Lavern R. Davidhizar, DO.
High school and university sports physicals—sometimes referred to as “athletic physicals” or “pre-participation exams (PPEs)”—are standard medical exams used to screen young athletes before they participate in sports practice, games, or competitions.
The purpose of such an exam is to check that a child, teen, or young adult is healthy enough to participate and compete in sports. Across the U.S., nearly every state, including Alaska, requires a yearly sports physical for student athletes.
What Happens During a Sports Physical?
A typical sports physical or PPE exam has two main parts.
First, the doctor conducts a medical history/interview, where the student (and/or parent) speaks with the doctor about the patient’s health and history.
Next, the doctor conducts a physical exam.
If you’re an athlete, the focus of your sports physical will vary slightly depending on whether you are male or female.
●Young men are at much higher risk than women of sudden death from cardiac events; because of this, male athletes' physicals screen more rigorously for heart conditions.
●Young women are more at risk for stress fractures, osteoporosis, ACL injuries, certain knee and foot disorders, and eating disorders and body image concerns. Physicians will be on the lookout for any signs of these problems.
Part 1: The Interview and Medical History
During the interview portion of the exam, a doctor will take a full medical history, which includes asking questions about:
●General health: including any past or ongoing medical issues or concerns like a history of heart murmur or high or low blood pressure
●Allergies: environmental allergies like pollen or pets; foods; medications
●Medications: past and current
●Injuries: past and current (such as broken bones, stress fractures, problems with joints, concussions, and soft tissue injuries like muscle strains or tendonitis)
●Past surgeries: orthopedic and otherwise
●Family history: For example, does the student athlete have any relatives with heart disease, cardiomyopathy, or arrhythmia? Have any close relatives died of heart problems, or been disabled by heart problems, before age 50? The physician will also ask about any known inherited conditions.
The physician may ask additional questions to check for symptoms and behaviors that can indicate a need for further testing. For example, he or she may want to know:
●When you exercise, do you ever have chest pain? Discomfort (like a squeezing or tightness)? Shortness of breath? Wheezing?
●Do you ever have episodes of fatigue or exhaustion? When you’re exercising? How about when you’re not exercising?
●Have you ever fainted?
●Do you currently, or have you ever, taken nutritional supplements or used anabolic steroids or other performance-enhancing drugs?
●Do you use alcohol or recreational drugs?
Part 2: The Physical
After this Q&A portion of the exam, the doctor will proceed with the physical. He or she may check the following:
●Blood pressure and pulse
●Blood hemoglobin, cholesterol, and urine
●Heart and lungs
●Reflexes (for neurological responses)
●Abdomen (to check for hernias or an enlarged spleen)
●Skin (to rule out infections or contagious conditions)
●Bone growth and musculoskeletal health; a short orthopedic check that looks at flexibility, spine alignment and posture
●Genitals (for males, to rule out testicular masses or hernias)
Occasionally, the physician may recommend ordering a special test such as X-rays, additional blood tests, electrocardiograms or stress tests.
Medical Clearance to Participate in Sports
At the conclusion of the exam, if the doctor deems the student healthy enough to play sports, he or she will clear the student to play and will provide what’s called a “medical clearance.”
This clearance, intended for the school system and coaches, will note whether it's safe for the athlete to play the sport without restrictions.
The clearance will also specify whether any special adjustments or modifications need to be made in order for the athlete to participate safely. (For example, the student may need to carry an Epipen or inhaler, or may require special shoe inserts or safety equipment.)
Do I Need to Bring Any Forms to My Sports Physical/PPE Exam?
Possibly. Depending on the rules in your state, you may need to provide a doctor paperwork from your school: either a sports physical form, a pre-participation physical evaluation form (or "ppe form"), or an athletic release form. (For football, this is often called a "football physical form.")
Some physicians have these forms available at their offices.
For you to get medical clearance to play, the form must be signed by a doctor and given to your school or coach.
Do Coaches Need Medical Clearances?
Yes. Even if you feel you’re healthy, your coaches will need the results of PPE clearance exams to help them plan rosters and find substitutes. They also need to know if injured athletes require rehabilitation or physical therapy before they can be cleared.
If you’re injured, PPE exams are also opportunities for coaches, athletes, parents, and doctors to work together to create a rehab plan so you can make a safe return to your sport. Your doctor can prescribe exercises or sports medicine programs to re-build strength and improve performance. Referrals to specialists (like cardiologists or orthopedists) are also possible.
Why Do I Need a PPE Exam/Sports Physical Every Year?
Frankly, you need an exam every year because it’s the law. Most states in the U.S. now mandate some form of annual sports physical before students are allowed to participate. If you play any team sport, you will likely be required by your high school to take an exam and get medically cleared to participate.
From a health perspective, annual exams are important because young athletes’ bodies are still growing and changing. Also, athletes may incur injuries between sports seasons. Finally, annual pre-sports screenings help to rule out injury or underlying health conditions that may have developed since your last annual exam.
The purpose of a PPE exam is to help avoid putting a student athlete at unnecessary risk of serious injury or harm during the course of a sports season. Therefore, careful, regular screenings are needed to inform schools and coaches as to your ongoing health and fitness.
What will the doctor check for each year?
●General health. Are you still in good enough health to participate safely? Are there any changes to your health since last year? If you have a known health condition or disorder, are you able to safely participate in sports? The doctor will also check for any previously undetected conditions or congenital anomalies that may put you at risk for injury.
●Existing conditions. If you have a known condition (such as asthma, seizure disorders, or sickle cell anemia) the physician will give special attention to these. Are you healthy enough to play safely (possibly with modifications)?
●Fitness level. Are you in good enough physical conditioning to begin attending practice and competing in events? If not, is additional preparation and training advised to get you in shape in time?
●Healing of injuries. If you were hurt the previous season, what’s the progress on your recovery? Will you be able to play when the season begins? Have you had any concussions in the last year? (If so, the physician will check for post-concussive syndrome.)
●Size and growth. Is your size and rate of growth appropriate for your age?
Annual check-ups before you start your sports season allow your doctor the chance to track your health and progress over time. The continuity allows your physician (and your coaches, parents, and school) to get a complete picture of your ability to safely train and compete.
Where Can I Get a PPE Exam/Sports Physical in Soldotna?
Most physicians’ offices and many walk-in clinics will be able to give pre-season sports physicals. If you have a regular doctor already, call the office to find out if you can schedule an exam.
In Soldotna, you can also call Alaska Family Medical Clinic. We offer sports physicals/PPE exams and can walk you through the process.