Medical / Biodata Screening

Please note all information will be kept strictly confidential. Team/emergency medical use only

Name Ajinkya Parte Date 28/7/2017

Name of the Assessor

Cricket Information (tick and/or circle):

Batsman (L/R) R All-Rounder

Pace Bowler (L/R) R Throw with left arm

Spin Bowler ( L / off / leg ) Throw with right arm

Wicketkeeper

Date of Birth 16/11/1994 Age 22

Mobile No 9769988344

Any relevant ongoing or past medical conditions (e.g. diabetes, epilepsy, asthma, allergies etc)?
NO

Any current/regular medications/TUE's ? NO

Any relevant past surgeries; Y N (please list ALL relevant);

NO

Orthotics?N Non-veg

Injury History
Include the side of the body and the date of injury of any current AND/OR past injuries or symptoms

Head/Face/Jaw NO

Neck NO

Shoulder NO

Elbow/forearm NO
Wrist/Hand/Finger NO

Chest/Upper Back NO

Ribs/Abdomen NO

Lower Back NO

Buttocks NO

Groin/hip NO

Thigh (front/back) NO

Knee NO

Shin/Calf NO

Ankle/Foot/Toes NO
medical use only

7/2017

gies etc)?

or symptoms
 LOAD RECORD

Have you been playing

matches in the N
previous 4 weeks?

Matches

Last Week

2 Weeks Back

3 Weeks Back

4 Weeks Back

Have you been training

in the previous 4 Y
weeks?

Sessions

Last Week 2

2 Weeks Back 2

3 Weeks Back

4 Weeks Back

How many overs have

Y/N
you bowled recently?

Overs

Last Week

2 Weeks Back

3 Weeks Back
4 Weeks Back
CORD

When was your last match?

When was your last training session?

