Sports physicals, also called a pre-participation physical examination (PPE), are typically required for high school and college athletes before they are cleared to practice and compete. The examination usually consists of medical history (what the parent/athlete completes) and a physical exam (what the physician performs) and to make sure that the athlete is healthy enough to participate.

However, the sports physical is typically NOT required for out of school sports as in leagues and clubs. Does this make sense? Of course not!

The newest version published in 2019 by the American Academy of Pediatrics has expanded in scope to include kids in activities outside of organized sports. It also urges middle-school through college-age athletes to have their sports physical during the well-child exam to ensure that they receive comprehensive care within the medical home. We would like to add that all children should have a proper sports physical at the time they begin sports which for some is as young as 4 – 5 years old.

Here is the link to the History Form and the link to the Examination Form (the doctor part). Make sure these are the forms used by your school or league.

Go through the History Form slowly and read each question. You may discover (uncover) some medical issues you have not considered before. This is not to scare you, but to make you take a step back and really think about your child(ren) and family.

The Heart. If you think there may be a possibility of heart issues, see this fantastic Athlete Survey. Answer each question Yes or No. Watch the videos to help you fully understand each question (questions 4 – 13 on the History Form). Be honest!

The Heat. It is really hot in Texas! So let’s take the heat very seriously. Answer these questions:

• Has your child been training over the summer? Inside or outside?
• Has your child spent the rest of the day inside or outside all summer?
• Has your child had trouble or complications from exercising in the heat (e.g., feeling sick, throwing up, dizzy, lack of energy, decreased performance, muscle cramps, headaches, change in behavior)?
• Has your child previously been diagnosed with heat exhaustion or exertional heat stroke?
• If yes,
  • How many times (write down the dates)?
  • Were there any complications?
  • How long did it take to return to sports?
• What color is your child’s urine?
  • Iced-tea color means dehydration
  • Lemonade color (light yellow) means good hydration
  • NOTE: hydration is a DAILY responsibility!

Here is the link to the 2015 National Athletic Trainers’ Association Position Statement: Exertional Heat Illnesses

​The Head: Has your child played football or other collision/contact sport since a young age? Have they sustained head contact (head hitting the ground, head hitting equipment, head hitting another player) that has been diagnosed as a “concussion?” Have they sustained head contact, but not exhibited obvious signs and symptoms?

Below is a list of signs and symptoms. Review these with your athlete. It may be eye opening for you.

• Physical: Headache, Nausea, Vomiting, Balance Problem, Dizziness, Visual Problems, Fatigue, Sensitivity to Light, Sensitivity to Noise, Numbness/Tingling, Physical Pain other than Headache,
• Thinking: Feeling Mentally Foggy, Feeling Slowed Down, Difficulty Concentrating, Difficulty Remembering,
• Sleep: Drowsiness, Sleeping Less than Usual, Sleeping More than Usual, Trouble Falling Asleep
• Emotional: Irritability, Sadness, Nervousness, Feeling More Emotional

Many sports physicals are performed in a mass or group setting vs being performed by your child’s personal pediatrician. We recommend that you discuss this with your child’s pediatrician and make it part of your child’s annual wellness examination. Kids change: they grow, they have injuries, their physical abilities change, their emotional status changes, and their cognitive abilities change. It is so important to monitor this annually with your pediatrician. And make sure your pediatrician understands sports injury care. Many do not.

Below are five stories of athletes being saved by a proper sports physical. Yes, SAVED by a proper sports physical.

• ​Jaylen Brantley
• Randy Russell
• Clarence Kennedy
• Sam Schoonveld
• Kyle McCabe

Competing hard and safety do not have to be mutually exclusive. Do the right thing and get your child ready.

References and Additional Reading:

• ​Missed Opportunities in the Preparticipation Physical Examination for High School Athletes.
• ​Web-based multimedia athlete preparticipation questionnaire: introducing the video-PPE (v-PPE).
• ​Preparticipation Sports Physicals: A Comparison of Single Provider and Station-Based Models.
• ​What can family medicine providers learn about concussion non-disclosure from former collegiate athletes?