Refocusing the adolescent preparticipation physical evaluation toward preventive health care.

The traditional preparticipation physical evaluation has come under much scrutiny by sports medicine physicians in recent years, following a number of studies that have found it to be of low yield and not cost effective. There is a general consensus among these researchers that a refocused preparticipation physical evaluation presents an excellent opportunity for health education. In this article, I review recent research that shows that the traditional "head-to-toe" physical exam is unnecessary and is more effectively replaced by a detailed history and focused physical exam. I present current epidemiologic and sociologic data that is pertinent to all health care professionals working with adolescents. Various methods to uncover potential problem areas in the young athletes' lives are also discussed. Each format may be adapted to local or community standards and needs. The approach to the preparticipation physical evaluation presented in the article allows athletic trainers to have an active role in the most important aspect of health care: the prevention of disease and injury.