THE IMPORTANCE OF PREPARTICIPATION PHYSICAL EXAMINATIONS
As the season arrives, it is crucial for athletes to submit their “physical” forms for fall sports to avoid missing out on the excitement of two-a-day practices and upcoming football, track, cheerleading, and other sports activities. But what sets these examinations apart from regular checkups?
by Dr. Susan Sugerman | Contributor
The main purpose of preparticipation physical examinations (PPE) for athletic eligibility is to identify any life-threatening or disabling conditions, as well as issues that could lead to injuries or illnesses during physical activities. It’s important to note that a PPE is not a replacement for an annual, comprehensive medical and psychosocial-behavioral wellness exam as advised by the American Academy of Pediatrics, which is often included as a wellness benefit by major health insurance plans.
PPEs are frequently performed in collaboration with your child’s school athletic department in the form of “station examinations.” In this setup, athletes move between different stations in public areas like school buildings or gymnasiums to have their medical history reviewed and undergo a physical examination, completing one section at a time. When conducted privately at your child’s primary care physician’s office, the PPE may be integrated with or separate from the annual wellness exam, depending on specific office policies. While obtaining a PPE from your usual healthcare provider may offer a quicker and more holistic approach, the station-based method can sometimes better detect subtle health issues.
In Texas, public schools, and many private institutions, utilize the Texas University Interscholastic League Preparticipation Physical Evaluation form, which can be downloaded online before your child’s appointment.
MEDICAL HISTORY
The medical history of an athlete is the most critical indicator of their risk during both training and competition. A thorough screening of medical history aids healthcare providers in determining the need for any additional evaluations before granting clearance for participation. This screening includes a detailed account of:
• Current and past injuries
• Symptoms of concussions
• Cardiac issues
• Medical history (including chronic and recent illnesses)
• Menstrual history
• Changes in weight
• Medications being taken
PHYSICAL EXAMINATION
The physical exam specific to athletic clearance is both general and detailed. Vital signs, such as blood pressure, resting heart rate, and body mass index, can help identify conditions like hypertension, deconditioning, and malnutrition, among others. For example, certain physical activities, like weight lifting, may cause blood pressure to spike; thus, it’s crucial to know the athlete’s baseline levels. Assessing the cardiovascular system requires various examinations while in different positions. Additionally, a comprehensive evaluation of the musculoskeletal system covers all major muscles and joints from head to toe and is often presented as an 11-point examination that is not usually part of an annual wellness visit. Lab tests may be considered on a case-by-case basis, and routine testing is not generally required for most athletes.
CLEARANCE FOR PARTICIPATION
After completing the screening based on the athlete’s medical history and physical examination, the authorizing provider will issue clearance in one of three ways: 1) cleared without restrictions, 2) cleared with specific restrictions, or 3) cleared pending evaluation or rehabilitation for a particular condition. The last two categories may necessitate further assessments or treatments before the athlete can return to their sport. It is advisable to complete your child’s PPE well ahead of the season’s start to allow ample time for addressing any issues, ideally in time for those anticipated two-a-days!
