injury prevention
• Performance indicator
• Assist with setting training regimes specific to requirements of a sport.

There is concern regarding specificity of a test for the sport in question. However, it has been illustrated that some studies have taken this into account. Also a paucity of literature is available on pre-season assessments. Besides being expensive and sometimes impractical to perform sport specific fitness and strength tests, further research is required in this area.

References

Chin MK, Steininger K, So R, Clark C and Wong A (1995)

Physiological profiles and sport specific fitness of Asian elite squash players. British Journal of Sports Medicine 29:158-164.

Chin MK, Wong A, So R, Sui O, Steininger K and Lo D (1995)

Sports specific fitness of elite badminton players. British Journal of Sports Medicine 29:153-157.

Gurray M. Pappas A, Michaels J, Maher P, Shakman A, Goldberg R and Rippe J (1985)

A comprehensive pre-season fitness evaluation for professional baseball players. Physician and Sports Medicine 13:63-74.

Knapik J, Bauman C, Jones B, Harris J and Vaughn L (1991)

Pre-season strength and flexibility imbalances associated with athletic injuries in female collegiate athletes. American Journal of Sports Medicine 19:76-81.

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Orchard J, Marsden J, Lord S and Garlick D (1997)

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Pickard R and Pyke F (1981)

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Roetert E, Plorkowski P, Woods R and Brown S (1995)

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Sapega AA (1990)

Current concepts review - Muscle performance evaluation in orthopaedic practice. Journal of Bone and Joint Surgery 72A:1562-1574.

Steininger K and Wodick R (1987)

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Telford RD (1980)

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Exercise Physiology Educational Resources 1998