Newswise — Your son is chomping at the mouthpiece to play high school football. But before he can embark on next month's tradition of two-a-day practices, he'll need to participate in another ritual " the sports physical.
He joins more than 12 million middle and high school athletes who each year are anxious to get a doctor's blessing, which is required to participate in sports, says Jay Noffsinger, M.D., professor of pediatrics at Saint Louis University School of Medicine and director of the sports medicine clinic at SSM Cardinal Glennon Children's Hospital.
"The ultimate goal is to have them all pass, but safely," he says. "We don't want to disqualify someone but we'd like to prevent catastrophes and pick up on conditions that predispose an athlete to physical injury."
Not all sports physicals are created equal, he adds. Here is Dr. Noffsinger's prescription for the best sports physical.
·Get your exam six weeks before practices start. That way, if a doctor picks up on a physical weakness such as an ankle that has been sprained 10 times and needs strengthening before competition, the athlete will have time to do the necessary rehab. "Six weeks is a pretty good amount of time to be sent into physical therapy and decrease the risk of re-injury."
·Answer the medical history form completely. A complete history identifies about three-quarters of the problems that affect athletes, and gives the doctor important clues about whether more intensive examinations are necessary. For instance, hypertrophic cardiomyopathy, which typically runs in families, is the number one cause of sudden cardiac death in young athletes. Because it usually is asymptomatic, doctors rely on a medical history to detect it.
·The parent and student should both sign the medical history form. Parents and children remember things differently " the medical histories given by athletes and parents separately agreed only 39 percent of the time, according to one study.
·Beware of "locker room" style sports physicals, where athletes line up in a large open room and a doctor gives them a quick head-to-foot once-over before signing on the line that clears a student athlete to participate. "That's the worst possible method," Noffsinger says. "There's no privacy, and there's too much noise to detect any problems, such as heart murmurs. It's very superficial." A better option is the "station" physical, which also might be given at schools but is much more comprehensive. It includes stops at multiple stations that typically are manned by health professionals who assess different aspects of an athlete's condition. A physician reviews all findings before issuing a final recommendation for clearance.
·Expect to have your vision checked. An athlete's vision with contacts or glasses should be at least 20/40. If one eye doesn't meet that standard, prepare to wear protection gear to protect the one good eye.
·Hypertension is the top reason athletes are disqualified. However some football players and other large athletes may get a false high reading because the standard cuff used to take blood pressure is too small to get a accurate measure.
·Tell your doctor if you have ever blacked out suddenly while in the middle of a game or a competition. "These are the patients who need a full medical workup for a potentially dangerous heart problem that can be extremely serious."
·Let your doctor know if you've had heat illness or a concussion before. "Heat illness is a preventable cause of death in sport. A history of one significant heat illness places an athlete at higher risk of a second occurrence," Noffsinger says. "And if you had a concussion, you are five to six times more likely to have another."
"As obesity rates skyrocket among children and teens, one of the last things we want to do is discourage physical activity," Noffsinger says. "Athletes in general are a lot healthier than the examining physician. The goal of the sports physical is to detect problems that may be life threatening or disabling and to pick up on conditions that may make them vulnerable to injury."
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