Like any injury, a pre-participation evaluation can be interpreted in two ways:
1. Evaluate someone who has not been injured - the aim of the evaluation is to look for readiness for the event, generally and specifically; and
2. Evaluate someone who HAS been injured - the aim of the evaluation is to look for readiness for the event in addition to structural integrity of the injured part.
For example, a person who has suffered a lateral ligament sprain should have their ligament evaluated for structural integrity, in addition to potential causes, contributing factors and complicating factors.
The following guidelines for obtaining a diagnosis are up-to-date and based on information from the Cochrane Collaboration, an organisation whose mission is “to ensure that patients receive effective interventions for the best health outcomes based on up-to-date evidence, and that healthcare providers have up-to-date and easy access to the latest evidence.”
• Clinical tests include those for disruption of ligaments, and include the anterior drawer test of ATFL function and inversion tilt test of both ATFL and CFL function. The reliability of these tests has been questioned in recent systematic reviews (Hubbard & Hicks-Little, 2008), and it has been suggested that these tests alone are not sufficient to accurately determine the extent of ligament damage because of the large variation in individual variation .
Containing an evaluation to these two tests would do a disservice to the individual, as they do not evaluate the contribution of the part to the patterns and power required for the activity. See below for PPE's that further evaluate these elements.
Hubbard, T. J., & Hicks-Little, C. A. (2008). Ankle Ligament Healing After an Acute Ankle Sprain: An Evidence-Based Approach. J Athl Train, 43(5), 523-529.