A healthy living blog from Marshfield Clinic Health System

4 things to know about a sports physical


Sports physicals identify if your child is at risk for underlying issues.

Before the sport season starts, it is important for your child to have a pre-participation physical examination, or sports physical. The screening will identify underlying areas of concern that may become a risk during the sports season.

Family and medical history identify risks

The sports physical can be a part of your annual well-child visit with a primary care or family medicine provider. Your child’s provider will review any past injuries, fractures or sprains that might affect your child’s physical ability. You’ll also talk about your family history that may predispose your child to a risk for cardiac issues during strenuous activities.

“In our comprehensive list of questions, one aspect of the child’s family and personal history that is incredibly important is any history of potential undiagnosed heart problems,” said Dr. David Holz, a Marshfield Children’s pediatrician at Marshfield Clinic Health System. “Sudden deaths in family members from unknown causes including drownings, sudden infant death syndrome and single car accidents could be due to heart issues.”

During the sports physical there is a head to toe physical exam.

“We pay special attention to the heart and cardiovascular exam to make sure there isn’t anything that could raise concerns,” said Dr. Holz. Providers also listen to the lungs for wheezing, coughing, shortness of breath or other signs of asthma. Finally, providers will complete a full exam, checking joints for normal range of movement, signs of swelling or other restrictions.

Timing is important for annual sports physical

Schedule exams at least four to six weeks prior to the season and practice start date. This gives plenty of time to act on any potential problems, which may include needed tests, visits to a specialist or physical therapy.

Most schools will recognize the physical as current for two years. Dr. Holz encourages annual visits since your child is still growing and developing. There’s much that can change over a year that can affect your child’s ability to participate in sports.

Athletes who had an injury during the season may benefit from repeat physicals in the same year.

“We’ll focus on the injured area to see how it healed,” Dr. Holz said. “We evaluate how the next sport will place stress on your body, if it can withstand those demands or if there’s a risk of a reoccurring injury.”

A sports physical is more than a physical exam

Not all sports screenings need to take place in the doctor’s office. You have options, but Dr. Holz recommends opting for your primary care provider.

“Your child should be seen by a professional who has adequate training to identify potential clues that can point to possible heart-related problems both from the patient’s history and the exam,” he said.

Your provider has experience to identify underlying issues and can make referrals for any needed follow up evaluations.

Opportunity to ask questions

One common concern parents have is concussions. Providers can do a pre-concussion screening. This can provide valuable information down the road if the child has a head injury.

“Interestingly, many kids can show a number of symptoms related to concussions without ever actually having a concussion,” Dr. Holz said.

These symptoms can include short attention span, poor focus, irritability and fatigue. These are problems that many adolescents commonly experience at baseline. It’s helpful to have this information before starting a sport.

“Otherwise they might be unnecessarily restricted from activity after an injury because they test positive for a concussion due to symptoms they already showed even prior to the injury,” Dr. Holz said.

Families of competitive athletes are sometimes hesitant to bring up their pains or mild injuries. They are concerned their child will not be able to compete. However, kids are generally only limited or removed from participating if there’s a high risk to either the child’s health or longer term complications.

“We support adolescents being active, but not at the expense of their safety and future well-being,” Dr. Holz said.

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How to recognize kids’ concussion symptoms


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