2. The Pre-Participation Physical Examination
Chapter 6
The Pre-Participation Physical Examination

3. Objectives Upon completion of this chapter, you should be able to:
Discuss the needs and overall goals of the pre-participation physical examination
Distinguish between office-based and station-based exams
List the important components of the pre-participation physical examination

4. Objectives (cont’d.)
Upon completion of this chapter, you should be able to (cont’d.):
Describe the clearance process for athletic examinations
Discuss confidentiality concerns with recordkeeping

5. The Pre-Participation Physical Examination (PPE)
Originally consisted of a short physical, often less than five minutes
Today, it can be a comprehensive assessment of an athlete’s overall health and ability to perform
Goal is to maintain health and safety of the athlete

6. Goals of the PPE Determine general health
Disclose defects that may limit participation
Detect conditions that may predispose to injury
Determine optimal level of performance
Fulfill legal and insurance requirements
Provision of opportunities to compete for those with health conditions that may preclude blanket approval
(ie. Athlete with diabetes can still participate, but needs access to medical services and may have to take special precautions

7. The PPE (cont’d.) Timing
Should take place at least six weeks prior to the beginning of the athlete's sport season
End of school year through mid-summer
Any athlete rehabilitating over the summer must be reevaluated
In Texas, must be completed at the beginning of the year due to off season workouts
Most other states don’t have year round athletics, therefore no offseason

8. The PPE (cont’d.) Station-based PPE
Examination by several different specialists
Each responsible for one aspect
Includes medical history and basic measurements of blood pressure, height, weight, and eyesight

9. The PPE (cont’d.) Station-based PPE (cont’d.)
Specialists often include:
Family physicians
Orthopedic specialists
Physical therapists
Athletic trainers
Podiatrists
Pediatrician

10. The PPE (cont’d.) Station-based PPE (cont’d.) Advantages:
Low cost
Athlete will see several different sports medicine specialists throughout the exam process
Disadvantages:
Difficulty of recruiting volunteer physicians
Finding a facility

11. The PPE (cont’d.) Office-based PPE Traditional doctor’s office
Family physician usually has patient's complete medical history as a basis
Quiet setting

12. Components of the PPE Medical history is the cornerstone
Identifies about 75% of problems affecting athletes
Recommended baseline:
Medical conditions and diseases
Surgeries and hospitalizations
Medications
Allergies

13. Components of the PPE (cont’d.)
Recommended baseline (cont’d.):
Immunization status
Menstrual history
Pulmonary status
Neurological status
Musculoskeletal status
Injuries or illness since last exam

14. Components of the PPE (cont’d.)
Standard components:
Height
Weight
Pulse
Blood pressure
Eyes, ear/nose/throat, heart, abdomen, genitalia (males only), skin, and musculoskeletal

15. Clearance for Participation in Sports
Three categories:
Unrestricted clearance
Clearance after completion of further evaluation or rehabilitation
No clearance for certain types of sports or for all sports

16. Clearance for Participation in Sports
When abnormality found, must consider:
Does it place athlete at increased risk of injury?
Is another participant at risk of injury because of the problem?
Can the athlete safely participate with treatment?
Can limited participation be allowed while treatment is being completed?
If clearance denied for only certain sports, what activities can they safely participate in?

17. Clearance for Participation in Sports (cont’d.)
Sports are classified based on degree or level of contact and strenuousness
Contact or collision sports
High risk of traumatic injury
Limited contact sports
Some risk of traumatic injury
Noncontact sports
Low risk as a result of force

18. Recordkeeping Managing resulting information is crucial
Information must be made available to coaches, trainers, and the athletic director
All information contained on the PPE form must be kept strictly confidential
Secured in the office or under lock and key
Should be kept for a minimum of seven years

19. Conclusion
The PPE has evolved to become a comprehensive approach to medical assessment
Can be either office-based or station-based
Determining clearance is the most important PPE result
The ultimate goal of the PPE is to allow athletes to compete safely