Choose a well child exam over a sports physical

Duane Hougendobler, MD, PPG – Pediatrics, helped organize and administer mass sports physical events for area schools for nearly 30 years. During these exams, he saw as many as 350 kids in one night! Now, his mission is to get kids back into the doctor’s office at least once a year for a proper one-on-one evaluation.

During the first two years of a child’s life, the well child exam is very robust. We see patients as newborns, then at 2 months, 4 months, and so on until they are 3. At the age of 3, these visits become yearly until they are 18 years old. Every child should be seen by a physician every year, no matter what. Whether they have health issues or not. We can identify conditions like scoliosis and heart murmurs and get them up to date on their vaccinations.

Sports exams

A proper “sports exam” should be incorporated into the well child visit and conducted by a pediatrician or family doctor. During this exam, the physician does the same things they would do for any child, and then asks additional questions pertaining to the specific sports the child is participating in. The doctor can address any prior injuries and the healing process, including therapy. The exam is the same, but the conversation is a little different.

 

The problem with the old model

For some time, local schools would hold mass sports physical events. This model was born of the idea that we could get all of these young athletes to fulfill the Indiana High School Athletic Association (ISHAA) requirements in the same day. Families liked the option because they believed it would cost more to go see the doctor and be less convenient. At those events, the sports physical was essentially confirmation that the child had a heart, lungs, etc. That was really it.

A major issue with these mass events, was that children did not receive immunizations. Often, when we finally did see a child in the office, they were way behind on adolescent immunizations. In addition, it was loud and impersonal. Kids were giggling and the gymnasiums, where the events were often held, were large and echoed. The setup made it hard to hear and didn’t allow doctors to dig into the psycho-social aspects of care. We didn’t get to ask about how things were going at school, food insecurity, personal safety, etc. Sometimes these sports physicals were the only time that family and child had a touchpoint with healthcare, and in that environment, things like sleep and signs of ADHD, and so on, could not be addressed. 

The bottom line is that these were not effective exams. But they fulfilled the requirement. Fortunately, things have changed drastically. What we pay attention to has changed drastically.

The benefits of a doctor’s visit

There’s been a huge shift away from these mass sports physicals, which has resulted in a higher percentage of in-office visits and vaccinations. These appointments give the physician time to talk about things like proper sports nutrition and safe ways to improve performance. For example, we know that it’s not good to focus on just one sport. Neglecting to participate in at least two different sports prior to high school can increase risk of overuse injuries and hinder the athlete.

A lot of times, athletes will mention that they can “play through the pain”, but obviously, we don’t want that. We want to get them started with the proper treatment as quickly as possible and then follow their progress and healing.

Detecting mental issues early on can lead to far better outcomes as well. There was a recent study that indicated that treating anxiety in adolescents greatly reduced their need for medication during adulthood.

 

 

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