100+ Free ABPMR Sports Medicine Practice Questions

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A 17-year-old football player sustains a head-to-head collision and is briefly dazed but does not lose consciousness. Sideline SCAT5 shows headache, photophobia, and difficulty concentrating. What is the appropriate immediate disposition?

Remove from play for the remainder of the game and initiate graduated return-to-play protocol

Return to play after a 15-minute symptom check on the sideline

Administer ibuprofen and reassess in 30 minutes

Allow play if neurologic exam normalizes within 10 minutes

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2026 Statistics

Key Facts: ABPMR Sports Medicine Exam

~200

Total MCQ Items

ABPMR Sports Medicine Subspecialty Examination

~7-8 hr

Total Exam Time

1-day computer-based test including breaks

~25-30%

MSK Injury Weight

Largest domain on the joint subspecialty content outline

$2,500

2026 Subspecialty Fee

ABPMR Sports Medicine initial certification

1 yr

Required Fellowship

ACGME-accredited Sports Medicine fellowship after PM&R residency

Pearson VUE

Test Delivery

Computer-based testing at authorized centers

The ABPMR Sports Medicine subspecialty exam is the multi-board Sports Medicine certification taken via the PM&R pathway. The 1-day computer-based exam contains approximately 200 single-best-answer MCQs over ~7-8 hours and covers MSK injuries (~25-30%), concussion/TBI (~10-12%), medical issues in athletes including cardiovascular and environmental (~12-15%), exercise science and ergogenic aids (~8-10%), pediatric sports medicine (~6-8%), regenerative and procedural sports medicine (~6-8%), MSK ultrasound and imaging (~6-8%), return-to-play and ethics (~6-8%), and doping/WADA (~4-6%). The 2026 initial subspecialty fee is approximately $2,500; eligibility requires an ACGME-accredited Sports Medicine fellowship after PM&R residency.

Sample ABPMR Sports Medicine Practice Questions

Try these sample questions to test your ABPMR Sports Medicine exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 17-year-old football player sustains a head-to-head collision and is briefly dazed but does not lose consciousness. Sideline SCAT5 shows headache, photophobia, and difficulty concentrating. What is the appropriate immediate disposition?

A.Remove from play for the remainder of the game and initiate graduated return-to-play protocol

B.Return to play after a 15-minute symptom check on the sideline

C.Administer ibuprofen and reassess in 30 minutes

D.Allow play if neurologic exam normalizes within 10 minutes

Explanation: Per the Concussion in Sport Group (Amsterdam 2023) consensus, any athlete with suspected concussion must be removed from play immediately and not returned the same day. Symptomatic athletes follow a graduated 6-step return-to-sport progression with at least 24 hours between stages and re-evaluation by a licensed clinician. Same-day return increases risk of second-impact syndrome.

2A 22-year-old soccer player sustains a non-contact pivoting injury with an audible 'pop' and immediate knee swelling. Lachman test is positive with soft endpoint. Which structure is most likely injured?

A.Anterior cruciate ligament (ACL)

B.Posterior cruciate ligament (PCL)

C.Medial collateral ligament (MCL)

D.Lateral meniscus

Explanation: Non-contact pivoting injury, audible pop, rapid hemarthrosis (within hours), and a positive Lachman test (most sensitive for ACL) are classic for ACL rupture. Pivot-shift is most specific. PCL tears typically occur from posterior tibial blow (dashboard injury). MCL tears follow valgus stress with localized medial pain. Meniscal tears cause mechanical symptoms (catching, locking) rather than rapid effusion.

3Which of the following is the FIRST-line management for a Grade I lateral ankle sprain in a recreational athlete?

A.Functional rehabilitation with early weight bearing, bracing, and proprioceptive training

B.Strict non-weight bearing in a short-leg cast for 4 weeks

C.Immediate operative repair of the anterior talofibular ligament

D.Long-leg cast immobilization with crutches

Explanation: Functional rehabilitation — early protected weight bearing, semi-rigid bracing or taping, range of motion, peroneal strengthening, and proprioceptive training (wobble board, single-leg balance) — yields better outcomes than rigid immobilization for Grade I-II sprains. Cast immobilization is reserved for severe Grade III injuries with instability or fracture. Surgery is rarely first-line.

