## 4 Discussion  
The current literature does not provide a satisfactory number of studies with similar conceptualization to compare our results concerning prevalence of cardiac risk factors or cardiac abnormalities. Most of the epidemiological studies presenting data of cardiac PPS emphasize elite junior FP or differ in the extent of instrumental diagnostics. The purpose of this study was to obtain and present epidemiological data of pre-adolescent and adolescent semi-professional FP including cardiac pathologies, past injuries, and orthopedic disorders. The main findings of this retrospective analysis are the following: among the respondents of the BFV's PPS program, more than 20% indicated suffering from one or more medical \begin{table}
\begin{tabular}{l l l l l l l l} \hline \hline
**Traumatic Injuries** & \(n\) & **\%** & **Overuse Injuries** & \(n\) & **\%** & **Orthopedic Disorders** & \(n\) & **\%** \\ \hline Fractures & 19 & 3.6 & [PERSON]’s disease & 7 & 1.3 & Foot deformities & 18 & 3.4 \\ Ligament ruptures & 10 & 1.9 & Lower back pain & 6 & 1.1 & Scoliosis & 15 & 2.9 \\ Ligament strain & 4 & 0.8 & Tendinitis/Tendon irritation & 6 & 1.1 & Coxa/Genua valga/vara & 6 & 1.1 \\ Muscle strain & 3 & 0.6 & Shortened hamstring muscles & 4 & 0.8 & Thoracic deformities & 6 & 1.1 \\ Muscle fiber rupture & 2 & 0.4 & Epiphyseolysis & 2 & 0.4 & Unequal leg length & 3 & 0.6 \\ Ankle joint distortion & 2 & 0.4 & Apopysitis calcanea & 2 & 0.4 & Pelvic misalignment & 2 & 0.4 \\ Meniscus rupture & 1 & 0.2 & Bone edema & 1 & 0.2 & Osteochondoma & 1 & 0.2 \\ Bone bruise & 1 & 0.2 & Plica syndrome & 1 & 0.2 & Osteochondoma & 1 & 0.2 \\ Capsule injury & 1 & 0.2 & Growing pains & 1 & 0.2 & & & \\ Head trauma & 1 & 0.2 & Osteochondosis dissecans & 1 & 0.2 & & & \\  & & & Chondromalacia patellae & 1 & 0.2 & & & \\  & & & Spondylosis & 1 & 0.2 & & & \\  & & & Scheuermann’s disease & 1 & 0.2 & & & \\  & & & Knee joint effusion & 1 & 0.2 & & & \\ \hline \hline \end{tabular}
\end{table} 
Table 6: Traumatic and overuse injuries as well as orthopedic disorders, indicated as number of cases (\(n\)), ordered by frequency, and given as a percentage of the total study population (%). Figure 1: Listing of regular medication, indicated as a percentage of total study population (%). conditions. Concerning orthopedic conditions, nearly 1 out of 10 FP suffered from chronic orthopedic disorders. Fractures and ligament injuries have been reported most frequently among traumatic injuries (6.2%), followed by muscle injuries (1.0%). More importantly, the share of overuse injuries in the total number of traumatological conditions is more than 40%. The results from Table 4 show that cardiac abnormalities could be detected in 1 out of 20 (5.7%) semi-professional junior FP, either by querying the medical history (16.7%) or by instrumental (80%) or clinical (3.3%) examination. This represents a significant share, especially because the subjects did not show any documented symptoms or had not previously experienced any performance impairment. Remarkably, none of the detected cardiac and further internal medical conditions resulted, in exclusion from competitive sports. Although thirteen (3%) of the examined FP were recommended for a detailed cardiological or internal evaluation based on the screening results, there were no direct therapeutic consequences for these players. [PERSON] et al. presented their findings of a pre-competition cardiac assessment including medical history, clinical examination, resting-ECG and TTE among 155 male elite Under-17 FP. The rate of FP who needed further follow-up investigation due to the PPS was higher (8.4% vs. 3.0%), but there was also no exclusion from competition [41]. The results of the current study indicate that 15 out of 30 (50%) cardiac abnormalities could only be detected by TTE (see Table 4), and even required further investigation in some cases. This fact suggests that adding TTE on top of ECG (30%) for the screening of structural heart defects can be of great value when it comes to cardiological PPS.