TROY – Over the years, mass sports physical events conducted at schools were created to help students complete pre-participation physical examinations in an efficient manner. However, reports of sports-related illnesses and unexpected deaths have brought the effectiveness of this approach into question.
At least six medical societies – including the American Academy of Pediatrics (AAP) and the American College of Sports Medicine (ACSM) – now believe mass school physicals deny students the comprehensive care necessary to determine if they are healthy enough to participate in competitive sports. Children involved in athletic programs are required by the Ohio High School Athletic Association to receive a sports-specific exam that screens for potential health problems and provides quick identification of any immediate health dangers.
In recent years, the deaths of student athletes have become highly visible events. Recent research published in the Journal of Athletic Training found that sudden cardiac arrest is the number one killer of young athletes, claiming the life of a young American athlete every three days. Other common causes of non-cardiac sudden death in athletes may include sickle cell crises, heat stroke, and asthma, according to the ACSM.
Mark Zunkiewicz, MD, an orthopedic surgeon with Upper Valley Orthopaedics, said the best preventive measure remains an annual physical examination that includes detailed and accurate family and physical histories. Most medical societies agree this is best- accomplished with an individualized examination at a physician’s office. Dr. Zunkiewicz is co-chair of the sports medicine.
Dr. Zunkiewicz said sports physicals conducted at schools often require students to rotate among stations where physicians take vital signs, listen for signs of deeper problems such as heart murmurs, and look for pre-existing conditions like hernias. The physician’s recommendation is based upon these outcomes and information provided on a brief family history form completed by a parent or guardian.
“What we were doing at these schools were screening physicals where students spent a maximum of five minutes – many times less – at each station ,” said Dr. Zunkiewicz , who directed the musculoskeletal station at schools such as Tipp City. “The purpose of these physicals is to identify kids who are at-risk when participating in high-level or rigorous sporting activities. We are especially looking for kids with undetected cardiovascular problems that could lead to sudden death. We have been very lucky that our community has not experienced such an event and we want to implement the best measures to ensure it stays that way.”
Still, sports physicals aren’t just about preventing health problems that might take place in the sports arena. According to the AAP, school-related physicals are often the only visit most children and teenagers have with their physician each year. When students have their sports physicals completed by a team of doctors at school, they are denied an annual checkup that is often more in-depth, said Paul Weber, MD, a pediatrician with The Pediatric Group in Troy.
Patients who are seen by their primary care physicians have the benefit of a well-established relationship. In many cases it’s this trusted relationship that enables a physician to catch issues an adolescent may have simply forgotten about or thought was not important.
“The point is students who go to their primary care physician are getting a detailed personal history and a detailed exam with someone who knows them. We are trying to protect these athletes to the best of our ability, and we have come up with a way to make it better,” Dr. Zunkiewicz said.
Continuity of regular physical exams is invaluable for students – no matter what age. Well visits, which should begin in earnest at infancy to ensure needed immunizations, tend to take a backseat as children grow. Parents need to be mindful that some of the most important conversations and lessons relating to a child’s health will happen during the adolescent years, said Dr. Weber, an Upper Valley Professional Corporation physician.
“Most major health care organizations are urging children to have a well-child visit every year through their adolescence, so there really isn’t going to be a sports physical, per say, anymore,” Dr. Weber said. ““This allows us to make sure vaccinations are up-to-date and to conduct developmental screenings that touch on issues such as depression, anxiety, homelessness, drug use and sexual activity.”
Dr. Weber encourages parents to contact their child’s primary care physician now in order to ensure a physical can be done in a timely manner: “This recommendation is important for parents to know so that they can get into a doctor now instead of waiting until the end of August to get a form completed so a child can play football,” he said.
To find a primary care physician who can conduct student physicals, go to www.premierhealthnet.com/doctor.