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There is substantial risk of injury in most sports. The purpose of the
preparticipation physical examination is to "prevent life-threatening or
disabling injuries by identifying predisposing factors,
recommending preparatory and/or rehabilitative measures, and
assisting in matching the participant with an appropriate sport
and/or position." (Olympic Sports Medicine)
The examination should occur at least six weeks prior to preseason
practice. A complete medical history should be taken
which must include prior history of illness, injury, and surgery; drugs
taken; drug allergies; history of heart disease, hypertension, kidney
disease, dizzy spells, concussion, loss of consciousness, asthma,
allergies, diabetes; glasses or contacts; dental appliances; last
tetanus shot; and family history of heart disease, hypertension, stroke.
For girls, a history of the first menstrual period and the longest time
between periods is important.
The standard components of the PPE are height, weight, blood pressure,
pulse (radial and femoral) and examination of the eyes (visual
acuity and differences in pupil size), ears, nose,
throat,lungs, heart (rate rhythm and murmurs), skin (rashes and lesions),
abdomen (masses, tenderness, enlarged organs), neurological testing,
and stage of pubertal development must be completed.
For boys, the genitalia are examined for single or
undescended testes, testicular mass, and hernia.
A detailed assessment of the musculoskeletal system including contour and
and symmetry of the neck, back, shoulder/arm, elbow/forearm, wrist/hand,
hip/thigh, knee, and leg/ankle are performed. Any asymmetry, deformities
or swelling must be further examined. The ranges of motion of the shoulder, elbow, wrist, hand, hip, knee,
ankle and foot and the cervical, thoracic and lumbar spine aretaken.
General muscle strength of these areas is checked.
Often forgotten is checking flexibility (there is no such
thing as being double jointed - sometimes the ligaments are extremely
lax which allows greatly increased ranges of movement. This can
predispose the child to injury). Discuss any positive findings with the
examining doctor to determine if it is safe for your child to participate.
See
12-step screening may help reduce sudden death in young athletes
The screening includes 12 questions about personal and family medical history and a physical
examination to uncover aspects of a potential athlete’s health that could signal a cardiovascular problem:
Personal history
-Chest pain/discomfort upon exertion
-Unexplained fainting or near-fainting
-Excessive and unexplained fatigue associated with exercise
-Heart murmur
-High blood pressure
-Family history
-One or more relatives who died of heart disease (sudden/unexpected or otherwise) before age 50
-Close relative under age 50 with disability from heart disease
-Specific knowledge of certain cardiac conditions in family members: hypertrophic or dilated cardiomyopathy
in which the heart cavity or wall becomes enlarged, long QT syndrome which affects the heart’s electrical
rhythm, Marfan syndrome in which the walls of the heart’s major arteries are weakened, or clinically
important arrhythmias or heart rhythms.
-Physical examination
-Heart murmur
-Femoral pulses (groin pulse) to exclude narrowing of the aorta
-Physical appearance of Marfan syndrome
People with Marfan syndrome tend to have tall and slender bodies with arms and legs
disproportionately long compared to the trunk. They also usually have long fingers and toes.
The ligaments and joints are typically loose. Because of rib overgrowth, the chest may protrude
or be indented. Abnormal curving of the spine, called scoliosis (sko-le-O-sis), lordosis
(lor-DO-sis), or kyphosis (ki-FO-sis), can occur.
-Brachial artery (Upper Arm) blood pressure (taken in a sitting position)
See
The Preparticipation Physical Examination and
Contraindications to Athletic Participation in
Physician and Sports Medicine.
To order a copy of Preparticipation Physical Evaluation, call the
Physician and Sports Medicine at 1-800-262-4729 and
request ISBN #001627-5. The cost is $29.95 plus shipping and handling.
See
Position Paper on the Pre-Participation Physical Examination by the
American Chiropractic Board of Sports Physicians
and
Athletic Participation By Children and Adolescents
Who Have Systemic Hypertension
and
Ohio High School Athletic Association Preparticipation Examination
Form
and
Minnesota State High School League Preparticipation Examination
Form
Some interesting facts about football from the National Athletic Trainers Association
(NATA):
· For the 1,046,624 high school students who play football,
it is projected that approximately 39% will sustain a reportable injury.
· 61.2% of injuries occur during practice. 38.8% occur during
games.
· The most commonly injured body part (17.3%) is the hip/leg/
thigh area. 15.0% affect the forearm/wrist/hand, 14.5% the knee,
14.2% the ankle, 11.3% the head/neck/spine, and10.4% the shoulder/arm.
· The most common classification of injury is general trauma,
followed by sprains and strains. 5.7% of the injuries result in
fractures.
Here are some guidelines to minimize the risk of injury:
· Get in shape before the season. This means building
strength, improving cardiovascular fitness and increasing flexibility.
· Practice sound nutritional habits all year by following a
diet which is 50-60% carbohydrates, 20-25% fat, and 15-20% protein.
There is no miracle supplement!
· Hydrate, hydrate, hydrate - that means WATER! Athletes
need to drink 10-12 eight ounce glasses of water per day. Drink
before, during (every 45 minutes) and after practice (the rest of
the day)!
· Wear properly fitting equipment, i.e.. head gear, protective
pads, mouth guards and shoes.
· Perform a proper warm-up and cool down.
· All injuries should be evaluated immediately by a trained
health care professional.
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PREPARTICIPATION EXAMINATION - CHILDREN IN SPORTS