What are the goals and objectives of the pre-participation evaluation (PPE)?
The overall goal of the PPE is to help maintain the health and
safety of athletes. Its purpose is not to exclude athletes from
participation but to promote safe participation. If not cleared, most
athletes can be rehabilitated or redirected
to another sport. This goal is achieved by adhering to the evaluation's
three primary objectives. The three secondary objectives take advantage
of the doctor-athlete contact.
Primary objectives
- Detect conditions that might predispose the athlete to injury
- Detect conditions that might be life-threatening or disabling
- Meet legal and insurance requirements
Secondary objectives
- Determine general health
- Counsel on health-related issues
- Assess fitness level for specific sports
What are the appropriate time, setting, and structure of the PPE?
Ideally, the PPE should be performed at least six weeks prior to
pre-season practice, allowing time for correction or rehabilitation of
any identified problems. To avoid potential scheduling difficulties, the
PPE might be performed at the end of the previous school year.
Opinions vary regarding how often the young athlete
should be evaluated. In some high schools, a full annual evaluation is
the norm. Another option, followed primarily at the college level, is a
complete evaluation at an entry or new level, followed by an interim
annual evaluation.
The two most common settings for performing the PPE are the doctor's office or in a station-based screening environment.
What are the advantages of office-based PPEs?
An office-based exam is usually performed by the athlete's primary
care doctor. The doctor is familiar with the athlete's medical and
family history. The setting is much quieter and allows for the
discussion of multiple health issues that are pertinent to adolescents.
These include the use of drugs, supplements, and alcohol; sexual
activity; and other topics. Immunization history can be reviewed and
updated accordingly.
What are the advantages of mass PPEs?
These evaluations are less expensive. Multiple specialists can be
involved, such as athletic trainers, physical therapists, orthopaedic
surgeons, family doctors, and pediatricians who have a special interest
in sports medicine.
What are the advantages of office-based PPEs?
An office-based exam is usually performed by the athlete's primary
care doctor. The doctor is familiar with the athlete's medical and
family history. The setting is much quieter and allows for the
discussion of multiple health issues that are pertinent to adolescents.
These include the use of drugs, supplements, and alcohol; sexual
activity; and other topics. Immunization history can be reviewed and
updated accordingly.