Sports Medicine

The Committee on Sports Medicine of the Iowa Medical Society, and the Iowa High School Athletic Association, have been partners for many years in protecting the health, wellness, and safety of interscholastic student-athletes.  An important aspect of our collaboration is the annual mailing of policies, procedures and forms to physicians. This is our 24th annual physician mailing. We hope the following information and web links will be of special interest as you provide care for student-athletes in your area of the state. We encourage you to share this information with allied health professionals who may assist you in caring for young athletes.

2018 Resources and Guidelines

1. Athletic Pre-participation Physical Examinations. Iowa Code requires each athlete in grades 7-12 to have an athletic pre-participation physical examination annually. While state law requires a PPE, it does not mandate what should be included as part of that examination. The PPE form was updated by the Committee on Sports Medicine of the Iowa Medical Society in May 2014 and conforms to the 4th Edition of the PPE Consensus Monograph published in 2010. The PPE form contains health history information and physical examination components that the Committee on Sports Medicine considers minimum requirements when performing pre-participation physicals. Click here for the most current version of the form.

2. Medical Release for Return to Athletic Participation. The Iowa Medical Society Committee on Sports Medicine and Iowa High School Athletic Association have developed a medical release form that is recommended, but not required, when returning an injured student-athlete to participation following a concussion or other injury. The second page of the form provides guidelines to help licensed health care providers determine a student’s readiness to return to participation following a concussion. Click here for the form.

3. IHSAA Wrestling Communicable Skin Condition Report. The IHSAA Wrestling Communicable Skin Condition Report is required for use when clearing a wrestler with a suspect skin condition to return to participation (practice or competition). The form provides information that should make it easier for the health-care provider to indicate the location of any lesions on the face and provide specific information about a wrestler's readiness to return to participation. Click here for the report.

4. Concussion Management.
Click here for information on Iowa’s concussion management protocol and return to participation guidelines. We encourage you to familiarize yourselves with this information.

The Return to Play (RTP) protocol begins a little more conservatively than those in the Berlin consensus statement, but are not inconsistent with the Berlin guidelines. We encourage you to familiarize yourselves with this information. During the 2018-19 school year the Iowa High School Athletic Association, Iowa Girls High School Athletic Union and Iowa Department of Public Health will be reviewing and finalizing RTP protocol to comply with amendments to Iowa Code 280.13C. The implementation date is July 1, 2019. Until then the following RTP guidelines are still in place.

Return to learn is major discussion topic among those managing concussions in student-athletes. Iowa Code 280.13C has also been amended and requires schools to develop return-to-learn plans. The partners who comprise the Brian Injury Alliance of Iowa are promoting a publication titled, “REAP the Benefits of Good Concussion Management”. We believe this is an excellent publication and it will be reviewed to determine if the information it contains comply with the Iowa Code. Click here for a link to publication.

The American Academy of Pediatrics has an excellent article on returning to learn following a concussion.

The 5th international conference on concussion in sport was held in Berlin, October 2016, and the publication is now available.

5. Exertional Heat Illness

a. IHSAA Football Heat Acclimatization Policy. In the fall of 2013, the Iowa High School Athletic Association adopted a heat acclimatization policy for 9-12 interscholastic football. Click here to review the policy. We would appreciate you emphasizing the importance of proper heat acclimatization with any coaches, school administrators, players, and parents with whom you have an opportunity to speak.

b. Exertional Heat Illness Excerpt from White Paper Presented at Collaborative Solutions for Safety in Sport Meeting, March 26-27, 2015. Page 14 of this link provides Evidence-Based Practice Recommendations & Treatment Policy Points for Treating Exertional Heat Stroke. The emphasis is on cooling BEFORE transport.

6. IHSAA Football Contact Limitation Policy. Beginning with the 2015 football season, the Iowa High School Athletic Association adopted a policy limiting daily and weekly contact during preseason and regular season practices. This is one of the many steps taken to minimize the risk of concussion by football players. Click here to review.

7. Medical Conditions Affecting Sports Participation. The 4th Edition of the PPE Consensus Monograph published in 2010 contains concise and useful guidelines concerning the sports participation status of adolescents with certain medical conditions. Click here for a link to the “Medical Conditions and Sports Participation” document.

8. Rules Governing the Wearing of Special Equipment in High School Athletics. Click here for a link of what materials and equipment national high school rules allow when protecting an injured student-athlete.

9. Emergency Action Plans.
a. “Safe Sports School” - An initiative to help school administrators and healthcare providers evaluate their plans and procedures for the prevention and care of student-athletes is the National Athletic Trainers’ Associations’ “Safe Sports School” program. The program evaluates 10 plans & procedures regarding health services:
* Create a comprehensive athletic health care administrative system.
* Provide or coordinate pre-participation physical examinations.
* Promote safe and appropriate practice and competition facilities.
* Plan for selection, fit, function, and proper maintenance of athletic equipment.
* Provide a permanent, appropriately equipped area to evaluate and treat injured athletes.
* Develop injury and illness prevention strategies, including protocols for environmental conditions.
* Provide or facilitate injury intervention.
* Create and rehearse venue-specific Emergency Action Plans.
* Provide or facilitate psychosocial consultation and nutritional counseling/education.
* Educate athletes and parents about the potential benefits and risks in sports as well as their responsibilities.

The comprehensive athletic care administrative team includes a physician director, school administrator, school medical personnel (e.g. school nurse), and an athletic trainer as the coordinator. The purpose of the team is to enhance communication between school personnel and local or team physicians. We encourage you to visit with your local school’s athletic director about becoming a Safe Sports School. Click here for a link to the “Safe Sports School” program.

b. "Anyone Can Save a Life" - The IHSAA also continues to provide high school athletic directors’ information on “Anyone Can Save a Life”, which is a program promoting the development of emergency action plans and accessibility of AED’s at school activities. We encourage you to visit with your local school’s athletic director regarding these two topics. Visit the “Anyone Can Save a Life” website.

c. Sudden Cardiac Arrest – Part of any emergency action plan includes knowing what to do in a sudden cardiac arrest. The information sheet at the link below will be sent to all athletic directors this fall as way for them to educate student-athletes, coaches and parents/guardians. We encourage you to promote this information whenever possible. Click here for a Sudden Cardiac Arrest flyer.

There is no copyright on any of the information contained in this mailing or the information on student-athlete safety, which appears on the Iowa High School Athletic Association web site.

An additional resource you may find helpful is the Iowa Athletic Trainers' Society website.

By working together, the Iowa Medical Society, the Iowa High School Athletic Association, and physicians across the state have created a safer environment in which student-athletes may participate. We thank you for your efforts in caring for student-athletes and encourage you to contact the Iowa Medical Society or Iowa High School Athletic Association if you have any questions. If you have questions regarding any of the information provided in this mailing, please feel free to contact Alan Beste, ATC, LAT, and Executive Director of the Iowa High School Athletic Association: (515) 432-2011 or

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