PreParticipation Screening - The "Sports Physical"

It's that time of year - the fall sports season is getting closer and "official" practices are about to start. One of the typical requirements for high school sports is the "Sports Physical" or Preparticipation physical evaluations (PPE).

The goal of the PPE is to help maintain the health and safety of athletes. Are there any life-threatening conditions or conditions that may predispose your athlete to injury?

A paper reviewing state high school guidelines published in 2014 stated:

• "Our results show that inconsistencies in PPE policies exist nationwide." 
• 23 states required or recommended use of the most recently updated form (as of 2014) or a modified version of it
• 27 states required or recommended use of outdated or unidentifiable forms
• Ten states had not revised their PPE forms in >5 years
• 41 states required an annual PPE for 9th grade and up
• Only 1 state required a PPE for 8th grade athletes, 13 states for 7th grade, and 10 states for 6th grade.
• As of 2014 12 personal and family history items that were part of a complete PPE. Only 22 states address all 12 items and 15 states addressed fewer than 3 items.
  • "These findings are concerning because a 2012 study ... reported that in 40% of the sudden cardiac arrest cases studied, parents described the presence of at least 1 significant family history component before their child’s sudden cardiac arrest and in 27% of cases, a family member had suffered sudden death before 50 years of age because of a heart condition."

As of May 2019, the American Academy of Pediatrics has published a new monograph of updated guidelines. The history section - the part that you as the parent complete with your student-athlete - has been updated. 

A few things to consider:

1. Has your child's school district updated their forms?
2. The PPE is only required in schools and for 9th graders and above. The requirements for middle school athletes drop off significantly. But what about league and club sports? What about our kids age 5 - 12? These are our least prepared (physically) kids with our most poorly trained coaches.
3. Is the PPE performed as a "mass" examination (image above)? Or is it performed in your child's pediatrician's office by the pediatrician? Is the examination complete? Is it part of the annual wellness examination or performed separately?
   1. A 2019 study found that only 25% of pediatricians always complete all of 6 selected AAP-recommended PPE components.

Read more about the PPE here.

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