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Put out to pasture: what is our duty of care to the retiring professional footballer? Promoting the concept of the ‘exit health examination’ (EHE)
  1. Sean Carmody1,2,
  2. Christopher Jones3,
  3. Aneil Malhotra4,
  4. Vincent Gouttebarge5,
  5. Imtiaz Ahmad2
  1. 1 School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
  2. 2 Medical Department, Queens Park Rangers Football and Athletic Club, London, UK
  3. 3 Isokinetic Medical Centre, London, UK
  4. 4 Cardiovascular Sciences Department, St. George’s University of London, London, UK
  5. 5 Medical Department, World Players’ Union FIFPro, Hoofddorp, The Netherlands
  1. Correspondence to Dr Sean Carmody, Medical Department, Queens Park Rangers Football & Athletic Club, London, W12 7PJ, UK; seanocearmaide{at}

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Retired professional footballers are at a significantly increased risk of several health problems including osteoarthritis,1 mental health conditions2 and difficulties pertaining to suboptimal lifestyle choices.3 The aim of this editorial is to highlight the health issues faced by players in retirement, to advance the concept of the ‘exit health examination’ (EHE) and to promote the duty of care that clinicians, clubs and governing bodies have to ensure that the risk of poor long-term health outcomes is minimised.

‘Side effects’ of a career in professional football

Professional footballers are prone to recurrent and severe musculoskeletal injuries, which can occasionally be career-ending.4 Although these can in themselves increase the likelihood of developing osteoarthritis, they may also require surgical intervention, which heightens the risk.

Several studies have highlighted the increased prevalence of hip, knee and ankle osteoarthritis among ex-footballers compared with the general population, with much earlier onset of disease and increased likelihood of joint replacement reported.1 The presence of osteoarthritis in ex-footballers is associated with a poorer health-related quality of life and an increased risk of mental health …

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  • Contributors The idea, planning and composition of this article was contributed to by all listed authors. The final manuscript was proposed by the first author and agreed on unanimously by all others. There were no further collaborators involved in the process.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.