Most teens who participate in sports are anxious to get in the game. For their safety, however, many schools require a sports physical, also called a pre-participation exam (PPE), before an athlete is cleared to play. In the United States, millions of athletes — including teens — undergo sports physicals before they can begin competing.

Why are sports physicals necessary?

Sports physicals are intended to determine if an athlete is healthy enough to participate in sports and to help minimize the risk of sports-related injuries. Athletes are seeking medical clearance so they can train and compete safely.

The physical is designed to identify any high-risk disorder or condition that might affect an athlete's ability to play. The exam might also help determine the athlete's safe level of activity, which can have an impact on performance. If an existing injury or potential problem is identified during the sports exam, action can be taken to avoid future problems and to rehabilitate an existing injury.

The extent of the physical varies among doctors, but the goals of the exam are generally the same. Among the goals of the exam are to evaluate:

  • The athlete's general health
  • The athlete's current fitness level
  • Any existing injuries
  • Any condition that might increase the athlete's risk of injury
  • The athlete's level of physical maturity

When are sports physical done?

There is no hard and fast rule about when an athlete should have a participation physical, but six weeks before the start of the sport season begins is often recommended. This timing provides an opportunity to rehabilitate an existing injury or improve conditioning prior to participation in the activity. Proper conditioning is important because it can help prevent future injuries.

If the timing of the physical is too near the start of the season, there might not be time for an athlete to address any condition or injury, and the athlete might not be cleared to play.

In some cases, if there is not enough time to get healthy, an athlete might have to sit out part of the season.

Who conducts sports physicals?

The athlete's personal doctor might perform the exam. In some cases, the school will set aside time for a doctor or doctors to conduct sports physicals on site. In some cases, a physician's assistant or athletic trainer will assist with the exams.

Physical exams completed by the athlete's personal doctor are most likely to be complete exams, while exams offered by the school are more limited and not a substitute for an annual exam with the athlete's doctor.

What happens during a sports physical?

There are two components of the physical: the medical history and the physical exam. The history is an important tool in identifying conditions that might affect an individual's ability to participate and/or perform in sports. Issues addressed during the history include:

  • Status of immunizations, particularly tetanus
  • History of excessive weight loss or gain (This can suggest an eating disorder, such as anorexia or crash dieting.)
  • History of asthma
  • Family history of serious illnesses
  • Episodes of dizziness or collapse during activity
  • Menstrual history
  • Use of contact lenses or dental appliances
  • History of past conditions such as fractures, concussions, and heat illness
  • Allergies
  • Use of drugs, alcohol, dietary supplements, and/or performance enhancing drugs, such as steroids

The focus of the physical exam might include an evaluation of:

  • Lungs
  • Height and weight
  • Blood pressure
  • Vision
  • Heart (This is done to look for conditions such as murmurs and irregular heartbeat.)
  • Abdomen
  • Genitals

The exam might also include an evaluation of musculoskeletal issues such as posture, scoliosis, joint range of motion, knee extension, gait, and function of the arms and legs.

An assessment of the athlete's flexibility and endurance might also be conducted. The doctor, a coach, or an athletic trainer might perform this portion of the exam.

If the exam reveals nothing abnormal, the doctor will sign a form stating the athlete is cleared to participate in sports.

What happens if the doctor finds a problem?

The exam helps the doctor identify any conditions or problems that might keep the athlete out of the game or affect performance. If a problem is discovered, the doctor and athlete often can work together to develop a plan to get the athlete ready for competition.

If the doctor finds a problem, he or she might recommend certain tests and a follow-up exam. In many cases, the doctor can suggest treatment or a plan to rehabilitate an existing injury to get the athlete ready when the sport season begins. The doctor conducting the exam also works with parents and coaches to assist an athlete with a medical condition to compete safely.

If there are no abnormal findings during the exam, the athlete will be cleared to participate in his or her sport. It is important, however, that the athlete report any changes in his or her physical condition, because early diagnosis and treatment can help get the athlete back on track and back in the game.


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