The Importance of Sports Physicals for Active Children

Baseball catchers like Luke aren’t the only athletes prone to overuse injuries. