Pre-Participation Sports Physicals

As summer winds down, preparation for fall sports is top of mind for kids, parents and pediatricians. Pre-participation physicals are common at a time when families are busy getting ready to go back to school.

Some parents regard the visit as another box checked off on the back-to-school “to do” list. To your pediatrician, it is a chance to not only medically clear a child for sports, but also to go through a myriad of questions regarding school, behavior, nutrition and social issues.

A proper pre-participation physical covers many aspects, but namely achieves: 

  • Identifying underlying medical or musculoskeletal conditions that would make sports unsafe
  • Screening for underlying illnesses
  • Evaluating past injury patterns

A review of the family history may prompt a further evaluation as well, such as a history of sudden cardiac events. 

Pertinent issues that are typically covered include cardiovascular, neurologic, pulmonary and orthopedic conditions. Strategies are recommended for how to approach sports with certain medical conditions, such as asthma. Rarely is a child completely disqualified from sports, but may have some limitations placed. 

Good nutritional habits are another important topic. Is the child eating a balanced diet?  What is his/her calcium intake? This is especially important to the adolescent female. In addition, many youths have heard about supplements including creatine, either from friends or sometimes a coach. The potential harm of any supplement, and the lack of safety research, should be counseled to the athlete.

Many times a sports physical brings a teenager into the office who otherwise may not be seen that year or even over a few years. That visit helps maintain the patient-doctor relationship as it begins to mature from a parent-directed visit to a doctor-teenager visit.  It gives them a chance to address concerns at home, school performance, alcohol and sexual activity. 

While it may be tempting for a parent to go to an urgent care clinic to check off the “to do” of an annual sports physical, a great place to go is to your pediatrician, family practitioner or internist.  The medical home your primary doctor provides allows a partnership of care for your child, access to your child’s medical history, easy coordination for follow-up of any identified conditions and a doctor with whom the teenager is comfortable disclosing sensitive issues.

Parent involvement is still important, so make the appointment soon and plan on attending with your child.

Dr. Robert Atteberry is a Mercy Children’s Hospital St. Louis pediatrician.

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