Playing on a community or school sports team is a great way for teens to stay in shape and learn teamwork. That's probably why more than 38 million American children and teenagers play at least one sport.
Sports physicals typically start in middle school and go through high school. Many club sports, however, do not require a physician's clearance.
No matter which sport your teen plays -- whether it's soccer, football, baseball, track, or martial arts -- there's always a risk of getting hurt. The casualties of teen sports can range from minor sprained ankles and repetitive strains, to more serious conditions like heat stroke or concussion. Some kids have serious allergic reactions to bees and other stinging insects found around playing fields.
To avoid getting hurt or sick on the field, court, and track, teens need to be prepared. That preparation starts with seeing a health care provider for a sports physical to make sure their bodies are ready for the season ahead and that there isn’t a family history or past medical history that requires further attention.
Some states won't let young (middle school-age) athletes start a season or play a new sport without first having a sports physical. Even if your state doesn't require a sports physical, it's a good idea for every teen who plays a sport to get one annually to make sure they're in top shape and healthy enough to safely participate.
What Is a Sports Physical?
A sports physical -- also known as a pre-participation physical examination -- is a check-up to assess a teen's health and fitness as it relates to a sport. During the sports physical, the health care provider looks for any diseases or injuries that could make it unsafe to participate in sports by reviewing the family's medical history to ensure additional tests are performed if necessary.
Where Is a Sports Physical Done?
The teen's pediatrician can perform the sports physical. Physician's assistants and nurse practitioners also can do a sports physical and sign the required forms. While sports physicals are offered at other clinics, such as those inside some drug store chains, they can be combined with, but should not take the place of, an annual physical exam by your teen's health care provider.
Many schools also offer sports physicals. They'll usually set up stations around the gym, where health care providers will perform the different medical tests.
When Is a Sports Physical Done?
Ideally you should try to have the exam done about six to eight weeks before sports season starts. That way, if the health care provider wants to treat a condition, refer you to a specialist, or do a follow-up exam, there will be enough time before the sport begins to be cleared to play.
What to Expect During a Sports Physical
Your teen's sports physical should start with a thorough medical history. The health care provider will ask about any history of illness, hospitalizations, or injuries that might prevent your teen from playing, or that might limit the amount of activity your teen can handle. Your teen should be asked to fill out a health history form as well as a teen questionnaire that investigates daily habits and lifestyle choices ( it asks about drug and alcohol use, among other topics).
- Shortness of breath or chest pain during exercise
- Dizziness or fainting spells
- High blood pressure
- Excess fatigue
- Frequent headaches
- Eating disorders
- Vision problems (wearing glasses or contact lenses)
- Epilepsy or seizures
- Past surgeries or injuries (broken bones, fractures, dislocations, or concussions)
- Heart problems such as a murmur or abnormal heart rhythm
- Bone, joint, or spine injuries
- Skin problems
- Severe allergies such as to food, pollen, or stinging insects
- Liver or kidney problems
- Use of certain medications including prescription, over-the-counter, illicit, and herbal medicines
- A family history of heart problems or sudden death before age 50
The medical history will be followed by a physical exam, in which the health care provider will:
- Measure height and weight
- Take pulse rate and blood pressure
- Check the heart and lungs
- Check neurological function such as reflexes, coordination, and strength
- Test your child’s vision and hearing
- Check the ears, nose, and throat
- Look at joint flexibility, mobility, spinal alignment, and posture
- Screen cholesterol depending on the child's age, obtain a hemoglobin count, and perform a urinalysis
- Genital exam (to screen for hernias in males)
- Immunizations if needed
Girls may also be asked about their period, and whether it's regular. Additional testing such as blood tests, X-rays, or electrocardiogram may be ordered during the sports physical.
Will My Teen Be Able to Play?
At the end of the sports physical, the health care provider will decide whether it's safe for your teen to play the sport.
The health care provider's decision is based on several factors, including the:
- Type of sport and how strenuous it is
- Position played
- Level of competition
- Size of the athlete
- Use and type of protective equipment
- Ability to modify the sport to make it safer
If everything checks out during the sports physical, the health care provider will give the OK to play without any restrictions. Or the health care provider might recommend certain modifications, like using special protective equipment, carrying epinephrine auto injectors for severe insect allergies, or using an inhaler if your teen has asthma.
It's rare for teens to be barred from playing entirely. Most health conditions won't prevent kids from participating in sports, but sometimes they'll need treatment and a follow-up exam in order to play.
Finally, remember that even if your teen has a sports physical every season, if it is not a complete physical exam, he should still receive a comprehensive health exam each year. If your teen takes a break from sports one year, make sure they still receive an annual check-up.