You already know that playing sports helps keep you fit. You also know that sports are a fun way to socialize with your friends and meet people. But you might not know why the physical you may have to take at the beginning of your sports season is so important.

In the sports medicine field, the sports physical exam is known as a pre-participation physical examination (PPE). The exam helps determine whether it's safe for you to participate in a particular sport. Many states actually require that kids and teens have a sports physical before they can start a new sport or begin a new competitive season. But even if a PPE isn't required, doctors still highly recommend them.

What Is a Sports Physical?

There are two main parts to a sports physical: the medical history and the physical exam.

Medical history. This part of the exam includes questions about:

*serious illnesses among other family members
*illnesses that you had when you were younger or may have now, such as asthma, diabetes, or epilepsy
*previous hospitalizations or surgeries
*allergies (to insect bites, for example)
*past injuries (including concussions, sprains, or bone fractures)
*whether you've ever passed out, felt dizzy, had chest pain, or had trouble breathing during exercise

The medical history questions are usually on a form that you can bring home, so ask your parents to help you fill in the answers. If possible, ask both parents about family medical history.

Looking at patterns of illness in your family is a very good indicator of any potential conditions you may have. It's important that you answer any questions about medical history accurately and honestly - don't try to guess the answers. Most sports medicine doctors believe the medical history is the most important part of the sports physical exam, so you should take time to answer the questions carefully.

Physical examination. During the physical part of the exam, the doctor will usually:

*record your height and weight
*take a blood pressure and pulse (heart rate and rhythm) reading
*test your vision
*check your heart, lungs, abdomen, ears, nose, and throat
*evaluate your posture, joints, strength, and flexibility

Although most aspects of the exam will be the same for males and females, if a person has started or already gone through puberty, the doctor may ask girls and guys different questions. For example, if a girl is heavily involved in a lot of active sports, the doctor may ask her about her period and diet to help her avoid such conditions as female athlete triad.

A doctor will also ask questions about a person's use of drugs, alcohol, or dietary supplements, including steroids or other "performance enhancers" and weight-loss supplements, because these can affect a person's health.

Some schools may require that a sports physical include an electrocardiogram, or EKG, for all kids. An EKG, which takes about 10 minutes, measures the electrical activity of a person's heart. EKGs don't hurt - electrodes that measure a person's heart rate and rhythm are placed on the chest, arms, and legs, and a specialist reads the results.

At the end of your exam, the doctor will either fill out and sign a form if everything checks out OK or, in some cases, recommend a follow-up exam, additional tests, or specific treatment for medical problems.

Why Is a Sports Physical Important?

A sports physical can help you find out about and deal with health problems that might interfere with your participation in a sport. For example, if you have frequent asthma attacks but are a starting forward in soccer, a doctor might be able to prescribe a different type of inhaler or adjust the dosage so that you can breathe more easily when you run.

Your doctor may even have some good training tips and be able to give you some ideas for avoiding injuries. For example, he or she may recommend specific exercises, like certain stretching or strengthening activities, that help prevent injuries. A doctor can also identify risk factors that are linked to specific sports. Advice like this will make you a better, stronger athlete.

When and Where Should I Go for a Sports Physical?

Some people go to their own doctor for a sports physical; others have one at school. During school physicals, you may go to half a dozen or so "stations" set up in the gym; each one is staffed by a medical professional who gives you a specific part of the physical exam.

It's convenient to get the exam done at school. But even if you have a sports physical at school, it's a good idea to see your regular doctor for an exam as well. Your doctor knows you - and your health history - better than anyone you talk to briefly in a gym.

If your state requires sports physicals, you'll probably have to start getting them when you're in ninth grade. Even if sports physicals aren't required by your school or state, it's still a good idea to begin these exams if you participate in school sports. If you will be competing regularly in a sport before ninth grade, however, you should begin getting these exams even earlier.

Getting a sports physical once a year is usually adequate. If you're healing from a major injury, like a broken wrist or ankle, however, get checked out after it's healed before you start practicing or playing again. You should have your physical about 6 weeks before your sports season begins so there's enough time to follow up on something, if necessary. Neither you nor your doctor will be very happy if you come into his or her office the day before baseball practice starts and then find out there's something that needs to be taken of care before you can suit up.

What If There's a Problem?

What happens if you don't get the OK from your own doctor and have to see a specialist? Does that mean you won't ever be able to letter in softball or hockey? Don't worry if your doctor asks you to have other tests or go for a follow-up exam - it could be something as simple as rechecking your blood pressure a week or 2 after the physical.

Your doctor's referral to a specialist may help your athletic performance. For example, if you want to try out for your school's track team but get a slight pain in your knee every time you run, an orthopedist or sports medicine specialist can help you figure out what's going on. Perhaps the pain comes from previous overtraining or poor running technique. Maybe you injured the knee a long time ago and it never totally healed. Or perhaps the problem is as simple as running shoes that don't offer enough support. Chances are, a doctor will be able to help you run without the risk of further injuring the knee by giving you suggestions or treatment before the sports season begins.

It's very unlikely that you'll be disqualified from playing sports. The ultimate goal of the sports physical is to ensure safe participation in sports, not to disqualify the participants. Most of the time, a specialist won't find anything serious enough to prevent you from playing your sport. In fact, fewer than 1% of kids have conditions that might limit sports participation, and most of these conditions are known before the examination takes place.

Do I Still Have to Get a Regular Physical?

In a word, yes. It may seem like overkill, but a sports physical is different from a standard physical.

The sports physical focuses on your well-being as it relates to playing a sport. It's more limited than a regular physical, but it's a lot more specific about athletic issues. During a regular physical, however, your doctor will address your overall well-being, which may include things that are unrelated to sports. You can ask your doctor to give you both types of exams during one visit; just be aware that you'll need to set aside more time.

Even if your sports physical exam doesn't reveal any problems, it's always a good idea to monitor yourself when you play sports. If you notice changes in your physical condition - even if you think they're small, such as muscle pain or shortness of breath - be sure to mention them to a parent or coach. You should also inform your physical education teacher or coach if your health needs have changed in any way or if you're taking a new medication.

Just as professional sports stars need medical care to keep them playing their best, so do teenage athletes. You can give yourself the same edge as the pros by making sure you have your sports physical.

Reviewed by: Joseph A. Congeni, MD, FAAP, and Peter G. Gabos, MD
Date reviewed: July 2003