Home » Health & Safety Channel » General Safety Center » Pre-Participation Physical Evaluations: A Guide for Sports Parents

Pre-Participation Physical Evaluations: A Guide for Sports Parents

Important Injury Prevention Tool, But Not Foolproof

Conditions limiting participation

The ultimate decision on whether to participate is for the athlete and his or her parents to make.

The following abnormalities may make it unsafe for your child to participate in sports:

  • Acute illness
  • Blood-borne pathogens. Because the risk of transmission is so low (less than 1 in 1,000,000 games), HIV-positive athletes may participate unless their health is compromised.
  • Heart disease (hypertrophic cardiomyopathy, rhythm and conduction abnormalities, systemic hypertension, and valvular heart disease, but not benign functional murmur or mild mitral valve prolapse)
  • Skin (contagious lesions or skin conditions should rule out participation in contact sports) 
  • Eating disorder/female athlete triad
  • Eyes (functionally one-eyed athletes permitted only in sports that allow protective eyewear and do not involve projected objects (swimming, track and field, gymnastics, and not allowed to participate in wresting, boxing, or martial arts)
  • Pregnancy (no contact, collision, or strenuous sports)
  • Kidney(no high-contact sports for one-kidney athletes; flack jacket for moderate contact sports)
  • Musculoskeletal (depending on degree and type of injury, risk to athlete, and demands of sport)
  • Seizure disorder (one or more seizures within last 6 months held out of competition, especially in high-risk sports (skiing, gymnastics, high diving, collision sports, shooting, archery)
  • Asthma (but only if symptoms not controlled)


Maron BJ, Thompson PD, Ackerman MJ, Balady G, Berger S, Cohen D, et al. American Heart Association Council on Nutrition, Physical Activity and Metabolism. Recommendations and considerations related to preparticipation screening for cardiovascular abnormalities in competitive athletes 2007 update: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American College of Cardiology Foundation. Circulation 2007;115:1643-455.

Mahle WT, et. al. Key Concepts in the Evaluation of Screening Approaches for Heart Disease in Children and Adolescents. Circulation 2012;125:00-00. DOI: 10.1161/CIR.0b013e3182579f25 (accessed April 30, 2012).

Conley KM, Bolin DJ, Carek PJ, Konin JG, Neal TL, Violette D. National Athletic Trainers' Association Position Statement: Preparticipation Physical Examination and Disqualifying Conditions.  J Athl Tr. 2014;49(1):102-120. doi:10.4085/1062-6050-48.6.05.

Madsen NL, Drezner JA, Salerno JC. The Preparticipation Physical Evaluation: An Analysis of Clinical Practice. Clin J Sports Med. 2014; 24(2):142-149. 

Updated February 1, 2017