NATA Position Statement Review Part 6: Preparticipation Physical Examinations and Disqualifying Conditions

For athletic training students gearing up for the BOC exam, memorizing terms and protocols isn’t enough. You need to understand the “why” behind clinical decisions. That’s where the National Athletic Trainers’ Association (NATA) Position Statements come in. These documents go beyond textbook definitions; they translate research and best practices into real-world guidelines that shape how athletic trainers protect and support athletes.

In part 6 of our NATA Position Statement Review series, we’re diving into Preparticipation Physical Examinations (PPE) and Disqualifying Conditions. Whether you’re a student reviewing for the exam or a certified AT refining your practice, mastering this content will help you navigate athlete care with clarity, consistency, and confidence.

Why Are NATA Position Statements So Important?

Evidence-Based Standards: The NATA Position Statements consolidate best practices and current research into clear, actionable guidelines. The BOC exam reflects these standards, so familiarity can directly impact your exam performance.
Clinical Decision-Making: These documents offer practical tools to help guide decisions in real-world settings, such as when to refer, disqualify, or clear athletes for participation.
Legal and Ethical Protection: Following NATA-recommended guidelines helps protect athletic trainers legally and ethically, especially when dealing with conditions that could lead to injury or sudden death.
BOC Blueprint Alignment: The BOC exam tests knowledge across multiple domains—including risk reduction, healthcare administration, and clinical assessment—all of which intersect with position statement content.

Key Takeaways from the NATA Position Statement on PPE and Disqualifying Conditions

This particular statement outlines how to effectively conduct PPEs and determine safe participation in sports. Here’s what you need to remember:

1. Purpose of the PPE

Identify conditions that may place athletes at risk.
Ensure safe participation in sport.
Serve as the primary point of medical contact for many student-athletes.

2. Medical & Family History

Considered the cornerstone of the PPE.
Focus on cardiac history (e.g., sudden death, heart murmur), orthopedic injuries, and chronic conditions.
Use standardized forms like those recommended by the American Heart Association.

3. Physical Examination Components

General health (vital signs, vision, pulmonary, abdominal)
Cardiovascular screening (including heart murmurs and blood pressure)
Neurologic exam if history suggests concern (e.g., concussions, cervical spine injuries)
Musculoskeletal screening, especially in athletes with a prior injury history.

4. Condition-Specific Guidelines

Cardiac Issues: ECG is not recommended as a routine screen unless history/exam indicates need.
Diabetes: Develop a personalized management plan.
Sickle Cell Trait: Confirm status and provide education to minimize risk during exertion.
Mental Health: Include screening questions and plan for referral as needed.
Heat Illness & Hydration: Evaluate risk factors and educate on acclimatization protocols.

5. Timing and Administration

Ideally conducted 4–6 weeks before preseason to allow time for follow-up.
Can be done individually or in group settings using either single or multi-station formats.
Should be directed by a licensed physician, with athletic trainers playing a key role in administration and follow-up.

6. Clearance and Disqualification

Decisions should be evidence-based and individualized.
Disqualification should only occur with compelling medical justification.
Team physicians have legal authority to restrict participation when safety is compromised.

As an athletic trainer or a student preparing for the BOC exam, knowing the contents of this NATA position statement is essential. It reflects the standards of care you’re expected to know and apply. When you understand the rationale behind PPE protocols and disqualifying conditions, you’re not just prepping for a test—you’re preparing to protect lives.

Make sure you review not just this statement, but all relevant NATA Position Statements as part of your BOC exam preparation strategy.