Annual Sports Physical
Why is it that doctors and schools want your healthy teenager to have a school sports physical before the school sports season starts every summer? The reasons may not be what you think; they don't have to do with finding undiagnosed hernias or bad knees.
Schools want athletes to have physicals before sports start in large part because they want to be sure that an athlete's heart will tolerate vigorous sports. Every year in America a few athletes die unexpectedly during sports due to some kind of undiagnosed, rare heart defect. Doctors can help screen for such defects by listening to the athlete's heart for certain murmurs, asking about a family history of sudden death during exertion, and asking if the athlete has ever fainted / almost fainted while playing sports. Sometimes an heart tracing (EKG) or heart ultrasound (echocardiogram) is necessary to diagnose the problem. Schools are also concerned that athletes who have existing health problems are not playing a sport that will make their disease worse, etc. Diabetics, for example, may need insulin adjusted, athletes with some medical conditions should not play certain sports, etc.
Doctors want to see your athlete in part because sports physicals tend to be the only time healthy young people come to the doctor, and not primarily because they expect to find some abnormality on the physical examination of the athlete. At these physicals the chance that the doctor will find some kind of undiagnosed, serious physical abnormality is small. Most such abnormalities, if they exist, have been picked up on previous exams. What the doctor doing the school sports physical often really wants to do is just to talk to your teenager about what really gets teenagers in trouble - drugs, unprotected sex, depression, and injuries - especially car crashes.
That's because weird heart abnormalities are not what usually kill or seriously harm our teenagers. The most common causes of death of teenagers in Maine are first, car crashes, and second, suicide. Depression and thoughts of suicide are common among teenagers, and yet they often do not come to the doctor complaining of the problem. The school sports physical is a chance for the doctor ask the teenager about depression, about whether they use seatbelts, about whether they are sexually active or considering initiation of sexual activity, about drinking and drug experimentation, etc. That's the real benefit of getting the reluctant teenager to the doctor once in a while.
The annual sports physical is about the old equation of an ounce of prevention being worth a pound of cure.
Dr. Erik Steele, DO