Public Release: 

Should wilderness athletes have pre-participation exams? CJSM special issue shares expert updates

Wolters Kluwer Health

September 9, 2015 - Getting a sports pre-participation exam (PPE) is a familiar preseason ritual for student athletes. But what about the growing number of people, of all ages, interested in participating in wilderness athletic and adventure events? Issues and advice on the PPE for wilderness athletes are featured in a special September issue of the Clinical Journal of Sport Medicine, published by Wolters Kluwer.

The special issue provides health care providers, event organizers, and participants with an update on the PPE for wilderness athletes and adventurers. "By matching the patient's fitness and skill level to the environment, the physician can help reduce the risk of serious injury," according to a Guest Editorial by Dr. Chad A. Asplund of Georgia Regents University, Augusta, and colleagues.

Pre-Participation Exams for Wilderness Athletes--Expert Updates

Recent years have seen a surge in popularity of wilderness, adventure, and extreme endurance events. "Wilderness sports and adventures combine the traditional risks of physical activity and exertion with the remoteness and exposure associated with backcountry environments," Dr. Asplund and coauthors write. In contrast to the standard "sports physical," there's little information to guide the PPE for those interested in wilderness adventures--including growing numbers of middle-aged and older adults.

A collaboration between the Wilderness Medical Society and the American Medical Society for Sports Medicine, the special issue seeks to outline an "an appropriate process for evaluation of wilderness athletes and adventurers." Twelve invited contributions by noted experts provide updates on screening and medical evaluation for patients planning to participate in wilderness events and activities. The special issue is now available as a free download on the journal website:

A contribution by Dr. Gary Green of the UCLA Division of Sports Medicine provides insights into what should be included in the wilderness adventure PPE, which patients should receive one, and when. The main goal is not to "disqualify" patients with health risks--but rather to identify and address risk factors for injuries and illnesses during strenuous activities in remote settings or under extreme conditions. This reduces the likelihood of wilderness rescues and enhances the outdoor experience.

The wilderness adventure PPE addresses "extrinsic" risk factors related to the activity and environment, as well as "intrinsic" health issues and other characteristics that may affect the person's ability to participate. "The combination of underestimating risk and overestimating skills is a common denominator in many wilderness rescues," writes Dr. Green.

With sufficient lead time, a training program may enable participants to be better prepared for their outdoor experience. Dr. Green adds, "With a minimal amount of additional education, physicians can adequately assess both the intrinsic and extrinsic risk factors, address them and create a positive environment for their patients."

In addition to ethical/legal and general medical issues related to the PPE for wilderness athletes, the expert contributions address unique issues related to activities at high altitudes, mountaineering and climbing events, desert and land sports, water sports, extremes of cold and hot, and special populations. Dr. Asplund and colleagues conclude, "Proper screening and evaluation for participation should mitigate some of the risk of injuries, illnesses and deaths in wilderness and adventure athletes, and should allow for safer participation for recreational wilderness adventurers."

Click here to read this special issue.


About Clinical Journal of Sport Medicine

Clinical Journal of Sport Medicine is an international refereed journal published for clinicians with a primary interest in sports medicine practice. The journal publishes original research and reviews covering diagnostics, therapeutics, and rehabilitation in healthy and physically challenged individuals of all ages and levels of sport and exercise participation. CJSM is the official journal of the American Medical Society for Sports Medicine, the American Osteopathic Academy of Sports Medicine, the Australasian College of Sports Physicians, and the Canadian Academy of Sport Medicine.

About Wolters Kluwer

Wolters Kluwer is a global leader in professional information services. Professionals in the areas of legal, business, tax, accounting, finance, audit, risk, compliance and healthcare rely on Wolters Kluwer's market leading information-enabled tools and software solutions to manage their business efficiently, deliver results to their clients, and succeed in an ever more dynamic world.

Wolters Kluwer reported 2014 annual revenues of €3.7 billion. The group serves customers in over 170 countries, and employs over 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands. Wolters Kluwer shares are listed on NYSE Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Wolters Kluwer has a sponsored Level 1 American Depositary Receipt program. The ADRs are traded on the over-the-counter market in the U.S. (WTKWY).

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