Preparticipation sports examinations. Efficient risk assessment in children and adolescents.

Whether preparticipation sports examinations are necessary and what they should include are matters of debate, especially in the young because of the low yield of new medical diagnoses. The goal of the examining physician is to determine whether the athlete is mentally, developmentally, and physically capable of safely competing in recreational and competitive sports. We recommend that examinations precede the start of an activity by 4 to 6 weeks and be done every 3 years. History taking should include parental input and a private interview with the athlete when possible. The specific areas of the body to be used in a particular sport should be emphasized in the physical examination, and the amount of contact and energy required should be considered. Abnormal findings should be thoroughly evaluated to rule out risk of injury or sudden death before approval to participate is granted.