Every August, a flood of anxious parents call our health centers, desperate to schedule a sports physical that will allow their teen to participate in school-sponsored athletics as soon as possible. With the beginning of the school year, scheduling a medical exam becomes just one more thing to check off the list—but it shouldn’t be.
These pre-participation exams are important for two main reasons. First is the obvious legal reason: teens need to be medically cleared to play sports. Without a thorough physical assessment by a qualified medical professional, teens could be at-risk for severe health complications.
The second reason is at least as important as medical clearance: annual exams are sometimes the only opportunity we get each year to check in with this otherwise healthy population. Adolescents are among the highest risk-takers of any age group, and they’re experiencing physical and emotional changes that can leave them feeling overwhelmed and out of sorts, sometimes dangerously so. Not all teens feel up to handle the confusion of puberty, peer pressure about drugs and alcohol, curiosity about sex, and all the other things that make life an emotional roller coaster during high school.
As advertisements for back-to-school sales start, I often hear announcements about sports clinics, where teens can get a perfunctory exam that meets the minimum legal requirement, and parents can cross “Get sports physical done” off their list. These clinics are far better than no exam at all, but they aren’t nearly as good as a private one-on-one with their regular medical provider, with someone who can interpret exam results in the context of the teen’s (and their family’s) medical history.
On the medical side, a thorough sports physical can be truly life-saving. The strenuous demands of school sports can trigger severe problems resulting from previously undiscovered cardiac, respiratory, and orthopedic abnormalities. And if the student athlete has had concussive injuries, a thorough sports physical can pick up symptoms that may indicate whether further sports activity could lead to catastrophic harm.
As important as the physical exam is, the percentage of abnormalities that limit sports participation are dwarfed by the social and behavioral issues that I find during these exams, everything from undiagnosed mental illness to growth and development problems. With the parent’s permission, I include time during the exam to talk to teens without the parent in the room, because having a safe, confidential space with a non-threatening, non-judgmental medical professional they trust can have a huge impact on the health of teens. Even in the best parent-teen relationships, there are things teens do not want to share with their parents. Allowing them to express concerns, admit to behaviors they don’t want to share openly, or discuss other issues can help keep young athletes safe and healthy.
Of course, medical providers can only do their jobs if they have all the pieces of the puzzle. I cannot urge parents enough to share a complete and detailed medical history and to encourage their teens to be open and honest when answering a medical provider’s questions. Leaving out details or downplaying problems because they’re worried about getting medical clearance is a dangerous game. A problem that “only happened once” could be an indicator of something bigger. Lots of little, seemingly insignificant and unrelated issues may point to a condition or health problem the provider recognizes, something that could have devastating consequences if left unaddressed. Tell teens to tell the truth, the whole truth and nothing but the truth and we, as medical providers, promise only to limit play time if we think it’s necessary.
If you’re a parent with a son or daughter who needs a sports physical for the upcoming school year, don’t wait: call your medical provider today! And, unless your child is already 18 years old, be sure to accompany them to the appointment. This allows you to provide consent for treatment and it shows them you put a high priority on their health.
Justin Ebert is the medical director at MCHC Health Centers—a local, non-profit, federally qualified health center offering medical, dental and behavioral health care to people in Lake and Mendocino Counties.