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Setting, Structure, and Timing of the Preparticipation Examination: The Wilderness Adventure Consultation

Green, Gary A. MD

Clinical Journal of Sport Medicine: September 2015 - Volume 25 - Issue 5 - p 383–387
doi: 10.1097/JSM.0000000000000220
Care of the Wilderness Athlete

Abstract: Patients pursue wilderness experiences throughout the entire life cycle, and while outdoor pursuits are relatively safe, injuries do occur. Many of these adverse events can be anticipated, identified, and prevented through a wilderness preparticipation examination (PPE). To accomplish this, it is incumbent on the physician to assess the extrinsic and intrinsic factors faced by the patient and attempt to correct them to ensure an enjoyable experience in the outdoors. This article outlines the goals of the PPE along with identification of various risk factors that can influence a trip. Most injuries and rescues occur from underestimating the risks from extrinsic, environmental factors, and/or overestimating one's intrinsic skills. By matching the patient's fitness and skill level to the environment, the physician can help reduce the risk of serious injury.

UCLA Division of Sports Medicine, Pepperdine University, Malibu, California.

Corresponding Author: Gary A. Green, MD, UCLA Division of Sports Medicine, Pepperdine University, Major League Baseball, Pacific Palisades Medical Group, 15200 Sunset Boulevard, Suite 107, Malibu, Pacific Palisades, CA 90272 (

The author reports no conflicts of interest.

This article appears in a “Care of the Wilderness and Adventure Athlete” special issue, jointly published by Clinical Journal of Sport Medicine and Wilderness & Environmental Medicine.

Received February 06, 2015

Accepted May 05, 2015

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