Medical Conditions Affecting Sports Participation

In 1988 the American Academy of Pediatrics (AAP) published an analysis of medical conditions affecting sports participation.1 This statement was endorsed by the American Medical Association, replacing their own recommendations.2 A further modification of this analysis is presented here, with additions and changes that attempt to increase its accuracy and completeness and to include current information. In Table 1, sports are categorized by their probability for collision or contact. In "collision" sports (eg, boxing, ice hockey, football, or rodeo), athletes purposely hit or collide with each other or inanimate objects, including the ground, with great force. In "contact" sports (eg, basketball and soccer), athletes routinely make contact with each other or inanimate objects, but usually with less force than in collision sports. Table 1 does not separate collision and contact sports because there is no clear dividing line between them. In "limited contact" sports such as softball and squash, contact with other athletes or inanimate objects is either occasional or inadvertent. Sports with limited contact, for example downhill skiing and gymnastics, can be as dangerous as the contact or collision activities. Even in noncontact sports serious injuries can occur, such as in power lifting. Overuse injuries are not related to contact or collision. For all these reasons, the categorization of sports in Table 1 reflects imperfectly their relative risk of causing injury. The categorization does, however, give an idea of the comparative likelihood that participation in different sports results in acute traumatic injuries from blows to the body. We assessed the medical conditions listed in Table 2 to determine whether participation would create an increased risk of injury or adversely affect the medical condition.