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It’s time to start planning for preseason sports physicals

Photo by HeraldPost  - CC/Flickr

Photo by HeraldPost – CC/Flickr

Though it’s mid-summer, high school athletes should start thinking about the “who, when and what” for their preseason sports physicals.

Your primary care doctor is the best place to go for the physical, but don’t wait until the week before.

If something shows up on the physical, you want to make sure you have enough time to perform further tests.

Today, I had the chance to talk with WAKR host Ray Horner about this topic. We also discussed the raging debate going on about whether all kids should include an EKG in their physical to help prevent sudden cardiac deaths.

Stay tuned. I will dive deeper into this debate next week.

Below is an audio file and transcript of our discussion.

0:00

Horner: On board with us now, our good friend, Dr. Joe Congeni from Sports Medicine Center at Akron Children’s Hospital. Good morning, Joe. How are ya?

Dr. Congeni: Hey, Ray. I’m doing really [well]. How about you?

Horner: I’m doing very well. This time of the year we start to think about these high-school physicals to get ready for the fall sports season.

Dr. Congeni: You know we’re heading into that time of year, and you and I love it, I think, just as much as the kids. Don’t cha? Aren’t you starting to get pumped up already?

Horner: Oh yeah. All ready to go. After vacation, it’s all high school mode, for sure.

Dr. Congeni: [laughter] Well, I’m actually still on vacation this week. I’m getting my last batteries recharged in Hilton Head.

You know, once a year, we talk about the pre-sports physical. I wanted to just mention it today ‘cause there is something new for the first time in the last 25 years — really a hot debate. But, first of all, I wanted to cover the “who, what, when” of the pre-sports physicals.

Dr. Joe Congeni

Dr. Joe Congeni

The “who” is, really, “Who should I see?” You know, this is the time of year in our office, we get, gosh, it seems like every other call, every third call, people [calling] about where to go for their sports physical.

Really, the best place to go is your primary care doc. That’s your doc who knows you the best — and should know you the best — and should know about any changes in your care.

The problem is that a couple studies show in high-school athletes, more than 70 percent of kids don’t go to any doctor at all anymore. They don’t have a relationship with a doc, so many of them end up coming to sports medicine for their physical.

Really, the ideal place would be the primary doc, but that’s the way it is now. So, a lot of physicals are done at sports medicine centers, as well.

The “when” is important, too. I would really want parents and grandparents, and coaches even, to [understand] not to wait ‘til it’s too late.

What ends up happening is in August, kids play on August 10th or August 15th or August 20th and they wait ‘til the day before [to get their physical] — and that’s way too late. That’s why I’m talking about this topic in July. Get it done this week or next week.

You know, 10 to 15 percent of kids rated that have the physical done will have something on the physical that we pick up that needs studied further — needs further testing or treatment or something else done.

I mean that’s part of the exam. If somebody was doing this exam and just clearing everybody, there’d be no sense in doing it.

So, at this time at the physical, we pick up things like kids with elevated blood pressure or kids with hernias or kids with ankle sprains that didn’t heal well or shoulder injuries that they never saw anybody about or a heart murmur that might need further heart testing.

Photo by SGFsoccer - CC/Flickr

Photo by SGFsoccer – CC/Flickr

Or, you know what, more than 75 percent of the time if we pick up something, it’s from the history.

Kids will say, “You know, I’m having bad headaches now” or “You know what, I had a passing out episode last month.” Or, they might want to ask about supplements that they’re taking for sports, and things like that. So, it’s the perfect time to review all that kind of stuff with the doctor.

But, it should be done more than six weeks before the season starts, not the week before, so that if testing needs to be done, there’s plenty of time to have it done. That part’s important, too.

Now, getting to the “what to be done.” This is where there’s something new. For 25 years, we’ve been saying in sports medicine and medicine overall, there’s no blood tests, there’s no other tests that need to be done. It’s just not cost effective with the physical. The good clinical exam by a doctor is enough.

Now, there’s really a raging debate in 2013 going on about whether everybody, [due to] these kids dying with sudden cardiac deaths (heart problems), should get an EKG.

That’s a really complex argument going on, and for a lot of parents talking and asking about that, I was going to cover that issue in more detail next week. Should we do an EKG or not?

That part of the physical exam is a new debate, and I’ll tell you both sides of that next week. How does that sound?

Horner: Sounds good, Joe. Enjoy the rest of your vacation. We’ll catch up with you next week.

Dr. Congeni: Alright. Sounds good, Ray. Thanks.

Horner: Alright. Dr. Joe Congeni, Sports Medicine Center at Akron Children’s Hospital joining us.

About Dr. Joe Congeni - Director of Sports Medicine

Dr. Joe Congeni is the Director, Sports Medicine; Clinical Co-Director, Center for Orthopedics and Sports Medicine at Akron Children's Hospital. For the past 25 years, Dr. Congeni has been the “go to” source for national and local media looking for information about pediatric sports medicine.