Pre-Participation Physical Evaluations (PPEs): A Must For Every Athlete

Authors: 

Lindsey Barton Straus, JD

Conditions limiting participation

The ultimate decision on whether to participate is for the athlete and his or her parents to make.

The following abnormalities may make it unsafe for your child to participate in sports: 

  • Acute illness
  • Blood-borne pathogens. Because the risk of transmission is so low (less than 1 in 1,000,000 games), HIV-positive athletes may participate unless their health is compromised.
  • Heart disease (hypertrophic cardiomyopathy (HCM), rhythm and conduction abnormalities, systemic hypertension, and valvular heart disease, but not benign functional murmur or mild mitral valve prolapse)
  • Skin (contagious lesions or skin conditions should rule out participation in contact sports)
  • Eating disorder/female athlete triad
  • Eyes (functionally one-eyed athletes permitted only in sports that allow protective eyewear and do not involve projected objects (swimming, track and field, gymnastics, and not allowed to participate in wresting, boxing, or martial arts) 
  • Pregnancy (no contact, collision, or strenuous sports)
  • Kidney (no high-contact sports for one-kidney athletes; flack jacket for moderate contact sports)
  • Musculoskeletal (depending on degree and type of injury, risk to athlete and demands of sport)
  • Seizure disorder (one or more seizures within last 6 months held out of competition, especially in high-risk sports (skiing, gymnastics, high diving, collision sports, shooting, archery)
  • Asthma (but only if symptoms not controlled)

Sources:

Valovich McLeod TC, Decoster LC, Loud KJ, Micheli LJ, Parker JT, Sandrey MA, White C.  National Athletic Trainers' Association Position Statement: Prevention of Pediatric Overuse Injuries.  J Ath. Tr. 2011;46(2):206-220.

American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, American Osteopathic Academy of Sports Medicine. Preparticipation physical evaluation. 4th ed. American Academy of Pediatrics, 2010.

McCrory P, et al. Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012.  Br J Sports Med 2013;47:250-258. 

Madsen NL, Drezner JA, Salerno JC. The Preparticipation Physical Evaluation: An Analysis of Clinical Practice. Clin J Sports Med. 2014; 24(2):142-149.

Kucera KL, Klossner D, Colgate D, Cantu RC. Annual Survey of Football Injury Research 1931-2013 . National Center for Catastrophic Sports Injury (March 2014)

Fudge J, Harmon K, et. al.  Cardiovascular screening in adolescents and young adults: a prospective study comparing the Pre-Participation Physical Evaluation Monograph 4th Edition and ECG.  Br J Sports Med. 2014;48:1172-1178.

 

Tags: 

Pages