4A 45-year-old recreational tennis player presents with lateral elbow pain worsened by gripping and resisted wrist extension. Tenderness localizes to the lateral epicondyle. What is the most likely diagnosis?

A.Lateral epicondylosis (tennis elbow)

B.Medial epicondylosis (golfer's elbow)

C.Olecranon bursitis

D.Posterior interosseous nerve syndrome

Explanation: Lateral epicondylosis is degenerative tendinopathy of the extensor carpi radialis brevis (ECRB) origin. Pain at the lateral epicondyle, worse with resisted wrist/middle-finger extension and gripping, is classic. Histology shows angiofibroblastic dysplasia, NOT acute inflammation — hence 'tendinosis' terminology. Treatment: relative rest, eccentric strengthening, counterforce brace, possible PRP for refractory cases.

5A 16-year-old female cross-country runner presents with secondary amenorrhea, stress fracture of the tibia, and low BMI. Which condition does this triad represent?

A.Female athlete triad / Relative Energy Deficiency in Sport (RED-S)

B.Polycystic ovary syndrome

C.Hypothyroidism

D.Pregnancy

Explanation: The female athlete triad — low energy availability (with or without disordered eating), menstrual dysfunction, and low bone mineral density — is now subsumed under the broader IOC RED-S framework. Energy deficit suppresses GnRH, causing functional hypothalamic amenorrhea, low estrogen, and bone loss leading to stress fractures. Treatment requires restoring energy availability, often with multidisciplinary care.

6What is the primary fuel source during high-intensity exercise lasting 10-30 seconds (e.g., a 100-meter sprint)?

A.Phosphocreatine (ATP-PCr) system

B.Aerobic oxidation of free fatty acids

C.Aerobic oxidation of glucose

D.Anaerobic glycolysis with lactate accumulation

Explanation: The phosphocreatine (ATP-PCr) system fuels maximal effort 0-10 seconds. Anaerobic glycolysis dominates 10 seconds to ~2 minutes (lactate accumulation). Aerobic oxidation of glucose and fatty acids dominates beyond 2-3 minutes. Endurance training increases mitochondrial density and oxidative capacity.

7Which of the following is a banned substance under WADA's Prohibited List for in-competition AND out-of-competition use?

A.Anabolic-androgenic steroids

B.Caffeine

C.Glucocorticoids by inhalation

D.Pseudoephedrine below threshold

Explanation: Anabolic-androgenic steroids (S1 class) are prohibited at all times — both in- and out-of-competition. Caffeine is on the WADA monitoring program but not banned. Inhaled glucocorticoids are permitted; oral, IV, IM, or rectal routes are prohibited in-competition. Pseudoephedrine is prohibited in-competition only above 150 µg/mL urine threshold.

8A 19-year-old basketball player collapses suddenly during practice. ECG performed earlier showed marked left ventricular hypertrophy with deep Q waves. What is the most likely cause of sudden cardiac death in this athlete?

A.Hypertrophic cardiomyopathy (HCM)

B.Anomalous coronary artery

C.Long QT syndrome

D.Commotio cordis

Explanation: Hypertrophic cardiomyopathy is the leading cause of sudden cardiac death in young (<35) US athletes. Autosomal dominant sarcomere mutations cause asymmetric septal hypertrophy. ECG shows LVH, deep narrow Q waves (lateral and inferior), and T-wave inversions. Anomalous coronary arteries are the second most common cause. Commotio cordis is from a blunt chest blow during a vulnerable repolarization window.

9A football player practicing in 95°F heat with 80% humidity collapses. Rectal temperature is 41.2°C (106°F) and he is confused. What is the FIRST-line treatment?

