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INTRODUCTION

A comprehensive sports medicine program should incorporate sports pre-participation screening and injury prevention. Physical activity promotion, athletic pre-participation examination, and exercise prescription are other essential aspects of sports medicine that comprise the focus of this chapter.

ATHLETIC PRE-PARTICIPATION EXAMINATION

The athletic pre-participation examination (PPE) is a standard sports medicine practice with the primary goal of providing medical clearance for sports participation and promoting the health and safety of athletes in training and competition. The aims of the PPE include identifying medical conditions and musculoskeletal injuries that require treatment or that may be associated with an increased risk of morbidity or mortality during sports participation. Please see Figs. 26–1 and 26–2 for examples of a preparticipation physical examination and a clearance form.

Figure 26–1

Example of a preparticipation examination form.2 (©2010 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, and American Osteopathic Academy of Sports Medicine. Permission is granted to reprint for noncommercial, educational purposes with acknowledgment.)

Figure 26–2

Sample clearance form.2 (©2010 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, and American Osteopathic Academy of Sports Medicine. Permission is granted to reprint for noncommercial, educational purposes with acknowledgment.)

The PPE timing, frequency, and protocol are determined by individual sport governing bodies. Generally, it is advised that the PPE is performed prior to initial participation in organized sports teams, with interim medical history updates and physician follow-up as indicated, usually annually.

Most PPEs occur during individual medical office visits or in a station-based mass athlete screening setting. There are advantages and disadvantages to both methods, including differences in cost, privacy, efficiency, continuity of care, and ease of education and counseling.1

The PPE should include taking a general medical history of prior and existing medical conditions and musculoskeletal injuries, exercise history, prior hospitalizations or surgeries, family and social history, medications, supplements, and medication and environmental allergies. Critical elements of the physical examination include general appearance; vital signs; vision screening; examination of the cardiac, pulmonary, abdominal, musculoskeletal, and dermatological systems; and genitourinary examination in males. A comprehensive PPE form has been created through the collaboration of the American College of Sports Medicine (ACSM), American Academy of Family Physicians, American Academy of Pediatrics (AAP), American Medical Society for Sports Medicine, American Orthopedic Society for Sports Medicine, and American Osteopathic Academy of Sports and is available through the AAP and shown in Figures 26–1 and 26–2.2 Routine laboratory testing and imaging tests are not recommended as a part of the ...

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