Preparticipation sports examination of the child and adolescent athlete: changing views of an old ritual.

The role of the pediatrician in the management of the child athlete has expanded in accord with the burgeoning number of children involved in sports competition. Growing information regarding physiologic responses to exercise in the pediatric age group has added to the importance and utility of this involvement. The scope of the preparticipation evaluation has enlarged in response to these changes; newer issues such as injury prevention, body composition assessment, and athlete education become important in not only assuring safe participation but also optimizing athletic performance. At the same time, the low yield of important findings during these examinations has prompted a reassessment of when, where, and by whom they might be most efficiently conducted.