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August 1, 2010
Pre-participation physical for youth is a good idea

If you have an active child, he or she is probably involved in at least one sport.

"Although most youth can safely participate in just about any physical activity, it's a good idea to have your child undergo a pre-participation physical exam before getting started," advised Family Practitioner Michael Sevilla, M.D.

"In fact, if your child is on a school team, it's likely that he or she will be required to have this type of exam before the first official practice of the season."

Although the pre-participation physical exam (PPE) is common, parents may still have some questions about what's involved.

"This exam isn't meant to disqualify your children from playing sports," Dr. Sevilla continued. "Rather, it ensures that they can safely participate in the sport they want to play, or it directs them to another type of activity that's more appropriate for them.

"A sports physical is intended to help identify and deal with health problems that might interfere with your child's participation. For example, if he or she has frequent asthma attacks, a doctor might be able to prescribe a different type of inhaler or adjust the dosage so that the child can breathe more easily when running. Because exercise or cool air may trigger breathing problems, the physical exam is a good time to talk about how to best manage these kind of situations.

Fact Box

During a pre-participation exam, a doctor may:

Ask questions about your child's health and the health history of your family, such as:

- serious illnesses among other family members

- illnesses the child had when younger or may have now, such as asthma, diabetes, or epilepsy

- previous hospitalizations or surgeries

- allergies (to insect bites, for example)

- past injuries (including concussions, sprains, or bone fractures)

- whether the child has ever passed out, felt dizzy, had chest pain, or had trouble breathing during exercise

- any medications that the child is on (including over-the-counter medications, herbal supplements or prescription medications)

Conduct a physical exam, including:

- Listening to your child's heart and lungs

- Taking a blood pressure and pulse reading

- Checking the eyes, ears, nose, throat and skin

- Examining the back, joints, hands, feet, arms and legs

- Checking the abdomen

- Assessing for genital abnormalities or hernias

"Your doctor may also be able to suggest some ideas for avoiding injuries. For example, he or she may recommend specific exercises, like certain stretching or strengthening activities, that can help prevent injuries. Your physician also can identify risk factors that are linked to specific sports."

The PPE Exam

"During the actual exam, your doctor looks for physical problems that could predispose your child to injury, while also identifying any significant limitations that he or she may have while playing a certain sport," Dr. Sevilla added. "Very few seemingly healthy young people have a medical condition that will disqualify them from all sports, but it's not uncommon for a child to have to switch to a different sport because of a certain physical limitation.

"A doctor may also ask questions about the child's use of drugs, alcohol or dietary supplements, including steroids or weight-loss supplements, because these can affect a person's health," Dr. Sevilla advised. "Anabolic steroids, growth hormones and other products may have a negative effect on your child's development. Some of these substances increase the likelihood of injury or even death.

"At the end of the exam, the doctor will either sign off on the form if everything checks out, or in some cases, recommend a follow-up exam, additional tests or specific treatment for any identified medical problems."

When Not to Play

Many factors can cause a child to be disqualified from playing a sport. The results of a Mayo Clinic study showed that muscle and bone problems are the most common reasons for not passing a PPE. Old injuries that didn't heal properly or joints that aren't built to permit certain types of movement usually cause these kinds of disqualifications. Heart and vision problems are the next most common causes of disqualification.

"A child is rarely disqualified from playing all sports," Dr. Sevilla concluded. "Most often, a health condition prevents participation in sports with certain types of movement, such as pivoting or sidestepping. A child may be cleared for other types of activities that don't involve these types of movements."

Michael Sevilla, M.D., is a board certified family practitioner, affiliated with Salem Community Hospital's active medical staff. Appointments may be scheduled by calling his office at Family Practice Center of Salem, 2370 Southeast Boulevard in Salem, 330-332-9961.



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