The Importance of the Pre-Participation Physical Exam
Added by Katie Boushie on August 26, 2013.
As summer draws to a close, many fall sports are in the midst of preseason. One important aspect of safely partaking in sports is a complete and accurate pre-participation physical exam. Most schools require a pre-participation exam, but I will focus on youth sports (middle and high school) for this article. There are two types of exams commonly used in schools; an individual exam given by the child’s physician and a mass screening held at the school.
Either style of exam is adequate, as long as it takes an in depth and comprehensive medical history. Mass screenings are more common because they cost less, and guarantee compliance. Regardless, the exam should also include vitals, vision testing, a general medical exam, and fitness testing. The medical exam is the most important aspect because it identifies athletes that are at risk for and suffer from medical conditions that require further evaluation. Obviously, the medical exam is only helpful as long as it is accurate. Finding out athletes’ medical concerns is not meant to exclude anyone from sports, but to be as prepared and educated as possible should there ever be any need for medical treatment. A good medical history will help identify athletes with heart conditions and a history of concussions, two concerns that would not be discovered in a general medical exam.
Any child that may have or be at risk for a heart condition will benefit from an ECG to determine if they have Hypertrophic Cardiomyopathy, a rare heart condition that can result in sudden death. Currently, many health professionals advocate that all athletic participants should have an ECG; however, this is currently not financially feasible for many people. Similarly, receiving a pre-participation exam from the child’s physician may be the most thorough method, but not all children have this option.
Cardiovascular Screening History for Preparticipation Examinations: Critical Questions
|Exertional chest pain or discomfort, or shortness of breath?
|Exertional syncope or near-syncope, or unexpected fatigue?
|Past detection of cardiac murmur or systemic hypertension?
|Known family history of hypertrophic cardiomyopathy, other cardiomyopathies, long QT syndrome, Marfan syndrome, significant dysrhythmias?
|Family history of premature death or known disabling cardiovascular disease in a first- or second-order relative younger than 50 years? (More concern if younger than 40 years.)Source: http://www.aafp.org
Pre-participation exams are extremely valuable for both the school and the athlete. For the institution, they act as legal protection as the student and parent are acknowledging the risk associated with sports. As long as they are truthfully completed, the exam benefits the athlete, as the athletic trainer and school personnel will be adequately educated and prepared for any known medical conditions.