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By Kwabena “Bobo” Blankson, MD, FAAP / Contributor
Importance of Sports Physicals
During our busy adolescent medicine practice, I’ve noticed that many parents often regard sports or pre-participation physicals as just another task to complete, a mere formality to allow their children to engage in sports for the year. However, as a medical professional, I believe these physicals hold much greater significance. Here are the key components of a sports physical:
1.) Assessing Injuries
A comprehensive musculoskeletal examination can identify whether previous injuries have healed properly or if any new ones have arisen. If needed, physical therapy can be started to prepare your athlete for the upcoming season. It’s crucial to inquire if your child has experienced a concussion in the past, as these incidents often go unnoticed by both coaches and parents. Keep an eye out for signs like headaches, dizziness, irritability, memory issues, or changes in behavior. Remember, loss of consciousness does not determine the seriousness of a concussion. Encourage your student to communicate honestly about their injuries or feelings of being “off.” Assist them in understanding that resting both cognitively and physically after a concussion is not a punishment; it is necessary for them to return to their sport at full capacity. If you’re uncertain about a possible concussion, consult medical experts like myself for guidance.
2.) Heart Health Evaluation
A critical part of the sports physical is assessing heart health. Has your child ever fainted or experienced chest pain during exercise? Are there any family histories of sudden death at a young age? Your physician should examine your student athlete’s heart in at least three positions, listening for murmurs that could indicate issues. Recently, there has been debate regarding the necessity of EKGs or echocardiograms for student athletes. In my opinion, such tests should be performed only if significant concerns arise during the history and physical examination.
3.) Healthy Habits Assessment (95210)
A sports physical encompasses more than just a physical evaluation! In addition to the exam, I address five crucial healthy behaviors encapsulated in the 9-5-2-1-0 model:
9 hours of sleep (essential for muscle recovery and brain development)
5 servings of fruits and vegetables daily (minimum)
2 hours or less of screen time
1 hour or more of physical activity (although your child likely receives this, it’s important to maintain exercise during off seasons)
0 sugary drinks (Encourage water consumption! Sports drinks are acceptable, but water is a better choice.)
4.) Mental Health Evaluation
At our practice, we take every opportunity to evaluate mental health, regardless of the reason for the visit, whether it’s for a cough or a concussion. This is significant—adolescence can be quite challenging. The physical may be the only chance for a clinician to assess mental health, allowing the patient to express feelings of sadness, anger, or trouble coping. This also enables us to connect students to appropriate mental health services when necessary. We might request that you step out of the room briefly to facilitate a confidential moment with your young adult athlete. If any concerns arise, we will involve you in the follow-up discussions.
Parents, your role doesn’t end after the physical paperwork is signed. In fact, it’s just the start. Regular evaluations of your student athlete during the season are critical to their success, as well. Look for signs of burnout and ensure they aren’t pushing through injuries that require rest. Every parent should be vigilant about overuse injuries, especially at the start and mid-season. While training is key, studies indicate that youth who engage in over 16 hours of training weekly face a higher risk of injuries needing medical attention. Other studies suggest that training more hours per week than their age increases injury risk. It’s perfectly acceptable for parents to suggest, “take a day off,” even if it’s unpopular with the coach and their teen. A doctor’s note can also support this if needed.
Mental burnout is another form of overuse injury. If a teen experiences chronic fatigue, reduced performance, and a lack of enthusiasm for practices or competitions, consider the possibility of mental burnout. Keeping workouts enjoyable, incorporating cross-training, allowing one to two rest days each week, and scheduling longer breaks can help maintain an athlete’s freshness, focus, and overall well-being in sports, academics, and personal growth. It’s vital that our student athletes partake in sports for the right reasons: the love of the game, fitness, and social connections. Relying on wins, trophies, and awards won’t lead to lasting happiness.
I believe every young person has an athlete within them. This doesn’t mean that all are fit for varsity sports or destined for collegiate or professional play. However, it does mean fitness should play a key role in every student’s education and growth, and participating in activities that foster fitness is beneficial for their mind, body, and spirit.
So, when you take your student athlete for their physical, remember to strip away the “routine” aspect. This assessment could be the most important medical evaluation of the year!
