Page 66 - Athletic Health Handbook
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Objectives of the the athlete to interact with a medical Cardiac
Pre-participation Evaluation professional. Many adolescents Because some heart conditions may
do not get yearly medical check-ups, be life-threatening, it is extremely
Screen for life-threatening as is recommended. important to investigate cardiac
or permanent conditions issues. Heart problems may be
The most important function of the Logistics of the PPE related to the electrical conduction
PPE is to screen for life-threatening system and may result in rhythm
conditions that could cause Most schools and colleges require problem (dysrhythmias). Structural
permanent injury or disability. PPEs, prior to the first year of problems in the heart muscle or
Hopefully, by identifying athletes participation. Also, national and valves may produce sounds that
at risk, thoroughly performed PPEs international athletic organizations, can be heard by using a stethoscope.
will lower the incidence of death and most professional sports leagues, Most dysrhythmias and murmurs are
and permanent disability, either require PPEs. The exact requirements, benign and do not preclude athletic
by excluding these athletes from including the frequency of subsequent participation. Factors that may
participation or by requiring PPEs, (yearly, every two years, or only indicate more serious conditions
treatment of their conditions. before the first year of competition) are a history of syncope with exercise
vary among schools, states, and or a family history of unexplained
Screen for treatable organizations. sudden death or known cardiac
or avoidable injuries condition in a young close relative.
The PPE may also recognize The PPE may be performed by
conditions that might predispose the athlete’s primary care physician Neurological
an athlete to injury. By recognizing or by a coordinated medical team Any injury that has affected the
the problem, early treatment may with stations for different parts nervous system, such as a concussion
be initiated which may prevent of the exam. or spine injury, must be thoroughly
further injury. For example, evaluated before an athlete is cleared
recognition of an anterior cruciate Determination of Clearance for sports. Participation is never
ligament knee injury would result allowed until all symptoms have
in a recommendation for surgical The majority of athletes are cleared cleared. With some spine conditions,
treatment which would reduce for full participation after the PPE. the athlete may be cleared for
the risk of further knee injury. Some athletes, however, will need non-contact sports only.
Medical conditions such as exercise- further testing or evaluation by other
induced asthma or high blood specialists prior to clearance. It is very Musculoskeletal
pressure would also benefit from rare that an athlete is not cleared For many musculoskeletal injuries,
early recognition and treatment. for participation. In these rare cases the dictum “you can play if you can
where participation is restricted, play” applies which means that an
Opportunity for general efforts should be made to find an athlete can continue to play if they
medical interaction alternative sport at which the athlete can function without any significant
For many athletes, the only can participate. Sports may be risk of serious injury. Continuing to
interaction they may have with categorized by degree of activity and play with certain injuries, however,
the medical profession is the PPE. degree of contact. Certain conditions may predispose an athlete to further
The PPE provides an opportunity will allow participation for certain injury. For example, stress fractures
for a health professional to discuss categories of sport. For example, an and ligament injuries in the knee
medical issues with the athlete, athlete with a spine injury would not should be treated before allowing
including general health issues, be cleared for tackle football but may athletic participation.
lifestyle issues such as diet, smoking, be allowed to swim or run track.
drugs, alcohol, and sex, and allows Infectious diseases
the athlete a chance to ask any Conditions That May Lead With most standard viral or bacterial
questions they may have. It is to Disqualification illnesses, the athlete can resume play
important to note that the PPE once they recover. In general, athletic
is not considered to be a thorough Although rare, there are many activity should be avoided if there
medical evaluation, but realistically, conditions that may result in are symptoms below the neck,
it may be the only opportunity for disqualification from some or all sports.
The following are some examples of
conditions requiring disqualification:

THE PRE-PARTICIPATION PHYSICAL EVALUATION AND CONDITIONS RESULTING IN DISQUALIFICATION FROM SPORTS 66
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