The benefits of participating in school-based sports are numerous. Not only is it a great way for your child to stay in shape, but it provides an environment in which (s)he can develop an appreciation for the importance of team work and a means by which (s)he can ascertain life skills such as conflict resolution and time management.  It also can prove to be a fun way to foster communication and social skills.

Under normal circumstances school sports offer a safe venue in which the student athlete can develop these traits.  However, some children and teens may have an underlying health condition that could put them at risk if they were to participate in physical activity without it being treated or managed.  To protect the health and safety of the student athlete, many schools require a sports physical exam, also know as a pre-participation physical exam (PPE), prior to starting the season.  Even if your child is perfectly healthy, a PPE offers the opportunity for your child to discuss personal issues, such as sexual activity and drug use, with the physician that (s)he may not want to openly share with you.

Purposes of the pre-participation exam:  

• To identify life-threatening situations.
• To assess the musculoskeletal system to rule out conditions that could cause discomfort during physical exertion (e.g., tendonitis).

The PPE basically consists of two parts: the medical history and the physical exam.

Information obtained from the medical history:

• Health conditions present at birth.
• Past illnesses and injuries (e.g., bone fractures, sprains, concussions, etc.,).
• History of surgical and non-surgical procedures.
• Current health condition (e.g., allergies, asthma, etc.,) and symptoms (e.g., shortness of breath, wheezing, etc.,) experienced.
• Current lifestyle habits (e.g., diet, exercise, sexual activity, and drug, alcohol, and tobacco use, etc.,)
• Immunization records.
• Questions regarding menstrual activity for female athletes.
• Family history of congenital (at birth) health conditions and/or chronic diseases (e.g., diabetes, heart disease, etc.,).
• List of current medications, if any.

What to expect during the physical examination:

• Height and weight measurements.
• Assessment of heart rate and blood pressure and, in some cases, an electrocardiogram (heart rhythm).
• Evaluation of visual acuity and hearing sensitivity.
• Assessment of motor reflexes.
• Palpitation of pulse points.
• Evaluation of blood and urine samples.
• Examination of the cardiovascular system (e.g., listening to the heart and lungs via the stethoscope), eyes, ears, nose, mouth, throat, abdomen, and genitalia.

Depending on the results of the PPE, your child may be referred to a specialist for further evaluation.  It is a good idea to bring a list of medications and questions with you to present to the doctor. If your child is old enough, you may want to stay in the waiting room, at least part of the time, so that your child has an opportunity to discuss any personal questions with the physician privately.  It is important that you and your child completely and honestly answer all of the physician's questions to increase the student athlete's chances of experiencing a safe sports season.

Resources:

ACSM Fit Society Page, Summer 2009, "Pre-Participation Physical Examinations," Rich, B.