Sports Clearance Exams for Young Athletes

Youth participation in sports is growing in popularity, and for good reason. Studies show that children who participate in sports benefit in physical, emotional, and social ways, including:

• Motor skills – involvement in sports promotes improvements in coordination and acquiring new skill sets and large motor movements. 

• Self-confidence – individual and group sports help build confidence through successes and team-building.

• Social skills – group sports and interactions with other athletes and coaches involves working with others, both supporting and challenging them. 

• Healthy weight – kids who are more active, especially in sports activities outside of school, are more likely to be at a normal weight for their age and gender. This is particularly important in a time of rising obesity. 

• Friendship & fun – kids who are active in sports have more opportunities for making friends outside of school. 

• Sportsmanship – participation in sports means learning and following the rules and regulations, interacting with and respecting coaches and referees, and learning to handle losing, all of which are important life lessons. This is also a perfect opportunity for parents to model good sportsmanship as well.

Prior to participation in sports activities, it is important for your child or adolescent to be evaluated to see if he or she is healthy enough to play. The sports physical, or Pre-participation Physical Exam (PPE) will ideally be done with your Pediatrician. The basic purpose of the PPE is to make sure young athletes are and remain safe and healthy while participating in sports activities. This is usually part of the annual wellness exam, or well-child check up. It is beneficial to have this done by the Pediatrician because your adolescent is known to them, and his or her medical record is easily accessible and contains useful information for decision making. Your family’s Pediatrician will know your child better than an urgent care or other facility.  Pediatricians are also specially trained to recognize known conditions that could cause problems for children in sports. 

The American Academy of Pediatrics (AAP) advises against mass physicals or urgent care facilities for PPE completion. 

What are the important parts of a PPE?

• Heart health – Sudden death due to heart conditions is rare but devastating, and is something all Pediatricians strive to prevent. Part of the PPE is a detailed history of any symptoms that might suggest problems with the heart – chest pain with exercise, inability to keep up with friends, fainting spells with exercise, racing heart or skipped beats. A family history of any sudden, unexplained deaths in teens or young adults is important to report to the doctor. If any concerning findings are discovered during the PPE, your child will be referred to the Pediatric Cardiologist for examination before clearance to participate in sports.  

• Concussions and head injuries – Concussions are particularly concerning in our youth, because brain injury can have lasting cognitive effects. Young athletes who have had a concussion must be cleared by a physician prior to returning to play, and those who have had multiple concussions might not be cleared for further participation. Talk with the Pediatrician if there is any history of concussion or head injury for your child.  I will be discussing concussion in more detail next week. 

• Bone and joint health – Since young athletes’ bones and joints are still developing, they are prone to particular injuries. Overuse injuries are common, along with pain in the knees, ankles, and shins. Ankle sprains are common.

• Mental health – The pressure experienced in sports activities starts to occur at a very young age. While we hope that our young athletes are encouraged through play rather than discouraged, they often feel pressure to perform well consistently. These pressures can lead to anxiety, perfectionism, stress, and depression. Your adolescent’s Pediatrician will ask about these sensitive but important issues as part of the PPE. 

• Female athlete concerns – Young female athletes are at higher risk for certain bone and joint injures (ACL tears in the knee, in particular). They are also screened for signs of the “female athlete triad” which involves irregular menstrual cycles, bone mineral deficiency, and inadequate nutrition. 

What is the result of the PPE?

If you have a form that is specific to your child’s school or sport, bring that to the appointment with you to be completed. Some of these forms contain multiple questions that should be filled out by you prior to the appointment so that the doctor can review them. If your school or organization does not provide a form, a generic once can be given to you at the appointment.

There are four results of the PPE for the athlete, as determined by the Pediatrician: 

• medically eligible for sports without restrictions
• medically eligible for certain sports listed on the form
• not medically eligible for any sports, pending further evaluation and clearance
• not medically eligible for any sports

Most children are cleared completely for sports, without any restrictions of play. Keep in mind this may change throughout the season if a young athlete is injured or ill.

Participation in sports activities is beneficial for children in many ways. Encourage your child to try new things, this will stimulate development of new skills and abilities in addition to increasing his or her confidence and social skills. Before participation in organized club or school sports, be sure to visit the Pediatrician for the annual well-child check up and PPE. After cleared for participation – play hard and have fun! 

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