Children’s school sports physicals


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Why it’s important to have your children’s sports physicals done by their regular doctor

Let’s get physical(s)

If your child plans to participate in fall sports, it’s not too early to schedule his or her sports physical.

During the July and August scheduling frenzy, some parents opt for the convenience of a physical at a school-sponsored clinic or walk-in location with a health care provider they have never met. These evaluations fulfill requirements for the Kansas State High School Activities Association (KSHSAA), but they may not ensure the complete screening and care your child needs.

A thorough annual physical conducted by the primary care physician who knows your child, has access to his or her medical history and has a rapport with your family not only fulfills the requirements but may reveal underlying health issues, says Philip Newlin, MD, a Via Christi Clinic pediatrician.

“It’s an opportunity for someone who knows you to look over things that may have been shoved under the rug; things that may be missed during a quick school physical,” Newlin says.

At age 16, Andrew Harms came to Newlin, his primary care physician, for a routine physical. Newlin saw something suspicious in Andrew’s throat and referred him to an ear, nose and throat specialist. A CAT scan revealed a tumor.

Andrew’s mother, Kathy, believes the benign tumor — removed before it grew large enough to restrict Andrew’s airway — would have gone unnoticed and may have resulted in a much more serious surgery had it not been for the thorough exam.

“I’ve always believed in having my children see a pediatrician for their annual physical,” she says. “They’re the ones who see kids every day. Dr. Newlin does a head-to-toe exam, not just a quick listen to the heart and lungs.”

The sports physical

The primary goal of a sports physical, also referred to as a pre-participation physical evaluation (PPE), is to obtain medical clearance for sports participation by detecting or ruling out two things: medical conditions that may predispose a child to injury, typically musculoskeletal; and conditions that may be life-threatening or disabling, specifically with the heart.

After the sudden deaths of several high school athletes from cardiac arrest in recent years, American Heart Association screening guidelines now call for medical history questions and physical exam elements to help determine if a child is at cardiac risk.

“Many athletes are very tough and competitive and won’t admit to any problems,” says Audrey Roberts, MD, a pediatrician for Via Christi Clinic in Newton. “They would have passed a quick PPE.”

Roberts notes the case of a patient who had lost more than 20 pounds and stopped growing taller since the previous evaluation, but neither the patient nor her parents had noticed. Through review of the teen’s medical record and questioning, Roberts says she discovered suspicious underlying symptoms that with testing concluded the girl had Crohn’s disease, a lifelong autoimmune disease of the gastrointestinal system that robs the body of nutrients.

The annual exam

Newlin says about one-third of the children he sees have an underlying health problem that needs to be discussed each year. One such patient is Brett Blackman.

Brett appeared to be a normal, healthy 1-year-old who wasn’t yet walking. Newlin looked at Brett’s growth chart, discovering his head circumference measured larger than average. Through further testing, Brett was diagnosed with hydrocephalus, a buildup of fluid inside the skull that leads to brain swelling. A shunt was surgically inserted to help drain the fluid. Today, Brett —  a 6th grader at Andover Central Middle School — is a healthy 12-year-old who enjoys playing baseball.

“Had we not seen Dr. Newlin that day, I don’t think another doctor would have put it all together from those symptoms,” says Brett’s mother, Kim.

More than a physical exam

A sports physical is often the only annual exam some adolescents receive, says Newlin. Having it with their regular physician offers opportunities to assess social and emotional development, discuss sensitive health matters like puberty, sex education and injury prevention, and advocate for healthy choices like avoiding tobacco, alcohol and drugs.

“Sometimes just hearing things from the doctor carries more weight than it does from a parent,” Newlin says.

Long-term relationships also can open doors to conversation and help lead children through their teen years. Newlin says it was the influence of his own pediatrician that led him down his chosen career path.

Many kids are modest, especially in the 10- to 15-year-old range, Roberts says. They may be too embarrassed to show or tell a parent about problems hidden under their clothing and they don’t pay attention to the color or consistency of their stool. Physicians’ directed questions can reveal potential problems.

“Walk-in physicals may be more convenient and less expensive, but the child gets so much more out of an exam with their own provider,” Kathy Harms says. “It establishes consistency and a relationship where the child feels comfortable.” 

For screening guidelines to check for cardiac risks and for more information, visit viachristi.org/school-physical

The benefits

In a full-screening physical evaluation, your child’s physician:

  • Reviews full medical history
  • Evaluates overall physical condition
  • Tracks growth and development progression, including puberty and social and emotional issues
  • Verifies current immunizations
  • Screens for potential problems such as cardiovascular issues and familial conditions such as high cholesterol and high blood pressure
  • Checks lymph nodes, organs, vision, posture, skin and genitals
  • Can assess behaviors such as eating disorders
  • Can arrange for follow-up care
  • Typically has access to on-site lab testing and vaccines

Preparing for your child’s physical exam

  • Fill out school’s sports pre-participation form.
  • Ask your child if there are any concerns. Think head to toe, asking questions about all parts of the body.
  • Don’t assume your child will bring up concerns at the exam. If your child is going without you, notify the physician of problems prior to the visit.
  • Schedule an annual eye exam with an optometrist.

 

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