Chapter 6

 Over the years, the PPE has gone from a cursory examination to a comprehensive overall assessment of an athlete’s health and ability to perform a sport at a highest level  Should take place at least 6 weeks before the sports season If musculoskeletal problems are found that will leave time for rehabilitation and strengthening of the area of concern

 Main goal is to maintain the health and safety of the athlete  Other goals include  Determination of the athlete’s general health  Disclosure of defects that may limit participation  Detection of conditions that may predispose the athlete to injury  Determination of the optimal level of performance  Classification of the athlete according to individual requirements  Fulfillment of legal and insurance requirements  Evaluation of the level of maturation of younger athletes  Evaluation of fitness and performance for possible improvement prior to participation  Provision of opportunities to compete for students with specific health issues that may preclude blanket approval  Provisions of opportunity to counsel youths regarding personal health issues.  Entry of the athlete into the local sports medicine environment, thereby establishing a doctor-patient relationship

 Station based  Benefits include many athletes examined in the same setting, often for lower costs Athlete examined by several specialists Stations include medical history and basic measurements (BP, height, weight, eyesight) Specialists include family physicians, orthopedic specialists, physical therapists, ATCs, podiatrists, and pediatricians Difficulties: Finding volunteer medical specialists an a location for the examination  Office based  Benefits include The family physician, the usual evaluator, has access to the complete medical history of the athlete The setting is quiet and allows for the discussion of multiple health issues. Immunization history is available and can be easily be updated.

 A complete medical history will identify 75% of all problems affecting athletes  Recommended baseline history Medical conditions and diseases Surgeries Hospitalizations Medications Allergies Immunization status Menstrual history Pulmonary status Neurological status Musculoskeletal status Injuries/illnesses since last exam  Recommended components of PPE Height Weight Pulse Blood pressure Eyes Ears/nose/throat Abdomen Genitalia Skin Musculoskeletal

 The term used for physical permission for athletic participation, is divided into 3 categories  Unrestricted  Clearance after completion of further evaluation or rehabilitation  No clearance for certain types of sports or all sports Sports are classified based on degree or level of contact and strenuousness, which could result in clearance for some, but not all sports.

 The physician must consider several questions if or when abnormalities are found  Does the problem place the athlete at risk for injury?  Is another participant placed at risk of injury because of the problem?  Can the athlete safely participate with treatment?  Can limited participation be allowed while the treatment is being completed?  If clearance is denied for only certain sports of sports categories, in what activities can the athlete safely participate?

 Physical forms are completed and signed by a physician  Is not considered valid until this is done  Information from the PPE is confidential and must be treated with the strictest of confidence by storing the forms in the ATCs or ADs office under lock and key  All PPE forms should be kept and stored for a minimum of 7 years after the athlete graduates or leaves the school  Statue of limitations