Pre-Participation Examinations are an Important Opportunity

By Mike McKenney, MS, ATC, NASM-CES

Pre-participation examinations (PPEs) are often considered a nucleus of densely packed chaotic activity with numerous orbiting particles and a singular goal in mind: to determine if an individual can safely participate in athletic activity.  PPEs come in all shapes and sizes ranging from full movement screens with performance testing, to simply collecting paperwork.  While this process is often fraught with mountains of paperwork and stress, we must not lose sight of what it really is: an opportunity.

During the PPE process, we have the opportunity to see into an athlete’s medical history, and analyze the information for red flags or other points of emphasis that may negatively impact their ability to participate safely.  A prime example can be found in the newly published NATA position statement on exertional heat illness.1 Table 2 in this document contains questions to include in PPE questionnaires or verbal screenings to help identify athletes who may be at risk for heat illness.  Additionally, the NATA position statement2 on pre-participation physical examinations contains numerous other recommendations to discover potentially harmful conditions.  But once these potentially serious conditions are ruled out, what other opportunities exist in a PPE?

Arguably, one of the most unique domains of athletic training is injury prevention, and the PPE process can be a source of information to prevent orthopedic injury.  In addition to an in-depth history2, there are many types of movement screens and technologies available that can be employed to establish a baseline movement profile.  This information can be used to guide rehabilitation and strength training strategies focusing on targeting areas of opportunity for each athlete.  However, in order for this process to be effective, the Athletic Trainer must act on the information they obtain.  Similar to pre-participation questionnaires, the results of movement screens are meaningless if they do not influence the decision-making of the sports medicine team.  It is crucial to implement an early intervention for an abnormal movement pattern that could potentially have an adverse effect on an athlete’s participation.

Similar to an annual review of your athletes’ health records, taking time to review your current PPE process to evaluate weaknesses and strengths is always a useful exercise.  It is also never too late to review available literature and add to your PPE for an upcoming season or for next year.  Further information can be found in the 2 sources included in this post, which provide an evidence-based guide to planning your next PPE, including instructions for a basic movement screen.2


1. Casa DJ, DeMartini JK, Bergeron MF, et al. National Athletic Trainers’ Association position statement: exertional heat Illnesses. J Athl Train. 2015;50(9):000-000

2. Conley KM, Bolin DJ, Carek PJ, et al. National Athletic Trainers’ Association position statement: Preparticipation physical examinations and disqualifying conditions. J Athl Train. 2014;49(1):102-120.