Preventing Sports Injury and Illness: Key Resources for Family Physicians.

In the United States, there are 212.6 million physically active persons older than six years (eFigure A), including 36 million youths and 7.8 million high school sports participants at approximately 36,000 secondary schools.1-4 Although physical activity clearly improves health outcomes, it also carries inherent risks, including injury, illness, and, rarely, death. Although a small percentage of family physicians currently hold a sports medicine certificate of added qualifications,5 most family physicians treat active patients or athletes, and many serve as team physicians. Given the limited attention paid to the role and importance of physical activity in medical schools6 and the limited exposure to sports medicine and musculoskeletal problems during residency, many physicians would likely benefit from additional knowledge to improve their ability to prevent and treat injuries from sports and physical activity. The Team Physician Consensus Conference Statements (http://www.acsm. org/public-information/team-physicianconsensus-conference-statements), which represent an ongoing collaboration between six major medical societies concerned with clinical sports medicine issues, is one helpful resource for physicians caring for athletes. The most recent version addresses the team physician’s role in preventing illness and injury, and discusses potentially helpful and ineffective or unproven strategies for preventing common or serious conditions and injuries that can result from physical activity (Table 1).7 One important area to address is the preparticipation evaluation. Although this evaluation has not been proven to prevent injury or death, most states require them for youth athletes. The fourth edition of the American Academy of Pediatrics’ preparticipation physical evaluation recommendations, which was previously reviewed in American Family Physician (http://www.aafp.org/ afp/2015/0901/p371.html), provides several practical tools and forms for the team physician, as well as guidance on screening young athletes prior to sports participation.8 The American College of Sports Medicine’s (ACSM’s) revised criteria on exercise preparticipation health screening offer clearer and more succinct advice for exercise testing in adult patients.9 The criteria state that to help eliminate barriers, excessive referrals, and overuse of medical resources, physicians should perform exercise testing only in persons at high risk of exercise-related complications who are starting a vigorous physical activity program. The Physical Activity Readiness Questionnaire (http://www.csep. ca/cmfiles/publications/parq/par-q.pdf) is a free self-screening tool commonly used to determine whether a patient should see a physician prior to physical activity. There are several live and online continuing medical education programs. Physicians with limited experience and background knowledge in sports medicine might begin with the ACSM Team Physician Course (http://www.acsm.org/attend-a-meeting/ acsm-team-physician-course). The American Academy of Family Physicians (AAFP) offers the Practical Advances in Musculoskeletal and Sports Care course (http:// www.aafp.org/cme/cme-topic/all/sportslive.html), which mixes didactic learning with hands-on practical experience, including field-side emergency management training and sessions at the AAFP’s Family Medicine Experience (http://www.aafp.org/ events/fmx.html). Highly experienced physicians may find more value in an advanced team physician course. This type of course is offered by the ACSM, American Medical Society for Sports Medicine, and American Orthopedic Society for Sports Medicine (http:// More online at http://www. aafp.org/afp.