This is the time of year for pre-participation physical examinations for school athletics. While some parents are ahead of the game and had their children examined in the spring, others may be questioning whether their children truly need such an exam.
Jennifer Mitchell, M.D., FAAFP, associate professor in the Texas Tech University Health Sciences Center Department of Family Medicine, says although many parents view these exams as an expense of money and time, they are necessary for children who are going to participate in football, baseball, basketball, swimming or any other sport.
The Texas University Interscholastic League requires a physical exam form be completed and on file prior to any practice, scrimmage or contest before, during or after school. The form must be completed prior to junior high participation and again prior to the first and third years of high school athletic participation.
In addition, a medical history form must be completed yearly and a physical examination form completed if there are any “yes” answers on the history form. Local district policies may require an annual physical examination.
Mitchell says there are other benefits to having your child complete these examinations, besides their eligibility to participate in athletics.
“This is sometimes the only visit a child will make to see a physician,” Mitchell said. “It is a good opportunity to review any chronic medical conditions and evaluate the medical treatments.”
Mitchell added that these exams also are an opportunity for parents to review their child’s preventive health care and to be sure all immunizations are up to date.
“A thorough physician will review adolescent issues with the child and give guidance on topics such as alcohol, tobacco and sexuality,” Mitchell said.
Vision screening is done to assess whether the child is beginning to need glasses. Typically, children with vision screenings of 20/40 or worse should be seen by an eye care specialist.
During the vision screening, the physician may reinforce the need for eye protection appropriate for the child’s sport and the use of a mouthpiece in contact or high-risk sports.
Vital signs are reviewed which could make one aware of an early presentation of elevated blood pressure. This is important as people with hypertension do better overall with early intervention.
A major benefit of the exam is the ability to screen for potentially serious cardiac abnormalities. There are more than 20 abnormalities identified that may predispose an athlete to sudden cardiac death. Some of these can be noted on careful historical questioning and examination. If there is a concern, the physician can order further testing such as an EKG, echocardiogram or exercise stress testing to further evaluate for this. These tests are typically not done during a routine exam. However, this is a controversial area and some programs are beginning to offer such testing as part of their evaluation.
Another benefit of the exam is to screen for potentially correctible musculoskeletal deficits — such as muscle weakness or tendonitis — that may predispose an athlete to injury. If abnormalities are noted, a rehabilitation program can be devised along with the athlete’s athletic trainer or coach to minimize the chance of injury.
Laboratory testing is not cost effective and is not routinely recommended for the screening exam unless something is brought up in the history or during the examination, implying a condition that needs further evaluation.
Overall, Mitchell says the Pre-Participation Physical Exam is an important aspect of sports participation. So parents, think of it as an investment in your child.