Millions of children participate in sports. To ensure safe participation during practice and competition, the AAP encourages youth to receive a preparticipation physical evaluation (sport physical) as part of their routine health supervision visit. The information on these pages can help pediatricians understand the impact sports physicals have on children's lives.
Preparticipation Physical Evaluation Overview
The PPE, also known as the sports physical, ideally will be conducted in the medical home during the health supervision appointment by the athlete’s primary care provider. If this is not possible, the PPE should be conducted at least 6 weeks before the first preseason practice to allow time to evaluate the athlete and treat any medical conditions found during the visit.
The frequency of a PPE is determined by the state. Learn more about your state PPE law.
The Preparticipation Physical Evaluation (PPE) Monograph, 5th Edition serves as a resource for medical providers to keep athletes safe and healthy while participating in sports. It provides helpful guidance on the proper timing, setting and structure of the evaluation to improve the health and well being of athletes. Find it on shopAAP.
The PPE was developed by the American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine and the American Osteopathic Academy of Sports Medicine. It is also endorsed by the National Athletic Trainers’ Association and the National Federation of State High School Associations.
Depending on state law, the PPE examination is conducted by an MD, DO, nurse practitioner or physician assistant with clinical training to evaluate and determine medical eligibility of the athlete on a broad range of health issues.
Forms are available to download. Please contact firstname.lastname@example.org if forms will be integrated into an EHR.
Medical History Forms
We encourage athletes or their families to fill out a medical history form before the examination that includes standard elements important to consider in evaluating the patient’s eligibility to participate in sports. The forms are available as downloadable forms in English and Spanish.
The primary care provider should review the medical history in a private setting with the athlete and their guardian and again in private with the athlete should there be any confidential information the athlete would like to discuss.
Physical Evaluation Form
The PPE physical evaluation form guides primary care providers in conducting a system-based examination to include cardiovascular, nervous system, general medical conditions, respiratory system, gastrointestinal and urogenital, dermatological, musculoskeletal and mental health.
When determining medical eligibility, the primary care provider should have expereince in evaluating athletes and determining if they are medically able to compete. Examinations in locker rooms or gymnasiums are discouraged as it does not provide the athlete with a confidential space for the PPE.
After the examination, the primary care provider can find the athlete:
- medically eligible for sports without restrictions
- medically eligible for sports without restriction, but further evaluation needed
- medically eligible for certain sports listed on the form
- not medically eligible for any sports, pending further evaluation
- not medically eligible for any sports
The PPE writing group has developed a standard medical eligibility form.
A supplemental history form for Athletes with a Disability is also available. Please note this form should not be used in place of the Special Olympics form.
If the child is participating in the Special Olympics please use:
Special Olympics Medical Form Special Olympics Medical Form Instructions Special Olympics Article 1 Sports Rules (appendix E)
Podcasts and Voices Blogs
Learn what others are saying. Listen to our podcasts and read our blog posts.
Return to Sports Guidelines - Episode 49
Hosts David Hill, MD, FAAP, and Joanna Parga-Belinkie, MD, FAAP, talk to Susannah Briskin, MD, FAAP, lead author of the AAP Covid-19 Guidance: Return to Sport, about infection prevention during youth sports and safely returning to physical activity after recovering from COVID-19.
Pediatrics on Call|
March 9, 2021
American Academy of Pediatrics