A.Immediate cold-water immersion (CWI) before transport

B.Acetaminophen and oral rehydration

C.IV dantrolene

D.Transport to ED first, then begin cooling

Explanation: Exertional heat stroke is defined by core temperature >40°C with CNS dysfunction. Cold-water immersion (CWI, 1.7-15°C) is the gold standard — 'cool first, transport second' — because mortality correlates with time above 40.5°C. Goal: drop core temp <38.9°C before transport. Antipyretics do not work (no hypothalamic reset). Dantrolene is for malignant hyperthermia, not heat stroke.

10An 11-year-old gymnast presents with progressive low back pain worsened with extension. MRI shows a bilateral pars interarticularis defect at L5. What is the diagnosis?

A.Spondylolysis

B.Spondylolisthesis

C.Scheuermann disease

D.Discitis

Explanation: Spondylolysis is a stress fracture of the pars interarticularis, most common at L5, frequent in young gymnasts, divers, and football linemen due to repetitive hyperextension. Pain worsens with extension (one-leg hyperextension test). Spondylolisthesis is forward slippage of one vertebra over another, often a sequela of bilateral spondylolysis. Treatment: relative rest, bracing, core stabilization.

About the ABPMR Sports Medicine Exam

The ABPMR-issued Sports Medicine Subspecialty Certification Examination is the PM&R pathway into the multi-board Sports Medicine certification, jointly sponsored by ABPMR, ABFM, ABIM, ABP, and ABEM. The single shared exam is administered by the participating boards and assesses comprehensive sports medicine knowledge: musculoskeletal injuries (sprains, strains, fractures, dislocations across shoulder/elbow/wrist/hip/knee/ankle/foot), concussion and TBI management (Amsterdam 2023 consensus, SCAT6/SCOAT6, graduated return-to-sport), exercise physiology and energy systems, ergogenic aids and sports pharmacology (creatine, caffeine, supplements), female athlete triad and RED-S, cardiovascular pre-participation evaluation (AHA 14-element history, athlete ECG interpretation, HCM and SCD risk), environmental injuries (heat illness, cold injury, altitude, exercise-induced bronchospasm, exercise-associated hyponatremia), pediatric sports medicine (apophysitis, OCD, Little League elbow, pitch counts), regenerative therapies (PRP, prolotherapy, ESWT), MSK ultrasound and imaging interpretation, return-to-play decision making, sports ethics and dual-loyalty, and WADA doping/Prohibited List. Requires completion of an ACGME-accredited 1-year Sports Medicine fellowship after PM&R residency.

Questions

200 scored questions

Time Limit

1-day CBT (~7-8 hours including breaks)

Passing Score

Criterion-referenced scaled score set by ABPMR (modified Angoff)

Exam Fee

~$2,500 initial Sports Medicine subspecialty fee (ABPMR 2026) (American Board of Physical Medicine and Rehabilitation (ABPMR) — co-sponsored multidisciplinary subspecialty / Pearson VUE)

ABPMR Sports Medicine Exam Content Outline

~25-30%

Musculoskeletal Injuries

Shoulder (rotator cuff, SLAP, AC separation, anterior dislocation/Bankart), elbow (lateral/medial epicondylosis, UCL, OCD capitellum), wrist/hand (scaphoid, TFCC), spine (spondylolysis, disc), hip (FAI, labral tear, snapping hip), knee (ACL/PCL/MCL/meniscus, PFPS, Osgood-Schlatter), ankle/foot (lateral sprain, syndesmosis, Achilles, Jones, navicular stress fx). Hamstring strain, quadriceps contusion, compartment syndromes (acute and chronic exertional).

~10-12%

Concussion & TBI

Amsterdam 2023 Concussion in Sport consensus, SCAT6 sideline assessment, SCOAT6 office tool, removal-from-play, graduated return-to-sport (6 stages, ≥24 h between stages), pediatric considerations (Child SCAT6), second-impact syndrome, persistent post-concussive symptoms, vestibular and oculomotor rehab, neuroimaging indications (CT vs MRI).

