Medical follow-up

Why a medical follow-up ?

Every year we ask you for a valid medical certificate or license, and we don’t mean to bother you!

Everyone has their own opinion on the matter, but here’s what sports physician Anne-Lise Desjacques thinks.

She explains the benefits of going to see a professional, and you’ll see that for her, it’s all about your personal health…

The certificate of non-contraindication to the practice of sport in competition : What is it for ?

When registering for a race, a medical certificate is always required.

Beyond the legal aspect for race organizers, what use is a certificate of no contraindication for the athlete ?

It’s a legitimate question, because to obtain this document, you need to get organized, make an appointment with a doctor (general practitioner or sports doctor for the more perfectionist), and devote time to the process… So, what’s the point?

This clinical examination has become commonplace, and practitioners sometimes go so far as to make light of it. Athletes even go so far as to hijack the system by falsifying old certificates… But isn’t it risky to proceed in this way ? Not only in legal terms, but above all for the athlete’s health ?

The aim here is to highlight the key points of the medical consultation required to draw up the certificate.

Indeed, this consultation falls within the scope of medical prevention, and there are few reasons for athletes to go and see their doctor for prevention… And yet: prevention is better than cure!

So, the certificate of no contraindication may be the reason why we go to see our sports doctor once a year, even if everything seems to be going well!

What does the sports doctor look for during this consultation?

It’s worth remembering that trail running is not yet fully federated, and that most trails do not require club membership. As a result, trail runners can only be monitored via the medical certificate consultation! So… don’t neglect it, take care of yourself!

A number of points need to be checked before giving athletes the “green light” to practice a sport intensively (both in terms of training volume and cardiac intensity during sessions or races).

Screening for cardiovascular and respiratory diseases

Let’s not forget that the heart is a muscle. After eight hours of sport a week, especially endurance sports, the heart muscle becomes stronger and thicker. This is known as cardiac hypertrophy or “athlete’s heart”. This is normal, and responds only to repeated and prolonged stress on the heart during exercise.
But sometimes, if it becomes excessive, it can interfere with its proper functioning.

What’s more, for some years now, more than 8 hours of sport a week has been considered a cardiovascular risk factor.
Which is a bit rich, you might say, given that we’re constantly told that exercise is good for your health!
Yes, but sport for health and sport for performance are two different things…. Prolonged exercise, especially at high intensities, promotes inflammation and, over the long term, can damage the arteries.

Finally, while sport is a good thing to do from age 9 to 99, let’s not forget that the body does age, and that physical fitness in sport is not a sign of absence of abnormality. Vessels also age, and their walls become rigid and calcified, leading to cardiovascular diseases such as heart attacks. The heart muscle also ages and can be the cause of heart rhythm disorders…

For these reasons, a thorough clinical examination and electrocardiogram (ideally every year, but at least every three years) are essential.

Screening for hormonal disorders or nutritional deficiencies

Unfortunately, hormonal disturbances are frequently encountered when practising sports on a large scale, especially endurance sports.
For women in particular, amenorrhea (“absence of menstruation”) is often trivialized as a comfortable part of everyday life as an athlete. But it’s important to look for the cause, and take a blood test to correct these disturbances. It’s also important to look for and prevent osteoporosis, which is the main consequence of amenorrhea.

Chronic fatigue or cramps are a frequent reason for consultation.
But before reaching these symptoms, we can look for dietary errors and frequent deficiencies, such as iron or magnesium deficiency.
Vitamin D deficiency is also a major risk factor for fatigue fractures. And despite the sunshine of the Alps, it’s essential to get enough from the diet.

A quick questionnaire on diet and, above all, a blood test are needed to detect these deficiencies, which are sources of injury or poor performance.

Finally, the energy deficit caused by a lack of intake of slow sugars or proteins (particularly animal proteins) is an error often identified in sport. The quest for a “healthy weight”, ethical or economic rules, or lack of time for cooking are all legitimate arguments, but unfortunately the cause of fatigue and injury.
These errors must be identified and corrected.

Postural assessment

As part of the regular medical check-up for top-level athletes, a postural assessment is required. Why not for all athletes?
In my opinion, it’s important to provide all athletes with the best possible support, whatever their level.

The postural assessment enables us to evaluate muscular flexibility and joint mobility by means of simple in-office tests.
This provides guidelines for progress and work.

Once again, this is part of medical prevention. For example, muscular tears are often favored by muscular/tendinous stiffness.

What to remember after the medical examination
?

When this consultation is carried out by a doctor specializing in sports physiology, you’ll have understood that the certificate is part of a more general consultation for the athlete’s annual follow-up and medical prevention.

Frequently, you will be given documents other than the medical certificate. You may expect your doctor to provide you with an electrocardiogram, or a prescription for a blood test to check for deficiencies (vitamins, minerals, hormone levels, etc.), or prescriptions for physiotherapy or orthopedic inserts.
The list is long and specific to each annual check-up !

At the end of the consultation, it’s important that the athlete leaves with some food for thought about his or her practice and day-to-day life.
Improving isn’t just about the values displayed on our watches and training applications ! Performance is global and multi-factorial!
And the magic of sport is that progress is infinite: eat better, recover better, plan your training better…
Not to mention the positive impact this has on injury prevention.