Doc Talk: When it comes to sports physicals, your primary care physician knows best

06/23/2013 3:34 PM

08/08/2014 10:17 AM

If your child is participating in school sports this coming fall, remember to schedule his pre-participation physical evaluation. In the summer scheduling frenzy, some parents opt for the convenience of a physical exam at a school-sponsored clinic or walk-in location with a health care provider they’ve never met. These physicals will fulfill the requirements of the Kansas State High School Activities Association, but they are not always the best option.

The best way to ensure your child gets the screening and care he needs is to have a thorough annual physical with your primary care provider — the doctor who knows your child, has access to his medical history and has a rapport with your family.

The primary goal of the sports physical is to obtain medical clearance for sports participation by detecting or ruling out 1) medical conditions that may predispose a child to injury, typically musculoskeletal, and 2) conditions that may be life threatening or disabling, specifically the heart.

After the sudden deaths of several high school athletes from cardiac arrest in recent years, the American Heart Association’s screening guidelines now call for eight specific medical-history questions and four key elements in a physical exam to help doctors understand if a child is at cardiac risk. The heart association recommends that the physical be performed by a physician who is knowledgeable about cardiovascular disease.

A physical is more than just an exam. The examination is only one component of getting an annual review of your child’s health. A review of past health issues such as surgeries, injuries and hospitalizations should always be a part of the annual health review. It is surprising how often even minor past health issues may still need monitoring and follow-up.

Your child’s family physician has access to your child’s records, is more familiar with your family’s medical history and can review your child’s overall growth and development. If something concerning is discovered, your doctor is best prepared to actually address it.

In addition to evaluating the patient’s physical condition, your physician’s annual health review includes verifying immunizations are current, looking for unsuspected or potential medical problems and screening for hereditary medical conditions like high cholesterol and high blood pressure. The provider typically checks lymph nodes and organs, posture, growth and development, including whether the child is progressing through puberty as he should. The physician can also discuss and address behaviors, emotional challenges and school performance issues not typically included in the limited sports exam.

The pre-participation physical evaluation is the only annual exam some adolescents receive. Having it with the primary care provider offers the opportunity to assess social and emotional development and discuss sensitive health matters such as tobacco, alcohol and drugs, puberty and sex education and injury prevention. The health review offers the opportunity for the family physician to be an advocate for healthy and wise choices during the teen years.

As a parent, I understand that teens will often listen to another adult voice with more acceptance than your own. Your physician can be another encourager of wisdom in decision-making during these critical adolescent years.

Regardless of where your child receives a pre-participation physical evaluation, here are guidelines to help you prepare:

•  Fill out the activity association’s form accurately and honestly before the exam.
•  Ask your teen ahead of time if they are having any symptoms that might need to be addressed with the doctor. Think head to toe and ask them questions about all parts of the body.
•  Don’t assume that your child will bring up concerns during the exam. If your teenager is going to the office without you, you should notify the doctor well ahead of time of problems so that they can be addressed during the visit.
•  Schedule an annual eye exam with an optometrist. Eye health is about more than just good vision.

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