Sports Medicine Rounds

September 23, 2004

Paul W. Baumert, Jr., M.D., FAAFP

Overview

•      Purpose of the PPE

•      Specific concerns

•      Recommendations

Purpose of the PPE

•      Identify conditions affecting participation

•      Evaluate general health

•      Provide a preventive medicine opportunity

•      Meet legal and insurance requirements

Primary Areas of Concern

•      Cardiac

•      Musculoskeletal

Cardiac Concerns

•      Related to sudden death

•      1996 AHA consensus panel recommendations

•      Cannot assume previous/high school screenings are complete and accurate

Musculoskeletal Concerns

•      Most common reason for disqualification from sport

•      Previous history of injury is the greatest predictor of future injury

•      Requires skilled examiners

High-risk Behaviors

•      Substance Use

•      Motor Vehicle Accidents

•      Sexual Behavior

Preventive Health Care

•      May be the only opportunity

•      Involves discussing sensitive, personal issues

•      May require innovative, new approaches

Female Athlete Issues

•      Disordered eating/nutritional history

•      Menstrual history

Conclusions

•      The PPE (since NCAA-mandated) serves as a tool

•      Health issues addressed should include:

–   On-field concerns

–   Off-field concerns

–   Female athlete

•      Should always involve primary care physicians with appropriate expertise

References

•       Baumert, P., Henderson, J., and Thompson, N.  Health risk behaviors of adolescent participants in organized sports.  J Adol Health 22(6): 460, 1998.

•       Maron, B., Thompson, P., Puffer, J., et al.  Cardiovascular preparticipation of competitive athletes: a statement for health professionals from the Sudden Death Committee (clinical cardiology) and the Congenital Cardiac Defects Committee (cardiovascular disease in the young), American Heart Association.  Circulation 94: 850, 1996.

•       Nattiv, A., Puffer, J., and Green, G.  Lifestyles and health-risks of collegiate athletes: a multi-center study.  Clin J Sports Med 7: 262, 1997.