The Pre-Participation Physical Examination (PPE)

The fall sports season is quickly approaching… has your athlete had his or her pre-participation exam (PPE) yet?


The pre-participation examination, or PPE, is a thorough medical evaluation that involves past medical history, sport-specific history, family history and a physical exam. The PPE is best done in a medical setting to ensure proper equipment and appropriate privacy; however, the large number of athletes involved, limited time for the exam and deadlines for participation often require the PPE to be done in a format of multiple “stations,” with several health care providers each focusing on their area of expertise.


The purpose of the PPE is not to disqualify or exclude an athlete from competition, but rather to help maintain the health and safety of the athlete in training and competition. The goals of the PPE are:

  • Identify medical and orthopedic problems that may place the athlete at risk for injury or illness;
  • Identify correctable problems that may impair the athlete’s ability to perform;
  • Maintain the health and safety of the athlete;
  • Assess fitness level for specific sports;
  • Educate athletes and parents concerning sports, exercise, injuries and other health related issues; and
  • Meet legal and insurance requirements.


After a thorough history and physical exam, the health care provider will make a participation decision (cleared to participate, temporary disqualification or permanent disqualification) by answering the following questions:

  • Is there a problem that places the athlete at increased risk of injury?
  • Is any other participant at risk of injury because of this problem?
  • Can the athlete safely participate with treatment of the problem?
  • Can limited participation be allowed while treatment is indicated?
  • If clearance is denied for certain activities, in what activities can they safely participate?
  • Is consultation with another healthcare provider necessary to answer the above question?

Overall, most athletes are cleared to participate in their sport. According to some studies, less than 2% of athletes are denied clearance. A few more athletes require further evaluation, about 13%, and most often that is for physical therapy, nutritional counseling or referral for previously unknown hypertension.


  • PPEs are often required for participation in middle school, high school, college and professional sports and may be performed in a medical office or group evaluation setting.
  • Although the PPE may identify health problems or needs not associated with exercise, it should not be used to replace ongoing medical care or routine check-ups with primary care physicians.


Most local schools sponsor a group PPE event offered at low cost to the athlete. If you missed your local PPE event or your school does not offer one, the PPE can be done by your primary care physician or sports medicine physician.

PPEs now offered at El Dorado Hills Sports Medicine!

As a physician, Dr. Preiss-Farzanegan is trained in the diagnosis and management of medical issues and she has further specialized training in sports medicine, including the administration of PPEs. Call today for a PPE appointment!

To learn more, click here to access PPE information from the American College of Sports Medicine (ACSM).