Welcome to Stay in the Game, a monthly blog where the team from the Queen's Center for Sports Medicine shares the latest tips on the treatment and prevention of sports injuries. We want to help you play hard and be well - a winning combination that will keep you in the game all season long.

Sports pre-participation evaluation


It's back-to-school season! As you prepare your child for the upcoming school year, don't forget about the all-important: sports physical. The State of Hawaii Department of Education requires that students obtain medical clearance prior to their sports season, and Dr. Rachel Coel, Medical Director at the Queen's Center for Sports Medicine, explains what it is and how to prepare.

What is it?

To participate in school sports, the State of Hawaii Department of Education requires that students obtain medical clearance prior to their sports season. The pre-participation evaluation, or PPE, can be completed by your child's primary care doctor, pediatrician or your family doctor. The purpose of the PPE is to screen for medical conditions that may place your child at risk of illness or injury during sports activity. A thorough medical history and physical exam can reduce risks if your child's doctor finds anything during the PPE that needs further evaluation.

Getting the PPE done by your child's primary doctor is helpful so they can check your child's full medical records and ensure that all vaccinations are up-to-date, or can schedule any shots that may be needed. Finally, your doctor may also use your PPE visit to discuss important health issues related to sports, including:

•  proper sleep
•  nutrition
•  hydration
•  steroid and drug use
•  puberty and hormone changes
•  mental health concerns such as stress, depression or anxiety

What does the PPE entail?

The first part of the pre-participation evaluation includes a detailed medical history. This portion includes a thorough set of questions about the athlete's current and prior injuries and illnesses, as well as questions about medical problems that may run in the family. Examples may include questions about concussions, sprains and strains, broken bones, chest pain or shortness of breath during exercise, and family history of heart problems or sudden death. Your child's doctor should review your answers with you to address any concerning medical conditions.

The second part of the PPE is a physical exam. During this part of the evaluation, the doctor will examine your child from head to toe:

•  looking in the eyes, ears, and mouth;
•  listening to the heart and lungs;
•  assess movement in the arms and legs;
•  checking the neck and back.

Vision should also be tested, and blood pressure, height, weight, and pulse will be recorded. Most PPE exams do not typically include drawing blood for lab studies, but some doctors may order an electrocardiogram (ECG) to study the heart in more detail.

For sport-specific concerns, your child's doctor may spend extra time on certain parts of the history or physical exam based on the sport(s) played. For example, a baseball pitcher may get a more detailed exam of the shoulder and elbow on the throwing arm, as these injuries could greatly impact a pitcher's performance and safety. Likewise, a doctor may spend more time examining the lower back of a gymnast or dancer, as these activities place more strain on the back.

How should you prepare?

One of the most important things you can do to prepare for the pre-participation physical exam is to carefully review your child's medical history questions and answer honestly. It is very important for you to know about your own health history, as well as any family health issues, especially heart disease, any sudden or unexplained deaths, or family deaths under the age 50. These answers may help your doctor assess other health conditions to be aware of for your child.

The pre-participation evaluation is an important safety measure for all youth sport athletes. It is a good idea to get a head start to get the sports physical done, so your athlete can be prepared for their sports season ahead.

The Queen's Center for Sports Medicine provides comprehensive care for the treatment and prevention of sports injuries and conditions for patients of all ages. To make an appointment, call 808-691-4449 or click the button below.

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