Sports Physicals

About Sports Physicals

In the sports medicine field, the sports physical exam — or preparticipation physical examination (PPE) — helps determine whether it's safe for kids to participate in a particular sport. Most states actually require that kids and teens have a sports physical before they can start a new sport or begin a new competitive season. But even if a PPE isn't required, doctors still highly recommend getting one.

The two main parts to a sports physical are the medical history and the physical exam.

Medical History

This part of the exam includes questions about:

• serious illnesses among family members
• illnesses that kids had when they were younger or may have now, such as asthma, diabetes, or epilepsy
• previous hospitalizations or surgeries
• allergies (to insect bites, for example)
• past injuries (including concussions, sprains, or bone fractures)
• whether the child has ever passed out, felt dizzy, had chest pain, or had trouble breathing during exercise
• any medications taken (including over-the-counter medications, herbal supplements, and prescription medications)

The medical history questions are usually on a form that you'll fill out with your child. Looking at patterns of illness in a family is a good indicator of any potential conditions kids might have. Most sports medicine doctors believe the medical history is the most important part of the sports physical exam, so take time to answer the questions carefully. It's unlikely that any health conditions your child has will prevent him or her from playing sports completely.

Physical Examination

During the physical part of the exam, the doctor will usually:

• record height and weight
• take a blood pressure and pulse (heart rate and rhythm) reading
• test your child's vision
• check the heart, lungs, abdomen, ears, nose, and throat
• evaluate your child's posture, joints, strength, and flexibility

Although most aspects of the exam will be the same for males and females, the doctor may ask girls and guys different questions if they've started or already gone through puberty. For example, if a girl is heavily involved in a lot of active sports, the doctor may ask her about her period and diet to make sure she doesn't have something like female athlete triad.

A doctor will also ask questions about use of drugs, alcohol, or dietary supplements, including steroids or other "performance enhancers" and weight-loss supplements, because these can affect a person's health.

At the end of the exam, the doctor will either fill out and sign a form if everything checks out OK or, in some cases, recommend a follow-up exam, additional tests, or specific treatment for medical problems.

Why a Sports Physical Is Important

A sports physical can help athletes find out about and deal with health problems that might interfere with their participation in a sport. For example, for a kid who has frequent asthma attacks but is a starting forward in soccer, a doctor might be able to prescribe a different type of inhaler or adjust the dosage for easier breathing during running.

The doctor may even have some good training tips and be able to give athletes some ideas for avoiding injuries; for instance, recommending specific exercises, like certain stretching or strengthening activities, that help prevent injuries. A doctor also can identify risk factors that are linked to specific sports. Advice like this will make kids better, stronger athletes.

When and Where to Go for a Sports Physical

Some athletes go to their own doctor for a sports physical; others have one at school. During school physicals, kids might go to half a dozen or so "stations" set up in the gym; each one is staffed by a medical professional who gives a specific part of the physical exam.

If your child's school offers the exam, it's convenient to get it done there. But even if the PPE is done at school, it's a good idea for your regular doctor to conduct an exam as well. Your doctor knows your kids — and their health history — better than anyone they talk to briefly in a gym.

If your state requires sports physicals, kids probably will have to start getting them when in ninth grade. Even if PPEs aren't required by your school or state, it's still smart for kids  to get them if they participate in school sports. And those who compete regularly in a sport before ninth grade should begin getting these exams even earlier.

Getting a sports physical once a year is usually adequate. Any athlete healing from a major injury, like a broken wrist or ankle, however, should get checked out after it's healed before starting to practice or play again.

Getting a physical about 6 weeks before the sports season begins allows enough time to follow up on something, if necessary. Neither your child nor your doctor will be very happy if the PPE is the day before baseball practice starts and it turns out there's something that needs to be taken of care.

If There's a Problem

What happens if your child doesn't get the OK from your doctor and has to see a specialist? Does that mean your young athlete won't ever be able to letter in softball or hockey? Don't worry if the doctor orders other tests or a follow-up exam — it could be something as simple as rechecking your child's blood pressure a week or two after the physical.

A referral to a specialist may help your child's athletic performance. For example, a kid who wants to try out for the track team but gets a slight pain in the knee every time he or she runs might see an orthopedist or sports medicine specialist to help figure out what's going on. Perhaps the pain comes from previous overtraining or poor running technique. Maybe the knee was injured a long time ago and it never totally healed. Or perhaps the problem is as simple as running shoes that don't offer enough support. Chances are, a doctor will be able to help your child run without the risk of further injury to the knee by giving offering suggestions or treatment before the sports season begins.

It's very unlikely that your child will be disqualified from playing sports. The ultimate goal of the sports physical is to ensure safe participation in sports, not to disqualify the participants. Most of the time, a specialist won't find anything serious enough to prevent someone from playing a sport. In fact, fewer than 1% of students have conditions that might limit sports participation, and most of these conditions are known before the PPE takes place.

What About Regular Physicals?

It may seem like overkill, but also getting a regular physical is important for athletes because these are different from a sports physical.

The sports physical focuses on well-being as it relates to playing a sport. It's more limited than a regular physical, but it's a lot more specific about athletic issues. During a regular physical, however, doctors address kids' overall well-being, which may include things not related to sports. You can ask your doctor to do both types of exams during one visit; just be aware that it'll take more time.

Even if a sports physical exam doesn't reveal any problems, it's always wise to monitor your kids when they play sports. If you notice changes in their physical condition — even if you think they're minor, such as muscle pain or shortness of breath — talk to the coach. You should also inform the phys-ed teacher or coach if your child's health needs have changed in any way or if he or she is taking a new medication.

Just as professional sports stars need medical care to keep them playing their best, so do young athletes. Help give your kids the same edge as the pros by making sure they get get their sports physicals.

Reviewed by: Kathleen B. O'Brien, MD
Date reviewed: August 2009
Originally reviewed by: Joseph A. Congeni, MD, and Peter G. Gabos, MD