“Sports physicals” are one of the most commonly demanded services by teens. These physicals required for participation in many school sports offer a chance to complete a comprehensive evaluation (EPSDT) and a screening process for a specific athlete and a particular sport.
Many schools provide their own form to fill out for sports participation, and we are linking a 2000 consensus form endorsed by AAFP, AAP and sports medicine groups. This form can be modified to suit your practice or can be used with the permission of the above groups. “BMI percentile” should be added to the physical form.
For further updated insights into the sports physical:
Medscape offers a comprehensive 2007 E-medicine article.
A 2001 review article from the AAP focuses on medical conditions affecting sports participation.
A 2000 AAFP article stresses cardiovascular screening.
Some points to consider:
- The importance of cardiovascular risk factors that might point to a hypertrophic cardiomyopathy, arrythmia, or pre-existing outflow obstruction. These include a family history of exercise-induced collapse, syncope or death, early family history of MI, or an exam finding of a murmur that is worsened by Valsalva maneuver. Persistently elevated blood pressure requires evaluation as well.
- An anaphylaxis and asthma history. Outdoor sports present a risk of hymenoptera stings or exercise-induced anaphylaxis. These conditions require evaluation and injectable epinephrine availability during exercise. Patients with significant asthma need PFTs and appropriate medical management of their disease. Most important is communication with the coaches that patients need to be able to take their own time-outs when they develop symptoms.
- Staphylococcal infections of the skin or other skin diseases need to be effectively treated before engaging in close contact sports such as wrestling.
- Inguinal hernias are important to recognize, but exclusion from sports is mostly related to incarcerated hernias.
- Visual and musculoskeletal abnormalities may limit sports participation in certain sports (e.g. baseball and gymnastics) but not others.
Resources
http://www.amssm.org/MemberFiles/ppehistory.pdf