Put out to pasture: what is our duty of care to the retiring professional footballer? Promoting the concept of the ‘exit health examination’ (EHE)

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. 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 …