HEALTH NEWS

By Marsha L. Taylor, M.D., Greene Family Medicine
Published: May 30, 2008

Even before this school year has ended, we are beginning to plan next year’s sporting season.  Many conditioning programs begin over the summer, and nearly all sport programs require the athlete to be cleared for participation by a physician.  Annually, around 10 million athletes are evaluated in pre-participation physicals, better known as sports physicals.  Of these athletes, only around 3-13% require additional evaluation and only 0.3-1.3% are denied clearance.
The main objectives of sports physicals include detecting conditions that may predispose the athlete to injury or that may be life threatening or disabling.  The goal is to maintain the health and safety of the athlete, not to deny participation.  As primary care physicians, we are always focused on prevention and being able to counsel our patients on healthy habits.  Sports physicals, often required by the school, allow us the opportunity to reach out to our adolescent patients.  Patients in this age group are usually not seen in the office on a regular basis because they have “out-grown” well child checks and are generally healthier than our older populations.  As primary care physicians, we see sports physicals as a great opportunity bring in a group of patients that may otherwise slip through the cracks.  Sports physicals give us the opportunity to determine the general health of the individual, counsel on health-related issues and high-risk behaviors, and assess fitness level for specific sports. 
Sports physicals consist of two parts, the history and physical exam.  The history (or question) portion of the sports physical is a crucial part of the visit.  The history is completed by the athlete and parents, usually before presenting for the visit.  The history identifies up to 75% of the problems in an athlete.  It is very important to take the time to answer all questions thoroughly and accurately.  This portion reviews past and current medical problems, surgeries, injuries and medications.  The history also reviews the athlete’s family history and investigates if certain symptoms have occurred during exercise.  The physical exam screens for any abnormality as well as assessing general well being. 
One of the recommendations from the Guidelines for Adolescent Preventive Services states that from ages 11 to 21 all adolescents should have an annual routine health visit.  Even if your child is not involved in sports it is important to schedule annual check ups.  The sports physical is different from a complete physical or well child check.  Sports physicals tend to be more focused on areas of health that may cause problems during participation, and are often not covered by health insurance.  Well child checks or complete physicals are more comprehensive, and are usually covered by insurance.  When scheduling an appointment for your child, you may choose to schedule a well child check rather than sports physical to ensure that other health issues such as vaccines are covered during the visit.  It is important to let your provider know during the visit whether or not you would like your child evaluated for sports.  More importantly, parents should ensure that they take plenty of time to complete the history portion of the sports physical prior to the exam, so that all risks can be assessed and there is no delay in completing the forms.  It is also important to schedule your child’s sports physical well in advance of when they will start training.  If you wait until a couple of weeks before, you may be frustrated to find that there are no available appointments.  Also, if additional evaluation needs to occur prior to clearance to participate, your athlete may have to sit out initial training or tryouts until they see the specialist.  It is also important to come to the appointment with your child.  You may be able to answer questions, or provide information to your child’s doctor that is important for the evaluation.  Even if you think you have nothing to contribute during the visit, you may find that your child will feel more comfortable knowing you are available if he or she needs you. 
The time has come to schedule next year’s sports physical.  Many clinics offer a sports physical day, with more convenient hours and less expense. Whether your child plays sports or not, remember to schedule your child for routine annual health exams.  Like sports physicals, school physicals (and preschool physicals) require advance planning and the appropriate forms.  There are several steps you can take, as a parent, to ensure that your child has the proper exam and forms at the correct time.  First, don’t wait until the last minute to schedule the appointment.  Also, make sure you accurately complete the history portion of the exam prior to the visit.  Lastly, bring all forms and medical records (with vaccine records if needed) with you to the exam.  (Forms are usually available from the school or preschool.) These few steps will allow you to avoid frustration of missing deadlines or having to return to clinic several times to get the proper forms completed.  Most importantly, it will allow for a thorough evaluation of your child, keeping him or her on the path to a healthy year. 
This article is one in a series of monthly columns by Greene Family Medicine where doctors will answer your health-related questions. If you have any questions that you would like to ask a doctor for this column, please send them to:

Greene Family Medicine, Attention: Paige Herndon, 140 Stoneridge Drive, Suite 100, Ruckersville, Virginia 22968