Almost 60 million children and adolescents participate in organized sports in the United States, and almost 8 million of those are involved in competitive athletics at the high school level. Pediatricians and family physicians understand that for many of these healthy athletes, the annual sports physical may be their only contact with a physician. So it’s important for physicians and parents to work together to get the maximum value for the adolescent during this annual visit.
Athletes should schedule this exam early so they see their physician at least four to six weeks before practice begins – realizing “I can’t practice tomorrow unless this paper is completed” does not constitute good medical care. The examination should be performed by the given athlete’s primary care physician.
In addition to the components of the pre-participation exam (PPE), this encounter offers the opportunity for the physician to address the gamut of issues affecting the developing adolescent: evolving relationships with peers and parents, developing sexuality, substance use and abuse, school performance, life plans, and risk-taking and safety, as well as immunization status. The list is extensive and is only adequately addressed by the primary care physician, who knows the patient and family well.
The PPE itself should begin, as should every visit with a physician, with a relevant and thorough medical history. A good history alone identifies 80 to 90 percent of all abnormalities. Cardiovascular history, both that of the patient and his or her family, should identify red flags that will lead to further evaluation when necessary to ensure the safety of the adolescent in a chosen sport.
Existing illnesses, such as asthma or diabetes, can be discussed and plans for management established. Some physicians and many school districts offer baseline neurocognitive testing, which is useful should the athlete suffer head trauma and be suspected of concussion. A musculoskeletal exam is essential, as is discussion of training and injury prevention. Female athletes should be evaluated for components of the female athlete triad: low energy (with or without disordered eating), menstrual dysfunction and bone mineralization issues.
The single most important message I can convey is to be proactive and schedule this annual visit with your child’s primary care physician. While you may be thinking, “This school year isn’t over yet!,” getting an appointment on the calendar now for early in the summer is the best plan to avoid the rush later.
Dr. Joseph Kahn is president of Mercy Kids (mercykids.org), an expansive network of pediatric care dedicated to meeting the needs of every child, every day. For more information or to find a pediatrician near you, visit mercy.net/laduenews.