Difficulties of the PPE and Preparedness for Injury

March 30, 2013

Physical examinations prior to athletic participation are an important aspect of being prepared for injury in the student-athlete. I don’t know of anybody who would disagree with that, but I believe that we may be complicating matters if we’re not careful. Organizations are recommending comprehensive PPEs and I understand we want to catch as much as we can on the front-end rather than when it occurs on the field. The lack of medical availability in secondary schools is well documented and may make the PPE that much more important. But where do we draw the line?

I was recently asked to consider a specific screening tool and was provided with the test in order to do so. I have since responded to the company with my thoughts. I appreciate their willingness to show me what they offer and part of my response to them spurred this post.

There are several things to consider when we are doing a Pre-Participation Exam.
• Medical History
• Orthopedic Evaluation
• Cardiovascular Evaluation
• Concussion History

But how do we know what is accurate and what is fluff? This may be of biggest concern with the medical history so it is super-important to express to the parent and the student-athlete how important being accurate with this information is. The Illinois High School Association’s form has 55 yes/no answers that must be filled out. ppe

An orthopedic evaluation can be any number of things. It could be as simple as the doctor asking them to perform a couple of quick movements or as complex as something like the Functional Movement Screen (FMS). It’s important to use this information in something meaningful or maybe we’re simply wasting time doing it. Evaluate why we’re looking at it is important. Is it simply because it’s on the sheet of paper?

Cardiovascular screenings are gaining traction with the increased rate of sudden cardiac arrest among athletes. Is it worth the time and money to require each athlete to have an echocardiogram done? Or are our doctors capable of making that determination on an individual basis?

Concussions are here to stay. They are a hot-button topic and one that we have to address. Addressing them as a part of the PPE process is also important but how do we do so? Should we do a BESS test? Maybe the King-Devick Test to have a sideline tool? ImPACT or other form of neurocognitive computer-based testing? All of them have their place, but how do we decide which to include?

Briefly, I’ve suggested upwards of ten different tests we could include in PPEs. What are most important? What are worth our time? What are worth the money? Most importantly, what do all of them tell us?

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One Response to “Difficulties of the PPE and Preparedness for Injury”

  1. TNT Man Says:

    An echo is critical in a high intensity sport. There are too many hidden defects. Cost is a real factor. Tough choices.


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