~8-10%

Cardiovascular Pre-Participation Evaluation

AHA 14-element PPE history and physical, athlete ECG interpretation (Seattle/International criteria — normal training adaptations vs abnormal findings), hypertrophic cardiomyopathy (leading SCD cause in young US athletes), arrhythmogenic right ventricular cardiomyopathy, anomalous coronary, long QT, Marfan/aortopathy, bicuspid aortic valve, myocarditis return-to-play, AED/EAP, commotio cordis.

~8-10%

Environmental Injuries & Medical Conditions

Exertional heat stroke (cool-first/transport-second with cold-water immersion), heat acclimatization (14-day football protocol), WBGT thresholds, exercise-associated hyponatremia, altitude illness (AMS, HACE — descend; HAPE — nifedipine), cold injury (frostbite, hypothermia), exercise-induced bronchospasm (EVH challenge, inhaled SABA, TUE), sickle cell trait exertional collapse, exercise-associated diarrhea.

~8-10%

Exercise Physiology & Sports Nutrition

Energy systems (ATP-PCr, anaerobic glycolysis, aerobic oxidation), VO2max, lactate threshold, training adaptations (cardiac, muscular, metabolic), FITT principle and exercise prescription, ACSM/AND/DC sports nutrition (CHO 6-10 g/kg/day, protein 1.2-2.0 g/kg/day), hydration, electrolytes, female-athlete iron, vitamin D, overtraining syndrome vs functional overreaching.

~6-8%

Female Athlete Triad / RED-S

Female athlete triad (low energy availability + menstrual dysfunction + low BMD) subsumed under IOC RED-S framework, evaluation of amenorrhea, DEXA in athletes (Z-score < -1 abnormal), Cumulative Risk Assessment, restoration of energy availability as primary therapy (not COCPs), male RED-S, stress-fracture risk stratification, multidisciplinary care.

~6-8%

Pediatric & Adolescent Sports Medicine

Apophysitis (Osgood-Schlatter, Sinding-Larsen-Johansson, Sever, Little League elbow medial epicondyle), OCD (capitellum, knee), spondylolysis in young gymnasts/divers, pitch-count limits (USA Baseball Pitch Smart), youth sports specialization (AAP guidance — multi-sport, rest days), generalized hypermobility, growth-plate injuries, return-to-sport decisions in seizure disorders.

~6-8%

Regenerative & Procedural Sports Medicine

Platelet-rich plasma (lateral epicondylosis, knee OA — limited recommendation per AAOS 2021), prolotherapy (hyperosmolar dextrose), extracorporeal shockwave therapy (chronic plantar fasciitis), corticosteroid injection (knee OA short-term), hyaluronic acid (AAOS strong against routine use), stem cell injections (limited evidence), percutaneous tenotomy. Ultrasound-guided injection technique.

~6-8%

MSK Ultrasound & Sports Imaging

MSK ultrasound principles (hyperechoic fibrillar tendon, anechoic fluid, anisotropy artifact), dynamic assessment (ATFL, snapping hip, peroneal subluxation), Doppler for neovascularization, comparison with MRI (bone marrow edema, deep cartilage), Ottawa Ankle Rules, plain radiography for stress fractures (often falsely negative early), MRI for stress reactions, advanced imaging for high-risk fractures (navicular, anterior tibial cortex 'dreaded black line').

~6-8%

Return-to-Play, Ethics & Team Physician Issues

Return-to-sport decisions (objective testing, functional tasks, psychological readiness — ACL-RSI), shared decision-making for cardiac conditions (HCM, LQTS, Marfan, bicuspid aortic valve), dual-loyalty conflicts, confidentiality/HIPAA in team settings, informed consent in adolescent athletes, on-field cervical spine immobilization (helmet/pads in place), 'when in doubt, sit them out,' weight-cutting safety policies (NCAA/NFHS wrestling).

