Preparticipation Evaluation, Rehabilitation, and Return to Play
The PPE is a screening tool, not a clearance exam in isolation: history (personal and family cardiac history, prior injury, medications, allergies, menstrual history) outweighs the physical exam in yield. Know the AHA 14-point elements conceptually and the red flags prompting cardiology referral: exertional syncope, chest pain with exercise, unexplained dyspnea, family history of premature sudden death, and a heart murmur. Screening does not include routine ECG for all athletes in most guidelines, though this is debated - answer according to the stated guideline.
Rehabilitation concepts: progressive loading, pain-guided progression, proprioceptive and neuromuscular training for prevention (e.g., ACL injury-prevention programs), and criteria-based rather than time-based return to play. Concussion return follows a stepwise, symptom-limited protocol with complete rest only briefly, then graded exertion; no same-day return.
Traps: clearing an athlete purely by elapsed time rather than functional criteria; using imaging as the return-to-play determinant; and skipping the cardiac family history. Rule of thumb: "criteria, not calendars." Worked example: a soccer player 6 weeks after ACL reconstruction wants to return - the answer requires passing strength symmetry, hop tests, and sport-specific drills, not merely the passage of time.