Timing And Frequency

The preparticipation examination should be done at least 6 weeks prior to beginning the sport season to allow time for rehabilitation of old injuries, improvement of flexibility and strength, and further evaluation of any illness or injury that may restrict participation. A complete preparticipation examination should be done upon entry to junior high, high school, and college. Screening history and blood pressure monitoring should be done in subsequent years. In addition, a more detailed examination on identified areas of illness and injury that occurred during the previous year should also be performed. This is the process that is endorsed by the National Collegiate Athletic Association, but few states have seen fit to follow.7

For those athletes older than the age of 35, the American Heart Association recommends exercise testing in men older than 40 years of age and women older than 50 who have one or more cardiac risk factors and/or symptoms of chest pain, palpitations, or syncope. Athletes who are 65 years or older and athletes with a history of coronary artery disease with or without symptoms should have an exercise stress test regardless of risk factors.8 When athletes are not allowed to participate in their sport, recommendations should be made for activity that is appropriate.

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