~4-6%

WADA / Doping & Pharmacology in Sport

WADA Prohibited List structure (S1 anabolic steroids, S2 peptide hormones/EPO, S3 beta-2 agonists, S4 hormone modulators, S5 diuretics/masking agents, S6 stimulants, S7 narcotics, S8 cannabinoids, S9 glucocorticoids, P1 beta-blockers), in- vs out-of-competition prohibitions, Therapeutic Use Exemptions (TUE), athlete biological passport, T/E ratio and IRMS confirmation, supplement contamination (NSF Certified for Sport, Informed Sport).

How to Pass the ABPMR Sports Medicine Exam

What You Need to Know

Passing score: Criterion-referenced scaled score set by ABPMR (modified Angoff)
Exam length: 200 questions
Time limit: 1-day CBT (~7-8 hours including breaks)
Exam fee: ~$2,500 initial Sports Medicine subspecialty fee (ABPMR 2026)

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ABPMR Sports Medicine Study Tips from Top Performers

1Concussion and same-day return-to-play: Amsterdam 2023 consensus mandates removal from play for any suspected concussion and prohibits same-day return regardless of symptom resolution. The graduated return-to-sport protocol has 6 stages with ≥24 hours between stages, advancing only if asymptomatic at the prior stage. Strict rest >48 hours is no longer recommended — early subthreshold aerobic activity speeds recovery. SCAT6 (and Child SCAT6 for ages 5-12) replaced SCAT5; SCOAT6 is the office assessment tool. Concussion grading systems (Cantu, AAN, Colorado) have been ABANDONED.

2Exertional heat stroke (core temp >40°C with CNS dysfunction) — 'COOL FIRST, TRANSPORT SECOND.' Cold-water immersion (1.7-15°C) is the gold standard; goal is to drop core temperature below 38.9°C before transport. Mortality correlates with time above 40.5°C. Antipyretics do NOT work (no hypothalamic reset). Dantrolene is for malignant hyperthermia, not heat stroke. Prevention via 14-day phased heat acclimatization protocol (NATA/ACSM/state HSAA) is essential, especially for high school football preseason.

3WADA Prohibited List highlights: Anabolic steroids (S1) and peptide hormones including EPO (S2) are prohibited at all times. Diuretics (S5) banned as masking agents. Stimulants (S6) including DMAA prohibited in-competition only. Inhaled beta-2 agonists (S3) — albuterol up to 1600 µg/24h, salmeterol 200 µg/24h, formoterol 54 µg/24h are permitted without TUE; higher doses or other routes require TUE plus documented EIB (positive EVH or exercise challenge). Caffeine is on the WADA monitoring program but NOT banned. Athlete biological passport tracks longitudinal markers to catch microdosing.

4Female athlete triad / RED-S: low energy availability + menstrual dysfunction + low BMD. The IOC's broader RED-S framework includes male athletes and additional consequences (immune, cardiovascular, GI, psychological). PRIMARY treatment is restoration of energy availability — combined oral contraceptives do NOT restore bone density and may mask the underlying energy deficit. DEXA Z-score < -1 in athletes is the abnormal threshold (more conservative than the -2 used for general population). Stress fractures and prior menstrual dysfunction are the strongest predictors of future stress fractures.

5Athlete ECG (Seattle/International criteria) — NORMAL training adaptations: sinus bradycardia, sinus arrhythmia, voltage criteria for LVH (without other abnormalities), early repolarization, incomplete RBBB, 1st-degree AV block, Wenckebach. ABNORMAL findings warranting evaluation: T-wave inversion beyond V1-V2 in non-Black athletes >16, pathologic Q waves, complete LBBB, RBBB with axis deviation, Mobitz II or higher AV block, ventricular ectopy ≥2 PVCs in 10-second tracing, WPW pattern, long QT, Brugada, ARVC pattern. Always interpret in clinical context with PPE history and physical.

Frequently Asked Questions

What is the ABPMR Sports Medicine Subspecialty exam?

