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Why young athletes should not skip their medical exams

Here’s how an annual checkup is vital to a child’s health

By Cliff Mehrtens
Novant Health

School sports are delayed in North Carolina because of the COVID-19 pandemic. When they resume — at the moment the plan is Sept. 1 — many athletes won’t have recent medical clearance.

For the 2020-21 school year, the N.C. High School Athletic Association has waived the requirement for a sports physical. That’s a concern to Novant Health pediatricians, who stress the importance of an annual well-visit for children.

Skipping an annual well-visit, of which the sports exam is a component, can have serious short-term consequences and possibly lead to chronic medical issues.

“This change has the potential to drastically and negatively impact a wide swath of middle and high school patients,” said Dr. Jamie Lye of Novant Health Eastover Pediatrics. “The ‘carrot’ of the signed sports physical form is, realistically, what drives a large portion of patients into pediatrician offices for checkups. Without that incentive, many will drop off of our schedules, missing not only vital physical reassessment for sports clearance, but also immunizations, depression screening, risk behavior assessment and chronic disease management.”

Lye said parents and guardians shouldn’t be concerned about safety at a Novant Health clinic. Since the pandemic began, extra safety measures for patients, visitors and team members have been in place.

“Pediatric offices have open access to safe, streamlined, in-person physical examinations,” he said. “I’m afraid this measure is designed to address a problem that does not exist. In any case, if it is safe enough for students to be playing school sports, it is certainly safe enough for them to come to an office for their checkup.”

Novant Health pediatricians are urging parents to schedule a well-visit for their athletes, regardless of the state ruling.

“The sports physical is just one component of the yearly well checkup,” said Dr. Ankita Patel of Novant Health Meadowlark Pediatrics in Winston-Salem, North Carolina. “We’re also making sure they’re up to date on their vaccines. We’re checking their hearing and vision. We’re watching how they’re growing to make sure they’re gaining weight appropriately. We’re checking for chronic diseases and managing food allergies, making sure their medications are up to date, doing blood work on certain visits. We’re also screening for anxiety and depression, which is really important right now with coronavirus and how kids are handling it.”

A lot can happen for many, for example, between ages 13 and 14, or 15 and 17, and should be monitored.

“If we don’t do a physical every year, things can get missed and it’s going to be a whole two years before some of these kids come in to a doctor’s office,” Patel said. ”As they get older, they’re not coming in as frequently for colds and things like that. Many things can happen in that time.”

There are several things we can find at a well-checkup that parents or children aren’t complaining about at the time. We’ve found heart murmurs that have been undiagnosed and hernias. I found testicular cancer on a teenager who was too embarrassed to tell anybody. He’d had a lump for a while.”

Sports physical versus well-visit exam: What’s the difference?

A sports physical typically focuses on reviewing a child’s current health status and medical history to determine if they’re healthy enough to play their sport. The physician reviews any injuries (current or previous) and determines risk. The areas of focus usually include height and weight, vision, hearing, blood pressure, heart health, muscle and bone health, flexibility and strength.

Patel said pediatricians also emphasize:

  • Educating the student on injury prevention.
  • Making sure the athlete understands proper hydration.
  • Teaching the importance of pre- and post-activity stretching.
  • Discussing concussion prevention (and management, if necessary).

A well-visit is more thorough. In addition to physical health, physicians also focus on developmental, emotional and social aspects. Your child’s cognitive and social milestones are assessed to ensure proper development in those areas. The physician likely will discuss important topics such as drugs and alcohol, peer pressure, healthy relationships and puberty.

Other important aspects of a well-visit include:

  • Discussing mental health and screening for depression.
  • Identifying a previously undiagnosed illness (diabetes, cancer, inflammatory bowel disease, cardiac disease, hypertension).
  • Monitoring of a chronic or known illness.
  • Keeping immunizations up to date.
  • Completing screening tests.

Bottom line: Your child needs to see a pediatrician every year to make sure they’re in good health and that doctors have the chance to catch problems early. That’s the safest course of action parents can take for their kids.