Sports Medicine
Sports Medicine questions test prevention, recognition, referral and - above all - return-to-play decision-making. The examiner is looking for criterion-based reasoning rather than a memorised number of weeks.
Prevention first
Pre-participation screening (history, cardiac, musculoskeletal) flags risk factors but does not predict injury on its own. Evidence-supported prevention includes strength and neuromuscular control programmes, gradual load progression, adequate recovery, protective equipment and enforcement of competition rules.
Return to play (RTP)
RTP is criterion-based, not calendar-based, and should be a shared decision between clinician, coach and athlete. Useful criteria are sport-specific and tissue-specific: full pain-free range of motion, strength around 90% of the uninjured side, pain-free sport-specific loading, completed sprint or throwing progressions, and psychological readiness. Progress through rehabilitation → modified training → full training → match play, with agreed re-injury markers.
Concussion
Any suspected concussion means immediate removal - no same-day return under any circumstances. Assess with a recognised tool such as SCAT, then follow a graduated, symptom-limited stepwise return (light aerobic work, then sport-specific drills, then non-contact, then contact), each step at least 24 hours and only if symptom-free. Clearance for contact should come from a medical doctor.
Emergencies and medication
Every event needs an emergency action plan: venue access, AED location, spinal precautions, a heat-illness cooling protocol and a designated caller. On anti-doping, athletes may use a needed prohibited medication under a Therapeutic Use Exemption where the criteria are met; a TUE must normally be obtained before use, with narrow retroactive exceptions.
Worked example
A footballer three weeks after a grade II hamstring strain is pain-free jogging and asks to play on Saturday. Reasoning: jogging loads the tissue far below sprinting and kicking, so pain-free jogging is not the relevant criterion. The criteria that matter are eccentric hamstring strength and pain-free high-speed running and kicking. Answer: not yet cleared - complete sprint and kicking progressions, meet the strength criterion, then return with reduced minutes.
Traps that cost marks
- Clearing an athlete because they are pain-free at rest.
- Quoting fixed timelines instead of criteria.
- Letting the coach or athlete alone make the RTP decision.
- Allowing same-day graded return after suspected concussion.
- Forgetting the emergency action plan in an emergency question.