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Management Strategies in Athletic Training Ch. 10

Pre-Participation Physical Examination (PPE)
first step in injury prevention; determine athlete’s readiness to particpate in chose sport; must:
1. identify disease or processes that will affect the athlete
2. be sensitive and accurate
3. be practical and affordable
Labeling options for participation clearance
1. passed
2. passed with conditions: require follow-up but may still participate
3. passed with reservations: may not participate in contact sports
4. failed with reservations: not cleared for requested sport (contact) but may do other sports
5. failed with conditions: may be reevaluated after medical condition is resolved
6. failed: no participation whatsoever
Why PPEs are performed
1. injury and illness prevention
2. compliance with association rules
3. education and counseling of athletes
4. compliance with standards of practice
HEADSS topics for education
Home life, Education, Activities, Drugs, Sex, Suicide
Ideal time to conduct PPEs
6-8 weeks prior to vigorous sport training
Health history updates
every athlete will require full physical when starting with an organization, but may need only health history updates thereafter; MINIMAL standard
Percentage of overall findings from PPE warranting follow-up
14%
Common elements of PPE
1. health history: best predictive, important part
2. physical examination
3. orthopedic examination: ROM, flexibility, accessory joint motion, muscle strength
4. special medical tests
5. physical fitness testing: not medically necessary; should be the last element of PPE
Most athletic injuries are:
reinjuries
Two important legal considerations to PPEs
consent, waiver of liability
Why to perform drug testing:
promote order and discipline, prevent or discourage illegal activity, deterrent to unfair competitive advantage
NCAA reasons:
eliminate the unfair advantage for a level playing field, eliminate athlete’s pressure to take drugs (safeguard health and safety)
When drug testing should be performed:
post-championship testing, preseason testing, year-round testing, in-house testing
Most common first level test
enzyme multiplied immunoassay technique (EMIT) ; uses light absorption and high in false-positives
Positive EMIT test must be confirmed by:
gas chromatography-mass spectrometry (GC-MS); gold standard
Liquid chromatography-mass spectrometry (LC/MS/MS)
may best keep up with designer drug strands
Two publishers of banned drug lists:
NCAA and Olympics
Common banned drugs:
stimulants, anabolic agents, diuretics, street drugs, peptide hormones and analogs
Ways to legally protect drug testing process:
1. develop written policies and procedures
2. clearly articulate the purpose of the program
3. make testing as sport-specific as possible
4. use valid and reliable measures
5. incorporate and appeal mechanism
6. protect the athlete’s privacy
7. obtain consent
8. inform potential athletes
9. inform current athletes
10. train and retrain personnel

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