The best place for your child’s sports physical is in the pediatrician’s office
Update February 2021: Schools are beginning their re-opening phases and with that means the return of school sports. Many teams have already started to practice and are hopefully continuing to use COVID-19 precautions as recommended by the American Academy of Pediatrics. Whether they’re playing on a court or a field, your child will need proof of a current sports physical examination. Furthermore, if your child had a past infection with COVID-19, they will need clearance as discussed below.
Why do kids need a sports physical?
Pre-participation physicals (sports physicals) are usually required by the school district or sports league to ensure your child is physically ready to play. In addition, sports physicals are the best way to inform coaches about a player’s medical issues or previous injuries.
The American Academy of Pediatrics recommends the pre-participation physical exam take place with the student-athlete’s primary care doctor. This allows for a complete and private visit with a physician who knows your child and is familiar with their health history, allowing them to evaluate any record of past injuries or concussions. The medical home is also the best place to get further referrals or testing if needed and to coordinate care that may be required throughout the season.
What should you expect during a sports physical?
During your child’s sports physical, your pediatrician will review your child’s medical records, family history and immunization records. A detailed history will also include reviewing allergies and medications. Certain conditions, like asthma, may require further instructions for coaches so be prepared to discuss all medical history. Your pediatrician may also screen for mental health concerns.
This is also a good opportunity for your pediatrician to counsel your athlete on healthy habits like good nutrition, drug and alcohol avoidance, and playing sports safely. Furthermore, your athlete may be reminded about, stretching, injury avoidance, hydration and practicing in the heat.
After completing a detailed medical history, your pediatrician will perform a complete medical exam. This will include height, weight, blood pressure, heart rate and vision. Female athlete’s may be asked about their menstrual cycle and the physical exam will likely include an assessment of pubertal development for everyone. Male and female athletes may be screened for inguinal hernias so please remind your child that the doctor is allowed to check their private parts for this purpose. If your pediatrician feels your child is cleared for sports, they will be able to complete required paperwork. Some things come up during the sports physical that may require clearance to be delayed or to occur under certain conditions. Your pediatrician will order any tests or referrals required and may recommend a return visit to complete your child’s clearance and follow up on concerns.
What if your child had COVID-19?
COVID-19 infections can result in inflammation of the heart, known as myocarditis. Therefore, all athletes should be cleared to return to sports following an infection. All athletes should be out of isolation (10 days from the start of symptoms or positive test with symptoms resolving and no fever for 24 hours) prior to beginning a return to play.
- Mildly symptomatic patients with asymptomatic or minimally symptomatic infections who screen negative for any new onset chest pain, shortness of breath, or heart palpitations during or following their illness, and who have a normal physical exam, can begin their gradual return to play.
- Moderately symptomatic patients who had fever for more than 4 days, fatigue, body aches and/or a hospital stay (not in the intensive care) for their illness will require clearance from a cardiologist. They may need blood tests, electrocardiograms, imaging or other testing.
- Severely symptomatic patients who required intensive care or intubation (breathing tube) or those who had multi-system inflammatory syndrome in children (MIS-C) will be restricted from sports for at least 3-6 months.
Gradual return to play is similar to the return to play following a concussion. See the summary below adopted by the American Academy of Pediatrics.
