Updated guidance for the sports physical examination includes expand sections on female athletes and athletes with disabilities and a new section on transgender athletes. The recommendations also include information on legal and ethical issues regarding these exams.

The publication, “Preparticipation Physical Evaluation (PPE) Monograph, 5th Edition; which was jointly produced by the American Academy of Pediatrics (AAP), the American Academy of Family Physicians; so the American College of Sports Medicine, the American Medical Society for Sports Medicine; so the American Osteopathic Academy of Sports Medicine, and the American Orthopaedic Society for Sports Medicine.

Eligibility to participate in sports

PPEs are use to determine eligibility to participate in sports and sport camps for youth from middle school through college. How often PPEs should be perform varies by state; but they are typically require every 1 to 3 years. Other requirements may also differ. They can be determine by various athletic organizations; so high school state athletic/activity associations, or state law.

The sports physical can alert us to any red flags if a family is predispose to a condition or illness,” William O. Roberts, MD, FACSM, FAAFP, coeditor of the publication, said in an American Academy of Pediatrics news release. “For instance, if a parent or sibling has a history of heart disease or if the child has had prior concussions; so the primary care physician would want to know that for future monitoring.

The authors say athletes or their families should complete a medical history form prior to the examination. Medical history forms in English and Spanish, a physical evaluation form, a medical eligibility form; also forms relate to athletes with disabilities are available on the AAP website.

Chapter on transgender issues

Other changes to the recommendations are the addition of a chapter on transgender issues; so as well as expand chapters on athletes with disabilities and female athletes, Roberts said. The evaluation form includes a question on sexual identity at birth and identifying gender. The clinician should review the medical history with the athlete and their guardian privately; also then again privately with the athlete to give the athlete an opportunity to discuss confidential information.

When an athlete is medically ineligible to participate in a sport or all sports, the questions of who needs to know of the restriction and how this should be communicate frequently arise,” they write. Coaches and school administrators can be told that the student isn’t eligible to participate without violating the Health Insurance Portability and Accountability Act or other privacy laws. Further explanation may require a sign medical release.

They also uses routine healthcare visits to encourage his patients to participate in sports and “develop a lifelong habit of physical activity. Bernhardt agrees: “Every patient coming into your clinic should be consider an athlete, as we are in the business of promoting wellness and physical activity. They want every child to get exercise, whether that’s on the playground, on a bike, a hike, or skateboard,” they said in the news release.