Cricket Format?
 STANDING MEASURES LEFT RIGHT

Knee to wall 15 13

Single Leg Squat Flat

Star excursion test

Lumbar flexion

Lumbar extension 20 16

Lumbar lateral flexion 45 45

Lumbar quadrant no pain no pain

Shoulder elevation (sagittal) full full

Shoulder elevation (frontal) full full

Shoulder Horizontal add 25 22

Shoulder HBB 17 13

Hawkins Kennedy no pain no pain

O'Brien's Test no pain no pain

Empty Can no pain no pain

SEATED LEFT RIGHT

Test

Hip IR 90 25 30

Hip ER 90 11 25
 Slump Test

Cervical flexion normal normal

Cervical rotation normal normal

Cervical extension normal normal

Cervical lateral flexion normal normal

Thoracic rotation normal normal

Thoracic extension normal normal

Thoracic lateral flexion normal normal

 SUPINE LEFT RIGHT

Lying to long sit malleoli

1st MTP Extension 50 54

Shoulder ER at 90 88 87

Shoulder IR at 90 side lie 63 49

Shoulder Relocation no pain no pain

FABER

Passive SLR 88 89

Active Knee Extension 176 178

Groin squeeze 60

Hip quadrant no pain no pain

PRONE LEFT RIGHT

Hip IR 0 22 15

Hip ER 0 19 30

Knee bend (R1,R2) 123 127

Combined elevation

Forced ankle PF no pain no pain

END OF PLINTH LEFT RIGHT

Thomas test Hip Extension 16 18

Thomas test Knee Flexion 108 100

Thomas test Hip Abduction 29 23

COMMENTS Grading/Units

Cm/degrees

Pelvis, knee, 90, Sx, Total/4

cm

9 L1-S1 change cm

cm - Index to popliteal crease

cm +/- distance from floor

Pain/No pain

Full/Restricted/SCAP kinesis

Full/Restricted/SCAP kinesis

cm - elbow crease line to axilla

cm - L ?? R

Pain/No pain

Pain, Weakness

Pain, Weakness

COMMENTS Grading/Units

Grading/Units

degrees

degrees
symmetrical degree KE, symmetry, +/-

Normal/Restricted/Sx

Normal/Restricted/Sx

Normal/Restricted/Sx

Normal/Restricted/Sx

Normal/Sx/degrees

Normal/Restricted/Sx

Normal/Restricted/Sx
COMMENTS Grading/Units

L=R Change in malleoli L to R

degrees

degrees

degrees

Pain/no pain/improved ROM

L>R Sx, R=L

degrees

degrees

130 mmHg

Sx reproduction

COMMENTS Grading/Units

degrees

degrees

degrees

11 degrees

Sx reproduction

COMMENTS Grading/Units

degrees

degrees

degrees
 STRENGTH LEFT RIGHT STRENGTH

Calf endurance 25 22 Hamstring 90/90 bridge

Groin squeeze Shoulder ER at 90

Hip abduction Shoulder IR at 90

Hip adduction Shoulder ER at 0

Hip flexion Shoulder IR at 0

TEST 27 - POSTURAL ASSESSMENT

Head Forward
Left
Shoulders
Right Depressed
Thoracic Spine Neutral
Lumbar Spine Neutral Decreased Lordosis
Pelvis Neutral Anterior tilt
Left Neutral Varus
Knees
Right Neutral Varus
Left Medial Arch = Flat
Foot
Right Medial Arch = Flat

KEY FINDINGS
Tightness Weakness Posture
 LEFT RIGHT

71sec 70sec

ESSMENT

Scoliosis

Notes
 WORK LOAD MONITORING SHEET
Week 1 - Week 2 - Week 3 -
Activity Workload Workload
RPE Mins RPE Mins RPE Mins
Factor Factor
Day MONDAY MONDAY MONDAY
Gym Session
Running Session
Match
Skill Practice
Acute Workload Sub - Total
Day TUESDAY TUESDAY TUESDAY
Gym Session
Running Session
Match
Skill Practice
Acute Workload Sub - Total
Day WEDNESDAY WEDNESDAY WEDNESDAY
Gym Session
Running Session
Match
Skill Practice
Acute Workload Sub - Total
Day WEDNESDAY WEDNESDAY WEDNESDAY
Gym Session
Running Session
Match
Skill Practice
Acute Workload Sub - Total
Day THURSDAY THURSDAY THURSDAY
Gym Session
Running Session
Match
Skill Practice
Acute Workload Sub - Total
Day FRIDAY FRIDAY FRIDAY
 Gym Session
Running Session
Match
Skill Practice
Acute Workload Sub - Total
Day SATURDAY SATURDAY SATURDAY
Gym Session
Running Session
Match
Skill Practice
Acute Workload Sub - Total
Day SUNDAY SUNDAY SUNDAY
Gym Session
Running Session
Match
Skill Practice
Acute Workload Sub - Total
TOTAL ACUTE WORKLOAD

TOTAL ACTIVITY WISE

WORKLOAD
- GYM SESSION
- RUNNING SESSION
- MATCH
- SKILL PRACTICE
 Week 4 -
Workload Workload
RPE Mins
Factor Factor
MONDAY MONDAY

TUESDAY TUESDAY

WEDNESDAY WEDNESDAY

WEDNESDAY WEDNESDAY

THURSDAY THURSDAY

FRIDAY FRIDAY
SATURDAY SATURDAY

SUNDAY SUNDAY
RATE OF PERCEIVED EXERTION
Max Effort Activity
10 Feels almost impossible to keep going. Completely
out of breathe, unable to talk

Very Hard Activity

9 Very difficult to maintain exercise intensity.
Can barely breath & speak a single word

Vigorous Activity
7-8 On the verge of becoming uncomfortable
Short of breath, can speak a sentence

Moderate Activity
4-6 Feels like you can exercise for hours.
Breathing heavily can hold short conversation

Light Activity
2-3 Feels like you can maintain for hours
Easy to breathe & carry a conversation

Very Light Activity

1 Anything other than sleeping
Watching TV, riding in a car, etc.