The ABPMR Sports Medicine Subspecialty Certification Examination is the PM&R pathway into the shared multi-board Sports Medicine subspecialty. The same exam is co-sponsored and administered by ABPMR (PM&R), ABFM (Family Medicine), ABIM (Internal Medicine), ABP (Pediatrics), and ABEM (Emergency Medicine). The 1-day computer-based exam tests comprehensive sports medicine knowledge — MSK injuries, concussion management (Amsterdam 2023), cardiovascular pre-participation evaluation, environmental injuries, exercise physiology, female athlete triad/RED-S, pediatric sports medicine, regenerative therapies, MSK ultrasound, return-to-play decisions, ethics, and WADA doping. Eligibility for the PM&R pathway requires ACGME-accredited Sports Medicine fellowship after PM&R residency and ABPMR certification (or board-eligible status).

Who is eligible to take the ABPMR Sports Medicine exam?

Candidates entering through the ABPMR pathway must (1) be ABPMR-certified or board-eligible in PM&R, (2) have completed an ACGME-accredited 1-year Sports Medicine fellowship, (3) hold a valid unrestricted medical license, and (4) submit application through ABPMR within the eligibility window. Equivalent pathways exist through ABFM, ABIM, ABP, and ABEM. The same exam is taken regardless of primary board pathway; the issuing board is the candidate's primary specialty board.

What is the format of the Sports Medicine subspecialty exam?

The exam is a 1-day computer-based test administered at Pearson VUE test centers, consisting of approximately 200 single-best-answer multiple-choice questions delivered over roughly 7-8 hours including breaks. Items frequently include clinical vignettes, sideline scenarios, athlete ECGs, MRI/X-ray/ultrasound images, and exam findings. Content is distributed across the joint subspecialty content outline shared across the participating boards.

How much does the 2026 ABPMR Sports Medicine subspecialty exam cost?

The 2026 ABPMR Sports Medicine subspecialty initial certification fee is approximately $2,500. Cancellation/refund follows the ABPMR schedule with decreasing refunds as the exam date approaches. Continuing Certification (MOC) for sports medicine includes annual LLSA-style activities and a 10-year recertification cycle, each with associated fees. Retakes within the eligibility window require full re-registration and fee payment.

When is the 2026 exam administered?

The Sports Medicine subspecialty exam is typically offered once per year, usually in late spring or early summer (historically April-May), with applications opening in the prior fall and a submission deadline before the testing window. Candidates schedule their specific Pearson VUE appointment after application approval. Confirm exact 2026 dates on the ABPMR Exams page (or the equivalent page of the candidate's primary board).

How is the exam scored and what are the highest-yield topics?

ABPMR uses a criterion-referenced scaled scoring system with passing standard set by subject-matter experts via the modified Angoff method. Score reports include subdomain performance to guide future study. Highest-yield topics: Amsterdam 2023 concussion consensus and graduated return-to-sport, ACL/MCL/meniscus injury management and ACL prevention programs (FIFA 11+), HCM and athlete ECG interpretation (Seattle/International criteria), exertional heat stroke management (cool first, transport second), female athlete triad/RED-S evaluation, AAOS guidance on knee OA injections (corticosteroid yes; hyaluronic acid no), WADA Prohibited List structure and TUE process, on-field cervical spine immobilization, and pediatric overuse (apophysitis, pitch counts).

How should I study for the ABPMR Sports Medicine exam?

Use a structured 6-12 month plan during sports medicine fellowship. Map to the joint subspecialty content outline, leading with high-yield MSK injuries and concussion (largest content weights), then medical issues in athletes (cardiac, environmental, female athlete), exercise science, pediatric sports medicine, regenerative/procedural, MSK ultrasound, ethics/RTP, and WADA. Core resources: ACSM's Sports Medicine: A Comprehensive Review, DeLee, Drez & Miller's Orthopaedic Sports Medicine, Netter's Sports Medicine, Brukner & Khan's Clinical Sports Medicine, AMSSM CAQ-SM Self-Assessment Examination, AOSSM/AAFP/ACSM review courses. Drill timed MCQ sets, complete 1-2 timed mock exams, and stay current with the Amsterdam 2023 concussion consensus and 2020 ACC/AHA sports eligibility guidelines.