are sports physicals and well-child checkup the same thing?

It’s that time of year again. Kids are all getting their sports physicals and camp physicals. Did you know this is not the same thing as the annual well child check? Many people think that the $40 exam and paperwork they do at a walk-in clinic every summer is sufficient for their healthy teen, so why wait for an appointment to see the primary doctor? But this is not the case. I want to outline some key differences between a sports physical and a well check-up. They cannot be substitutes for each other.

A sports physical is an abbreviated physical exam. When we see someone for a sports physical (which we occasionally do, but we prefer it is done by the primary physician), we are looking for medical conditions which affect sports participation. This includes old injuries, medical problems which need management for sports (like asthma), and screening for conditions which can cause death during exercise (like genetic heart conditions). That’s it. We will probably talk some about recognizing the signs of concussion, or proper nutrition and hydration for exercise. But this really doesn’t cover the entire scope of medical issues a teen could be dealing with.

The annual well check covers everything. It should cover the above, especially in an athlete, but it covers much more. In teens especially, this is a good time to check growth, development, puberty status, vaccine status, school issues, and psychological struggles. This is the ‘sex, drugs, rock and roll’ checkup. At a sports physical, I’m not going to ask about sexual activity, school progress, substance abuse (unless they are sports-enhancing), or mental illness. Even if your child is not dealing with these, there is a good chance they know people who are, and this leads to questions they may be hesitant to discuss with their parents.

Well Child Check:

• All medical problems, including personal and family medical history
• Full physical exam
• Monitor year-to-year growth compared to peers
• Review all developmental issues appropriate for age
• Age-appropriate screening labs
• Vaccinations
• Referrals if needed for any of the above

Sports Physical:

• Medical problems which affect sports
• Inherited problems which affect sports
• Check for specific findings which affect sports
• Check height, weight, and BMI
• Review common subjects related to sports
• As needed labs
• No vaccinations
• Referrals if not cleared for sports

So, what types of serious medical problems could be missed at a sports physical? Here are a few of examples:

• A 17-year-old female who has migraine headaches, menstrual cramping, and questions about birth control could be cleared for sports without talking about any of these issues
• A 14-year-old male who has school difficulty due to bullying, and who has not started puberty, could be cleared for sports without addressing any of these issues
• A 12-year-old female whose family has a rare form of genetic cancer, but is not personally having any symptoms, could be cleared for sports without any additional screening.
• A 15-year-old male who is feeling pressured by his friends/teammates to smoke marijuana, but is scared of saying no or finding new friends, could be cleared for a sports physical without talking about it.

Do we do sports physicals in our clinic? Yes. But we also make sure that you have a primary care physician and have a well check-up scheduled with them before releasing you to play sports. It is such a critical component of a healthy childhood that it should not be substituted with a $40 walk-in exam by someone who doesn’t know your child and your family history.