Health > The Pre-participation Physical Evaluation

By: Kayla Fulghum, ATC

Every year thousands of athletes undergo a pre-participation physical evaluation. Physicals can identify an athlete who may be at risk for injury before he or she participates in a sport. The physical can reveal conditions that can warrant disqualification from participation in all or certain sports or it could warrant the use of special equipment such as a brace or eye glasses. The physical evaluation also sets a baseline in case of injury. This allows the athletic trainer to help the athlete get back to or as close to his or her original physical condition after an injury.

The pre-participation physical evaluation is administered by a family physician or by a group of individuals who work together with physicians and are trained in assessing the health of an athlete such as a Certified Athletic Trainer. Most often, an athlete’s annual physical evaluation is completed by a medical doctor in a private-practice setting. If the physician is the athlete’s primary-care physician then the doctor is more familiar with the medical history and the past health conditions of the athlete.

Another system of administering pre-participation evaluations is a station evaluation. The station evaluation can handle a large number of athletes at the same time and it is organized by stations using a group of individuals in the medical profession. The Institute of Athletic Heath Care and Research, Inc. (Columbus, Georgia) has screened over 36,000 athletes since 1976 using the station evaluation method. The Institute performs screenings once a year in the month of July.  Volunteers who help administer the evaluations at each station include medical doctors, dentists, certified athletic trainers, physical therapists, physician assistants, nurses, and other allied-health personnel.  Parents and coaches also assist in making these screenings possible.   

The evaluations include a medical history, height, weight, blood pressure, pulse rate, dental screening, vision screening, general medical screening, musculoskeletal exam, orthopedic screening, body composition, and a number of fitness assessments. After all the screenings are complete, then a physician will determine whether the athlete can participate in athletics or if there are any limitations for the athlete.

The following sections are included in the station pre-participation physical evaluation:

1. Medical History – The athlete’s medical history is recorded first. The medical history is a series of questions concerning any previous injuries or the athlete’s family history of certain diseases. Not only are past medical problems assessed but questions about existing medical conditions are also asked in the medical history section. The medical history is reviewed by the physician and the athletic trainer for certain signs and symptoms of disease. Participation release forms and insurance information sheets are often completed during the medical history section of the physical.

2. Physical Evaluation – The physical evaluation is comprised of many stations and often involves a number of volunteers to work each station. Height, weight, blood pressure, body composition, pulse, and sometimes vision exams can be performed by athletic trainers, nurses or physician assistants. Then the physician will examine the athlete’s skin, ears, nose, and throat and may also perform a dental exam. The physician will also listen to the heart and lungs and examine the abdomen, lymphatics, and the maturation of the athlete.
   
   

3. Cardiovascular Screening – The purpose of this screening is to identify any life-threatening conditions. The physician listens for abnormal sounds that may have developed in the past year or that has been missed in previous physicals. Abnormal sounds during a physical warrants referral to a cardiologist for additional tests before clearance.

4. Orthopedic Screening - This part of the physical is often completed by an athletic trainer or by an orthopaedist who specializes in sports medicine. The athlete’s flexibility and strength is assessed and he or she is checked for signs of scoliosis. If there is a previous injury, the athlete will undergo a series of tests to check the integrity of the injured area. If any new injury has occurred and needs special attention, a referral to an orthopedist will be made.

All parts of the pre-participation physical evaluation come together to assess the athlete’s overall health level. Clearance is made at the end of the screening by a state licensed physician who has reviewed the athlete’s history and has performed the general examination. Often, for those who are not cleared, there are certain criteria that have to be met before they can be cleared. In rare cases, it is found that playing sports could endanger or threaten the health of the athlete. If this happens, the athlete is denied participation or another sport is recommended. No matter the outcome, the pre-participation evaluation is one of the best tools to help prevent athletic injuries.

Institute of Athletic Health Care and Research, Inc.