Pre-Participation Athletic Examination

There is substantial risk of injury in most sports. The purpose of the preparticipation physical examination is to "prevent life-threatening or disabling injuries by identifying predisposing factors, recommending preparatory and/or rehabilitative measures, and assisting in matching the participant with an appropriate sport and/or position." (Olympic Sports Medicine)

The examination should occur at least six weeks prior to preseason practice. A complete medical history should be taken which must include prior history of illness, injury, and surgery; drugs taken; drug allergies; history of heart disease, hypertension, kidney disease, dizzy spells, concussion, loss of consciousness, asthma, allergies, diabetes; glasses or contacts; dental appliances; last tetanus shot; and family history of heart disease, hypertension, stroke. For girls, a history of the first menstrual period and the longest time between periods is important.

The standard components of the PPE are height, weight, blood pressure, pulse (radial and femoral) and examination of the eyes (visual acuity and differences in pupil size), ears, nose, throat,lungs, heart (rate rhythm and murmurs), skin (rashes and lesions), abdomen (masses, tenderness, enlarged organs), neurological testing, and stage of pubertal development must be completed. For boys, the genitalia are examined for single or undescended testes, testicular mass, and hernia.

A detailed assessment of the musculoskeletal system including contour and symmetry of the neck, back, shoulder/arm, elbow/forearm, wrist/hand, hip/thigh, knee, and leg/ankle are performed. Any asymmetry, deformities or swelling must be further examined. The ranges of motion of the shoulder, elbow, wrist, hand, hip, knee, ankle and foot and the cervical, thoracic and lumbar spine aretaken. General muscle strength of these areas is checked. Often forgotten is checking flexibility (there is no such thing as being double jointed - sometimes the ligaments are extremely lax which allows greatly increased ranges of movement. This can predispose the child to injury). Discuss any positive findings with the examining doctor to determine if it is safe for your child to participate.

See 12-step screening may help reduce sudden death in young athletes

See The Preparticipation Physical Examination in Physician and Sports Medicine.

To order a copy of Preparticipation Physical Evaluation, call the Physician and Sports Medicine at 1-800-262-4729 and request ISBN #001627-5. The cost is $29.95 plus shipping and handling.

See Athletic Participation By Children and Adolescents Who Have Systemic Hypertension

and Ohio High School Athletic Association Preparticipation Examination Form

and Minnesota State High School League Preparticipation Examination Form Some interesting facts about football from the National Athletic Trainers Association (NATA):

For the 1,046,624 high school students who play football, it is projected that approximately 39% will sustain a reportable injury.
61.2% of injuries occur during practice. 38.8% occur during games.
The most commonly injured body part (17.3%) is the hip/leg/thigh area. 15.0% affect the forearm/wrist/hand, 14.5% the knee, 14.2% the ankle, 11.3% the head/neck/spine, and10.4% the shoulder/arm.
The most common classification of injury is general trauma, followed by sprains and strains. 5.7% of the injuries result in fractures.

Here are some guidelines to minimize the risk of injury:

Get in shape before the season. This means building strength, improving cardiovascular fitness and increasing flexibility.
Practice sound nutritional habits all year by following a diet which is 50-60% carbohydrates, 20-25% fat, and 15-20% protein. There is no miracle supplement!
Hydrate, hydrate, hydrate - that means WATER! Athletes need to drink 10-12 eight ounce glasses of water per day. Drink before, during (every 45 minutes) and after practice (the rest of the day)!
Wear properly fitting equipment, i.e.. head gear, protective pads, mouth guards and shoes.
Perform a proper warm-up and cool down.
All injuries should be evaluated immediately by a trained health care professional.

Pre-Participation Athletic Examination

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