High school athletes are required by state law to have a physical examination before participating in sports. Most states also request a sports physical for middle school athletes. The American Academy of Pediatrics supports the preparticipation sports exam.
Years ago, sports physicals ensured growing children were safe to compete against one another. Today, we place more significance on the athlete's health history.
Discussing family history is essential. If a family member died from heart disease before age 50, it heightens the athlete’s risk. Your physician may recommend a cardiac workup, including a chest X-ray, EKG and echocardiogram. Some countries, like Italy, examine all athletes’ hearts before competition. In the U.S., where an estimated 35 million youth play organized sports, the cost for examinations would be prohibitive. Therefore, we reserve echocardiograms for those believed to be at risk.
During the physical, we focus on blood pressure, body mass index, visual acuity and obvious orthopedic issues. We also examine the abdomen (checking liver and spleen), genitalia (checking for hernias) and heart (listening for murmurs or irregular rhythm). Sports physicals are important because teenagers don't typically see their doctor unless they are sick. It's an opportunity to meet healthy young athletes, conduct a physical exam and have a discussion. Topics should include nutrition, social interactions, sex education and the hazards of drug and supplement use.
Still, the sports physical is a screening rather than a complete physical. Rarely is blood work done to check cholesterol, vitamin D or hemoglobin. In the future, a sports physical exam would ideally include:
- Medical history
- Physical exam
- Cholesterol and vitamin D levels
- Cardiac screening (EKG and echocardiogram)
- Baseline cognitive function test (in the event of concussion)
- Vital signs
- Vision test
- Flexibility and balance
To learn more about the benefits of sports physicals for student athletes, contact your physician.