The Sports Physical

What is a Sports Physical?

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.

The newest version published (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 (age) they begin sports which for some is as young as 4 – 5 years old.

A 2014 paper reviewing state high school guidelines stated:

  • "Our results show that inconsistencies in PPE policies exist nationwide." 

  • 23 states required or recommended use of the most recently updated form (as of 2014) or a modified version of it

  • 27 states required or recommended use of outdated or unidentifiable forms

  • Ten states had not revised their PPE forms in >5 years

  • 41 states required an annual PPE for 9th grade and up

  • Only 1 state required a PPE for 8th grade athletes, 13 states for 7th grade, and 10 states for 6th grade.

  • As of 2014 12 personal and family history items that were part of a complete PPE. Only 22 states address all 12 items and 15 states addressed fewer than 3 items.

    • "These findings are concerning because a 2012 study ... reported that in 40% of the sudden cardiac arrest cases studied, parents described the presence of at least 1 significant family history component before their child’s sudden cardiac arrest and in 27% of cases, a family member had suffered sudden death before 50 years of age because of a heart condition."

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. 

Below are five stories of athletes being saved by a proper sports physical:

 

Click here for the complete Preparticipation Sports Physical History Form

Click here for a printable PDF of the Preparticipation Sports Physical History Form

Click here for the Cardiac Screening Athlete Survey - see videos below

For your Pediatrician: Jonathan Drezner, MD, International Criteria for ECG Interpretation in Athletes Overview of Abnorma

 

References:

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?

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