by Allen Peabody, M.D.
With vacations, summer jobs, camps, sports and the like summer activities can quickly pile up. Before you know it, it is August again and almost time to start school. But like many people you have put off that one requirement of any child/adolescent competing in middle or high school sports, the sports physical (or more eloquently titled “the pre-participation exam”).
As its name suggests, this is a required medical exam that needs to be taken in order for a student to take the field, lace up their cleats, or pick up their tuba. While this can seem to be an annoying checkbox that needs to be crossed out; it has noble intentions. The primary goal is safe participation and to identify those with medical problems that could interfere with exercise or even lead to life threatening events. This is done in two steps: the questionnaire and the exam.
The questionnaire is, ironically, an actual checkbox that is supposed to be completed by the athlete and the parent. As a practitioner, I have found many times the questionnaire to be quite worthless if only one party participates in the answering of questions. Most teens do not know any family history (which is arguably the most important section) and most parents do not know how their teen feels when they are exercising. This is ideally completed before the exam and is used as a spring board to guide the visit. The exam itself is a head to toe comprehensive exam. The primary focus is on the cardiac and musculoskeletal systems, however it is required to be a complete physical.
The vast majority of athletes will be screened and cleared without any concerns. When concerns do come up either from the history alone or from an exam, finding a referral to a specialist is often indicated to rule out or help diagnose a problem. Because of this, it is wise to schedule the sports physical 4-6 weeks prior to the date the clearance is needed.
Where can this exam be performed? Between walk-in clinics, schools hosting group exams, sports medicine clinics, and your primary care office, there is no shortage of locations. Where should it be done? I must disclose my own bias as a primary care provider. The sports physical was not designed to replace the annual physical, but unfortunately most teenagers view this to be the case. The convenience of the walk in clinics is attractive, but the purpose of these clinics was not to displace the medical home. A comprehensive exam is best done where the provider knows you, your family, has your medical record, and has time and training to delve into the many other non-sports related issues pertinent to teens. Most of the time sports clearance can be done as part of the routine annual physical exam which most insurances are now being required to cover.
So as summer draws to an end, be prepared, avoid the rush, and go ahead and schedule an appointment today!
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