Summer is a good time to get the kids caught up on well-child checks, vaccination schedules and other routine appointments that help primary care physicians monitor and track your child’s health and well-being.
We asked Kristina M. Wilson, MD, MPH, who has served as medical director for several Arizona high schools, to weigh in on the differences between a typical check-up and a sports physical, which is often required of children and teens participating in sports teams and clubs.
Wilson recently was appointed chair of the sports medicine advisory committee of the Arizona Interscholastic Association, where earlier this spring she led the committee in the development and drafting of the AIA return-to-sport guidelines.
Dr. Wilson is a pediatric primary care sports medicine physician at Phoenix Children’s Hospital, where she serves as medical director for adolescent and pediatric sports medicine and sports physical therapy. She is also co-director of the pediatric Brain Injury and Concussion program at Barrow Neurological Institute at Phoenix Children’s Hospital.
Why is it important for kids to get sports physicals before participating in organized sports?
The purpose of a sports physical is to ensure that your child can participate in sports safely and to reduce their injury risk. It is best to have your child’s pediatrician or family medicine doctor complete the form. The American Academy of Pediatrics recommends asking your child’s primary care doctor to complete the sports physical as part of an annual checkup. That way, the provider with the greatest knowledge of your child’s past medical and family history is completing the evaluation.
What are the elements of a sports physical — what are you looking for?
The original purpose of the adolescent sports physical was to prevent sudden cardiac death, but has now expanded to address other important aspects of adolescent health and well-being that affect sports participation, including mental health screening, nutritional screening (particularly for female athletes), screening for concerns specific to disabled athletes, and for continued symptoms from previous concussions and head injuries.
The process of the physical starts at home by answering questions about your child’s health, previous injuries, illnesses, surgeries, and hospitalizations. The questionnaire should be brought to the sports physical for the provider to review. The provider will then conduct a physical exam and provide a clearance to participate in sports or make recommendations for further evaluation or treatment prior to participation in sports.
What is the difference between a “sports physical” and a typical well-child/teen check-up? Is it necessary to do both?
A sports physical is a focused evaluation looking only for concerns in the personal or family history and on the physical examination that would interfere with safe sports participation for the child. A well-child visit is a more thorough evaluation including screenings for vision, hearing, a confidential evaluation for any mental or reproductive health concerns, and to provide any immunizations your child is due to receive.
Your child should have both a well-child examination and a sports physical each year, but these can be done at the same time if these evaluations are completed by your child’s primary care physician.
Can a child’s regular pediatrician perform a sports physical or is it better to see someone who specializes in sports medicine?
The best place to have a sports physical completed is in the office of your child’s regular pediatrician. This allows the provider who knows your child’s personal and family history the best to complete the evaluation. All known risk factors that may put your child at risk for certain injuries are known and your pediatrician can make recommendations on how activity can be modified to minimize these risks.
If your child has had surgery for a musculoskeletal injury such as an ACL tear or has a history of a concussion, it may be more appropriate to have your child’s sports medicine provider perform the sports physical. With a history of more significant musculoskeletal injuries or concussions, a sports medicine provider is usually part of your child’s care team, but you should make sure that a copy of the form goes to their pediatrician.
Some of the walk-in clinics (at pharmacies, for example) offer sports physicals for kids and teens. Is this a valid option? Why or why not?
These clinics do not have access to your child’s complete medical and family history unless you bring it with you to the visit. Generally during these quick visits, the provider does not have time to review outside records that may contain information that will impact the safety of your child participating. Also, these providers often do not have access to other allied health care professionals such as physical therapy to provide recommendations and treatment programs for injury prevention when risk factors are identified.
What conditions might be discovered during a sports physical that could disqualify a child from participation?
It is rare that a child would be disqualified from participation due to something discovered during a sports physical. Concern over heart health is one of the biggest reasons for further evaluation prior to clearance. We find many athletes with high blood pressure that needs to be evaluated if it has not been in the past. Sometimes extra sounds from the heart are heard on exam that need to be evaluated by a heart specialist. Problems with exercise — passing out, or having trouble keeping up with other kids — can be signs that the heart is not working well.
What easily correctable conditions might be discovered during a sports physical that could actually enhance or lengthen a child’s comfort, performance and enjoyment of a sport?
The most common correctable condition we find is vision problems in athletes. Many athletes are referred to an eye doctor to get a new prescription for glasses, which helps prevent injuries that could occur as a result of poor vision. Younger kids often bring up knee or heel pain, which is often growth related. Treatments can help lessen the discomfort these kids are experiencing, which helps them continue to have fun in sports and want to keep playing rather than quit because of pain.
