MSHSAA Untitled Page (2023)



The first step in safe athletic participation should be a thorough pre-participation evaluation (PPE) by a physician who knows the athlete well. Each school shall require a physician’s certificate stating that the individual is physically able to participate in their chosen activity or activities from each student participating in sports activities or spirit. The most appropriate form is the consensus Pre-participation Physical Evaluation form recommended by the American Academy of Pediatrics, American College of Sports Medicine, American Academy of Family Physicians, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and the American Osteopathic Academy for Sports Medicine and care should be taken to address each part of the evaluation.

This annual physical is a very important part of comprehensive medical care for a young athlete. It gives the pediatrician or family physician an opportunity to address general medical history, probe potential issues related to physical activity including cardiovascular problems, as well as address sensitive issues such as drug and alcohol use with their young patient. In the event that an athlete and their parents do not regularly attend a medical office, they have the option of obtaining a physical evaluation certificate from any physician. The evaluation may be performed and the certificate may be signed by an Advanced Registered Nurse Practitioner or Certified Physician’s Assistant who are working in written collaborative practice with a physician provided the name of the physician with whom there is collaborative practice also appears on the certificate.

The medical certificate is valid from February 1 through the next school year. For example, a physical issued on February 1, 2015, is valid through the 2015-16 school year. Before a student begins try-outs or practices for sports activities or spirit, they must have a physical evaluation certificate and insurance verification on file with their school district.

A physician examining athletes in junior and senior high schools must use good judgment in deciding whether or not to restrict a student from competition. There are three major considerations for restricting persons from participation in athletics.

- Is there an injury, illness or condition which prevents the individual from competing fairly with normal persons?

- Is there an injury, illness or condition which might be aggravated by athletic competition?

- Does this injury, illness or condition place that athlete or another athlete at harm?

These are relative and circumstances alter decisions. It is the examining physician’s responsibility to determine qualification and disqualification for participation.

The specific standards for both physical examination and insurance are contained in By-Laws 3.9.

The physician’scertificate may be signed by an advanced nurse practitioner, a certified physician’s assistant in a writtencollaborative practice with a physician provided that the name of the physician with whom there is a collaborativepractice also appears on the certificate, or a chiropractor.


3.9.1 Each team must have 14 days of conditioning practice and each individual must have participated in 14 school conditioning practices on 14 different days prior to the date of the first interscholastic contest in all sports. This requirement shall be met if a student has been a member of another school sports team immediately preceding the sport season, has been actively practicing with the sport team, has had 14 days of physical conditioning and begins physical conditioning practice with the new sport team with no more than seven calendar days having passed between the two sports before beginning practice.

Conditioning Questions & Answers:

Q1: We have two members of our school football team who will be attending a National Guard camp during the first week of our school’s pre-season football practice. When they return, there will be only twelve practice days remaining prior to the date of our first game. If we schedule practice twice a day so they participate in at least fourteen practices during the twelve day period will they be eligible to participate in our first game?

A1: No. The Conditioning Standards require that each individual team member must participate in fourteen school practices on fourteen different days prior to the first game in which a student participates.

Q2: MSHSAA By-Law 3.9 provides that each individual player must have participated in 14 school practices on 14 different days prior to the first game in which a student participates in an interscholastic athletic contest, except when a student has been a member of another school sports team immediately preceding and has had the 14 days conditioning. What is meant by the term “immediately preceding?”

A2: The Board of Directors has interpreted the term “immediately preceding” in this particular provision to mean that no more than 7 days elapse since a student last participated in a practice and/or contest as a member of another school sports team. Thus, if a student plays in his school’s last football game on November 13, he would have until November 21 to begin practicing with the basketball team and be eligible immediately to participate interscholastically in the sport of basketball. If he waits until after November 21 to go out for the basketball team, then he would have to meet the conditioning standards by participating in at least 14 school practices on 14 different days prior to being eligible to participate in an interscholastic basketball contest.

Q3: Does cheer or dance conditioning practice count toward the 14 days of practice required under By-Law 3.9?

A3: No. Cheer and dance conditioning practices will not count toward the athletic conditioning requirement.

Q4: A player on our basketball team completed his 14 days of conditioning practice for the winter season and played in a few games before he was injured. He has now been out due to his injuries for over a month. His doctor indicates he will be released to practice soon. Will the student have to start his 14 days of conditioning over before he can play in a game?

A4: The student has met the provisions of the conditioning standard for the winter season so, technically, he will not need to complete an additional 14 days of conditioning to be in compliance with the by-law. However, the school, in consultation with your athletic trainer and the student's physician, will need to determine the timeline for the student's return to competition. Most likely, the student should not return to competition immediately. However, the specific circumstances must be taken into consideration before the timeline can be set (the student's general fitness level before injury, what if any conditioning was done during the injured period, type of injury, etc.). The health and safety of the student is of utmost importance, and his return must be determined on a case-by-case basis.


What is a concussion:

A concussion is a brain injury caused by a blow to the head, face or elsewhere on the body with a force transmitted to the head. Concussions can result from hitting a hard surface such as the ground or floor, from players colliding with each other or from being hit by a ball, bat or other sporting equipment.

Facts about Concussion

  1. A concussion is a serious brain injury
  2. Concussions can occur without loss of consciousness or other obvious signs
  3. Concussions can occur from blows to the body as well as to the head
  4. Concussions can occur in any sport
  5. Athletes can still get a concussion even if they are wearing a helmet
  6. Recognition and proper response to concussions when they first occur can help prevent further injury or even death

Signs and Symptoms of concussion include

  1. Headache or “pressure” in head
  2. Nausea or vomiting
  3. Balance problems or dizziness
  4. Double or blurry vision
  5. Sensitivity to light and /or noise
  6. Feeling sluggish, hazy, foggy or groggy
  7. Concentration or memory problems
  8. Confusion
  9. Sensation that one does not “feel right”

Why knowing you have a concussion is important

Most concussions resolve but some concussions can lead to chronic symptoms such as headache, decreased memory, sleeping problems or personality change. Rest, avoiding another blow to the head and following the advice of your medical staff are critical in helping you recover as fast and as safely as possible. Sustaining another concussion prior to recovery from the first increases your chance of long term symptoms. There have been reports of death with a second concussion in younger athletes. It is very important for you to report any concussion symptoms as described above to your athletic trainer or team physicians at the time of injury. This includes alerting the medical staff to symptoms in your teammates if you notice these.

Pre-Participation Physical Evaluation Form

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