If your child is among the 38 million American kids that play at least one sport, then you will know the importance of having a sports physical to ensure that the body is in top shape before the start of the playing season. No matter whether the sport of choice is hockey, soccer, or football, your body is working hard so there is always the chance of sustaining injuries and getting hurt.

What is a Sports Physical Exams?

A sports physical is a pre-season visit to the health care provider for a physical examination to assess your child’s health for diseases or injuries and ensure body fitness for safe participation in any sporting activities.  Even sporting superstars must go through sports physicals before they get on the field.

Goals and Objectives

The goal of the sports physical is to determine completely and accurately the young athlete’s ability compete safely.  The goals of a pre-participation sports evaluation are usually as follows:

  • Assessment of the general good health and evaluate existing injuries.
  • Monitor the fitness levels of the athlete.
  • Identify predispositions to injuries by examining physical conditions.
  • Assess the physiological and developmental maturation of the athlete.
  • Musculoskeletal evaluation and check for the athlete’s joint flexibility, mobility, spinal alignment, and posture.
  • Assess the speed, agility, power endurance, and balance of the athlete.
  • Detect poor pre-participation conditioning that increases the athlete’s risk of injury.

What Happens During a Sports Physical?

The athletic pre-participation physical will assess your medical history, followed by a physical exam, an orthopedic examination, and sometimes performance testing. During the evaluation of your medical history, your healthcare provider will ask questions about any history of illness, injuries, or hospitalizations that might limit sporting activities. The previous history of injuries may indicate a need for further treatment or surgery, or it may indicate a defect in the playing mechanics or equipment.

The health history form will help the physician know about medical problems in your family and help investigate daily habits and lifestyle choices (it asks about medicine, drug, and alcohol use too). To determine whether some athletes are at risk of head trauma in contact sports, their concussion history must be assessed to identify individuals who are at risk.

When athletes are minors, their medical and surgical histories must be signed off by a parent or guardian to ensure the authenticity of the information collected.

During the physical exam, the doctor will:

  • Measure the height and check weight for general fitness and evaluate the athlete’s risk for competing at certain levels.
  • Check and measure BP for elevations during sporting activity. Abnormal BP changes may be referred for follow-up care with the physician.  Generally a BP of 125/80 mm Hg or less for those aged 10-15 years and 130/85 mm Hg for those aged 16 years and older are considered fine.
  • Check the visual acuity of the athlete and though the eyesight does not need to be 20/20 for participating in all sports, poor vision can affect performance and result in injury.
  • Routine auscultation examinations can reveal murmurs or irregular rhythms, which require further evaluation.  Subtle abnormalities in the heart, hypertrophic cardiomyopathy, and Brock disease are major risks for athletes.
  • Check the abdomen to assess organomegaly because of the risk of rupture in contact sports.
  • Screen cholesterol and perform a urinalysis.
  • Genital exam (to screen for hernias in males)
  • Check immunizations.

If the screening history is negative, the orthopedic evaluation can be completed quickly with the following-

  • Assess the general body structure and cervical range of motion.
  • Evaluate shoulder functions through the performance of shoulder shrugs, abduction to 90°, and internal and external rotation.
  • Inspect the forearms with elbows flexed to 90°.
  • Check the hands for rotational deformities
  • Evaluate the proper function of the hips, knees, and ankles.
  • Assess joint flexibility and knee function through knee extension and patellar tracking.

At the end of the sports physical, if everything checks out, the healthcare provider will give the go-ahead for your young athlete to play the sport without any restrictions.  If any health problem is detected, the doctor will make recommendations for treatment or suggest modifications, like using protective equipment, or prescribing medications for the health problem to aid recovery.