Back-to-School Sports Test

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Doctor with female patient


Our kids are getting ready for a new school year. Along with all the school supplies we need to buy, we need to prepare for after-school activities, which often include sports.

If your child plays sports, most school districts and athletic leagues require an exam before your child can participate. The pre-participation physical examination is different from the yearly physical exam and well-check you might be used to for your child.

A key part of this exam is medical history, especially your family’s medical history. You will be asked about your child’s or family members’ history of diseases — such as asthma, epilepsy, and diabetes — as well as instances of dizziness and palpitations. None of these conditions automatically excludes your child from doing sports, but they are important to be aware of, as your child’s activities may be limited, or they may need accommodations. For example, some children only have asthma during exercise, so it’s important to diagnose and then manage it.

You might be surprised when you are asked about allergies. Parents sometimes forget that allergies can put your child at risk during sports. How so? Allergies to insects and bees can be a real problem for sports played outside during warm weather, and the ubiquitous team snack afterward can expose children to food they’re allergic to. So it is critical to know upfront if your child has allergies.

Many parents have heard stories about a young athlete who suddenly dies of a heart attack on the basketball court or baseball field. This often is a result of a condition called hypertrophic cardiomyopathy (HCM). Despite some news coverage, HCM is fairly uncommon, although there often is a strong family history. You and your child will be asked about any chest discomfort, murmurs, shortness of breath or dizziness, or feeling like passing out. (In the absence of a family history or a physical exam finding, EKGs and echocardiograms are not routinely done as part of this exam.)

This exam is a good time to talk about the role of supplements as well as performance-enhancing drugs, which teenagers sometimes use. Such supplements and drugs often have significant side effects and should never be used without a doctor’s guidance.

Although getting ready for school to start can be quite hectic, try to schedule the pre-participation exam at least 4 to 6 weeks before an activity is scheduled to begin, just in case lab tests or imaging studies need to be done, which then might require a visit to a specialist.


Questions? Comments? Email me at [email protected].


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