The importance of sports physicals

With the start of the new school year, many parents are scheduling their children for their back-to-school check-ups. According to Gabriel Neal, MD, clinical assistant professor at the Texas A&M College of Medicine, family medicine clerkship director with the Texas A&M Integrated Medicine Program and director of Texas A&M Family Care, sports physicals are an important part of that back-to-school checklist if your child or teen is considering even casually playing sports.

What is a sports physical?

The purpose of a sports physical is to give providers an opportunity to catch potentially life-threatening health problems that can be exacerbated by sports activity. Most schools require each student athlete to complete a sports physical prior to starting practice.

An average sports physical includes a comprehensive discussion about your child’s medical history and a physical examination. If the health care provider does not see any potential complications that may be exacerbated by the sports activity, then they will sign off on any required school paperwork. “If your health care provider does identify a possible issue, they may conduct further testing or recommend you see a specialist,” Neal said. “Other times, they may ask you wear a brace or make other modifications during moments of activity.”

Medical history to know prior your sports physical

In every sports physical, your health care provider will ask about your child’s personal medical history as well as that of your family.

When asking about family history, a health care provider will inquire about…

• Sudden or explained premature deaths from anyone before the age of 50 due to heart disease
• Disability from heart disease
• Certain cardiac conditions like Marfan syndrome, arrhythmias, etc.

When asking about personal medical history, a health care provider will inquire about…

• Excessive fatigue during exercise
• Previous diagnoses of a heart murmur
• Asthma or other breathing problems
• Constant headaches or a history of concussions

“In these conversations, your provider is listening for anything out of the normal,” Neal said. “Your family medical history provides great insight about any possible issues you and your child may experience as you age.” 

The physical examination during a sports physical

“One of the most important things we can identify during a sports physical are heart and lung problems,” Neal said. “We hope to keep the child healthy and injury-free.”

A routine physical examination during a sports physical includes an assessment of vital signs, vision screenings and hearing screenings. Providers also look for joint and muscle problems. “We perform a neurologic exam and heart and lung tests,” Neal said. “We make sure you have no problems with your head, shoulders, knees and back.”

If a provider sees an issue, they may recommend a specialist. However, if the issue is simply a history of twisted ankles or joint instability, they may just teach strengthening exercises and give the student athlete a brace to prevent further injury.

For men, the providers check for a hernia during a sports physical. For women, providers do not need to perform a pelvic exam. However, if their sports physical coincides with their annual well-women check, then the provider may suggest a pelvic exam, depending on other health factors.

“We may notice eating disorders in young athletes, especially in girls,” Neal said. “Some female athletes consume far too few calories for the amount they burn. This deficiency causes some to miss menstrual cycles.” On the flip side, he notes providers notice a lot of obesity and hypertension in children during their sports physicals as well.

Are sports physicals covered by insurance?

“Many insurances do not cover sports physicals for school,” Neal said. “We recommend pairing these physicals with the well-child visit, which most insurances do cover.”

However, many schools partner with local clinics to perform sports physicals on campus. If you cannot afford a sports physical, ask your school if they have any partnerships or local clinics that they suggest.

When is the best time to get a sports physical?

“The best time is to get a sports physical is four to eight weeks prior to the start of the season,” Neal said. “It will give us time to investigate any complications or concerns that come up.” Similarly, an earlier sports physical gives you more time to be evaluated by a specialist, if needed.

“A sports physical is a great way to engage teenagers in their health care, when they otherwise may not get their regular checkup,” Neal said. “We perform sports physicals to keep you alive and healthy, so do not be afraid to ask questions.”