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Sports physicals: a back-to-school must for student athletes

August 28, 2015 | Kristina Lindgren
Student athlete

Besides shopping for new clothes, notebooks and No. 2 pencils, many students have an even more important back-to-school ritual: the sports physical.

This vital checkup, required by schools before a child can join in athletic activities, is aimed at detecting problems that might pose a health hazard — such as:

For UCI Health pediatrician Paul Genser, these exams are an opportunity to make certain that his patients are healthy and ready to run cross-country, scrimmage or punt.

“We want to ensure that their participation in sports is a safe and healthy experience,” said Genser, a general practice pediatrician at UCI Health – Tustin who has been looking after kids’ health for more than 30 years.

Helping athletes play

The goal is to spot — and treat — conditions that otherwise could put a child engaging in strenuous activity at risk of serious injury, even death. 

“Because of these sports physicals, we’re able to qualify more kids than we disqualify,” Genser said. “In past, for example, if someone had asthma, the school would say, ‘You shouldn’t play.’ Now we can provide medication that allows them to participate in sports.

“The same is true for children who wheeze and cough when they play on grass. We’re able to give them medication.”

Detecting health risks before playing

These checkups, also known as pre-participation athletic evaluations (PAE):

  • Take about 20 to 30 minutes to complete
  • Usually start with a medical history
  • Assess the young athlete’s fitness and general health via a physical exam

Experienced pediatricians are able to detect injuries or health problems, including congenital heart conditions.

Sudden cardiac death, while relatively rare, is the leading cause of death among student athletes, according to the National Institutes of Health.

The California Interscholastic Federation this year began to require that coaches be trained to recognize the symptoms and empowered them to remove an athlete from competition if necessary. High schools, too, are requiring heart checks as part of the sports physical.

Heart testing crucial to prevent death

“We view the electrocardiogram as a standard part of our exam for high-school-level athletes, whether or not they’re participating in contact or exertional sports,” Genser said. “We’re looking for silent and unrecognized heart disease, such as electrical disturbances or arrhythmias, or enlarged hearts. It’s only a very small percentage of kids who have this, but the risk of competing with these conditions is substantial. The risk is sudden death.”

The test is done on the spot and the physician reviews the results. If any abnormality is detected, Genser said, the findings are sent to the UCI Health Pediatric Cardiopulmonary Clinic, where children’s heart specialist Dr. Anjan Batra and his colleagues can determine if further consultation and treatment are needed. “We have a very close relationship with his office.”

The pediatric heart services team also offers sports cardiology testing, when a higher level follow-up exam and clearance may be required.

Testing goals

The objectives of pre-participation sports evaluations, which have been around since the 1990s, are to:

  • Assess the athlete’s general health
  • Assess his or her physical fitness and conditioning
  • Evaluate prior or current injuries
  • Evaluate conditions that could make the athlete susceptible to injury
  • Assess the athlete’s developmental maturity
  • Detect congenital problems that could put an athlete at risk

Same-day exams available

At UCI Health – Tustin, where same-day appointments are often available for camp and sports physicals, the exam includes:

  • A thorough review of your child’s medical history
  • A review of immunization records to ensure they are current
  • A clinical review, including weight, height, blood pressure, pulse, heart, lungs, muscles and joints
  • Vision and hearing exams
  • A heart check and test for high-school age athletes
  • Information about preventing and recognizing signs of concussion
  • Completion of required paperwork

Some conditions may warrant limiting a child’s participation to less strenuous sports, at least for a time if, say, a hernia needs surgical repair or a heart arrhythmia requires treatment.

Promoting fitness

Genser said he also may recommend conditioning regimens to young athletes. “We work with children who need to strengthen parts of their body by giving them exercises that give them more confidence when playing.”

In the end, the physical helps reassure kids and their parents. It also serves to put children on a path to good health for life.

“We want to encourage kids to be physically active,” Genser said, “and help them have a healthy and safe experience.”

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