Sports Physicals

Written by: Laolu Lediju, MD – Family Medicine Physician

Sports season is here, and it is important to ensure that young athletes are evaluated and medically cleared for participation in sports. The sports physical evaluation is used to determine medical eligibility for youth sports in the United States. It helps to promote the health and safety of young athletes and to identify those who may need additional evaluation before participation in sports. An annual sports physical evaluation is required by most state high school athletic associations for participation in school-based sports.

According to the American Academy of Pediatrics guidelines, the goals of the sports physical include:

  • To determine medical eligibility of the athlete to participate in sports and evaluate general medical, physical, and psychological health.
  • To evaluate for serious medical or life-threatening conditions such as risk of sudden cardiac arrest and other conditions that may interfere with their sports performance or predispose the athlete to illness or injury.
  • To evaluate existing injuries, assess level of fitness, detect poor physical conditioning in athletes and inform athletes of correctible abnormalities before participating in sports.
  • To evaluate and screen for mental health disorders.
  • To provide an avenue for interaction between athletes and healthcare providers

It is recommended that a sports physical should be conducted at least 6 weeks before the first preseason practice/sports activity to allow time to evaluate the athlete and treat any medical conditions found during the visit. Sports physical includes a structured physical examination that focuses on the cardiovascular, musculoskeletal, neurologic, and other systems. It is also recommended to screen for depression, anxiety, and attention-deficit/hyperactivity disorder. The athlete is usually evaluated by healthcare providers and athletic trainers/physical therapist during a sports physical.

Steps on completing sports physical.

STEP 1 – Completion of sports physical form.

A sports physical form would need to be completed to collect important medical, surgical, and other health histories. A parent or guardian should be involved in the completion of the form. It is important to note any personal history of heart problems in the young athlete (chest pain with strenuous exercise), as well as family history of serious cardiac conditions or sudden death before 50 years of age. Health information obtained on the sports physical form include:

  • Medical history – screen for diabetes, infectious diseases, etc.
  • Surgical history – prior surgeries, organ dysfunction or organ loss (e.g., kidney or spleen)
  • Medications and Immunization history
  • Allergies – medication allergies, pollen, or grass allergies, etc.
  • Pulmonary – history of exercise induced asthma, excessive shortness of breath or coughing spells with exercise, etc.
  • Neurologic – history of seizures, concussions, neck, or spinal injuries
  • Environmental – history of heat stroke, heat cramps or heat exhaustion
  • Musculoskeletal – history of joint injury or dislocation, fractures, or sprains
  • Eye – vision problems, eye glass or contact lens use.
  • Mental health and general wellbeing history
  • Menstrual history in females

A positive history in any of these conditions could warrant further tests or evaluation to determine eligibility for sports participation.

STEP 2 – Physical examination and testing

A comprehensive physical examination is done from head to toe to screen for any abnormalities that can affect the athlete’s health or active sports participation. Most common abnormal findings during physical exam are decreased visual acuity and elevated blood pressures. Important details obtained during physical exam include:

  • Height – evaluate growth and development.
  • Weight – screen for obesity or eating disorders.
  • Cardiovascular – blood pressure, heart rate, evaluate for heart murmurs or irregular heart rhythms.
  • Eyes – visual acuity screening
  • Ears – hearing evaluation
  • Lungs – breath sounds
  • Gastrointestinal – abdominal swelling, enlarged organs, hernias, etc.
  • Skin – screening for rash e.g., scabies, ringworm is important for sports like wrestling.
  • Musculoskeletal – joint stability, strength, and flexibility, abnormal spine curvature
  • Neurologic – reflexes, gait abnormality

A young athlete would be medically cleared for sports participation if the medical history and physical exam are unremarkable. If there are concerns during the sports physical, further evaluation/tests could be done and if normal, the young athlete could be cleared for participation in time for the first sports activity of the season. If a condition is identified that may restrict an athlete’s medical eligibility for participating in a certain sport, shared decision-making should occur, including discussion among the athlete, the athlete’s family, and healthcare providers about the risks and benefits of participation. It may be appropriate to consider an alternative sports activity in which the athlete could participate.

The sports physical evaluation is also a common reason for young athletes to see a primary care physician and could serve to establish care for young athletes without a primary care physician. The sports physical allows for the inclusion of routine preventive health care into the visit when possible and this is usually covered by health insurance. Routine well-child visits and sports physicals help to keep your child healthy and safe and keep your child’s medical records and health history up to date.

Western Wisconsin Health has partnered with the Baldwin-Woodville, Ellsworth, Glenwood City, and Spring Valley School Districts to plan on site Sports Physicals for student athletes for a special discounted rate.  To schedule your sports physical or make an appointment with a healthcare provider please call 715-684-1111 or visit  Western Wisconsin Health, building a healthier tomorrow, together.