The following guidelines have been developed based on interviews with a number of certified athletic trainers around the country. This listing is not all-inclusive, but is designed to provide guidance.

In addition to these general guidelines, the National Athletic Trainers' Association encourages all athletes to develop the specific skills involved in their sport and to be aware of the rules governing their athletic endeavors.

It is essential to remember that medical, legal, financial and professional standards, limitations and requirements change continually and vary from place to place, person to person and setting to setting. These guidelines must not, therefore, be taken to represent uniformly applicable national standards.

General Guidelines
Every student-athlete should receive a pre-participation physical exam, including a general exam and an orthopedic exam. The general exam should include checks on height, weight, blood pressure, pulse, respiration, eye, ear, nose, chest and abdomen. The orthopedic exam should focus on joint flexibility, joint range of motion and a re-examination of past bone and joint injuries.

Athletes should work with athletic trainers and coaches year-round to ensure they maintain their condition with appropriate exercises and nutrition. In addition, athletes should engage in appropriate conditioning programs for a minimum of six weeks before the start of daily practice.

Athletes should focus on developing muscular strength and endurance, cardiovascular fitness and flexibility.

Good nutritional practices incorporate the basic food groups: grains, fruits and vegetables, dairy, and meat/poultry/fish. Athletes' diets should be high in complex carbohydrates while also including essential proteins and fats.

Athletes practicing or playing in warmer climates should become acclimatized to high levels of activity in hot weather. Practice should be held early in the morning or late in the afternoon.

Limit workouts and practices to no more than two hours.

The night before an event, athletes should hydrate with electrolyte fluids to reduce the risk of dehydration.

Fluid breaks should be offered at least every 45 minutes, and athletes should be entitled to unrestricted amounts of fluids to help prevent dehydration and other forms of heat-related illness.

All athletes should use appropriate equipment that fits properly. This equipment should be checked before and after each use to ensure that it is in proper working condition, and replaced or repaired immediately if any problems are noted.

Appropriate protective equipment should be worn in all practices as well as during competitions.

Shoes should fit appropriately and provide the necessary support for each individual sport.

Foot diseases, such as athlete's foot, should be treated immediately and fully to avoid more extensive problems.

Mouth guards should be used in all collision sports, including ice hockey, football and rugby; and recommended for all sports where contact could occur, including basketball, baseball, lacrosse, soccer, etc. Not only do they help to prevent dental injuries, but they can also absorb shocks from blows to the jaw or head and reduce the severity of these blows.

Players should stretch properly before and after workouts of any kind.

A minimum 15-minute warm-up period before any game or practice, and an appropriate cool-down period afterward, is recommended. Athletes should also warm up for five minutes during any prolonged breaks in activity (including half time, between periods, etc.).

Ice should be available on the sidelines of every game and practice to apply to appropriate injuries.

Injuries involving bones or joints should be examined by a licensed physician.
All injuries should be evaluated immediately.

Parents should be aware of who is responsible for injury care at their child's school. Parents should ask if this person is qualified to handle all injuries and provide proper instruction and rehabilitation, as well as whether he or she is available for both practice and games.

Every school with an athletic program should have a written emergency plan which is reviewed regularly and addresses every level of medical care for injured athletes.

Every school should be encouraged to develop an Injury Protection Manual, which answers any questions a parent may have about the way an injury is to be handled and who will be primarily responsible. The school should distribute this manual to all athletes' parents.

The athletic department should be encouraged to have an Emergency Medical Authorization Card on file for every athlete. This card gives parental permission for emergency medical care if it is required. The card should include name, address, parents' home and work phone numbers, etc.

The athletic department should be encouraged to have parents sign a waiver that indicates they are aware of the inherent risk of injury to their children.
Coaches should be certified in first aid and CPR and, where possible, earn a state- or nationally-approved certificate to coach specific sports.

All individuals involved in the athletes' health and safety -- including athletic trainers, coaches, physicians, emergency medical personnel (paramedics and EMTs), school administrators and parents -- should be encouraged to maintain cooperative liaisons.