1 | 2 | 3

PPE: Components of Exam

• Medical history. Providing a complete medical historyis the most critical component of the PPE. Because athletes tend to forget important information and because parents have great knowledge of family medical history, the form should be completed by both athlete and parent.

• Physical Exam (key components)

• Height and weight. A sudden weight change may indicate the presence of disordered eating/female athlete triad or use of performance enhancing drugs (large gain in muscle mass that cannot be explained by weight training alone)

• Eyes, ears, nose, throat: Visual acuity, pupil size, visual correction. Bloodshot eyes or discolored teeth may be signs of an eating disorder

• Cardiovascular (blood pressure, pulse, listening to the heart to check for murmur, hypertrophic cardiomyopathy)
  
  In contrast to some other countries (such as Italy), the standard of care in the United States, according to American Heart Association, is not to include an electrocardiogram (EKG) or echocardiogram (ultrasound of heart) as a routine part of the PPE in the belief that a complete and careful personal and family history and physical exam designed to identify or raise suspicion of heart problems are most cost-effective (particularly in light of the fact that the ability to detect life-threatening cardiac abnormalities is only marginally improved by additional non-invasive testing, which often leads to false positive results in athletes because of their intense training) Only athletes who have symptoms or significant family medical history should be further evaluated with specific diagnostic tests (i.e. echocardiogram etc.). Remember also that sudden cardiac death in youth athletes is extremely rare (about 300 deaths per year)

• Lungs

• Abdomen (infectious mononucleosis should rule out contact or strenuous sports participation for at least 3 weeks after onset due to risk of spleen rupture)

• Skin (Impetigo, herpes simplex, scabies, rashes, infections, and infestations; increased acne, especially on back, face and chest, abnormally large breasts in males (gynecomastia), stretch marks (cutaneous striae)) may indicate steroid use)

• Musculoskeletal. There are three different types of screening exams:

• General (quick assessment of range of motion, gross muscle strength, and muscle asymmetry, identification of significant injuries; appropriate for athletes with no injury symptoms)

• Joint-specific testing (much more thorough than general screen but significantly more time consuming; perform only if athlete has symptoms of current injury or history of previous injury, weakness or instability)

• Sport-specific testing (focus on areas of greatest stress for particular sport; for example, runners would be assessed for knee and ankle instability, strength and flexibility; recommended only for highly competitive athletes)

• Neurologic: Only performed if musculoskeletal exam is abnormal or on athletes with a history of concussions.

IMPORTANT MESSAGE You are on the Old MomsTeam.com website. This article has been updated and moved to the new website. Click here to be redirected to the new site or copy and paste into your browser: http://www.momsteam.com

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, 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)

1 | 2 | 3