A 15-year-old male with trisomy 21 patient presents requesting orthopedic clearance to compete as a gymnast in the Special Olympics. He has already been cleared by both his cardiologist and endocrinologist. He has been treated in the past for an elbow dislocation as well as bilateral recurrent patellar dislocations but presently has no complaints. He denies any pain, difficulty ambulating, and reports that his training has been progressing well. Which of the following is recommended prior to participation?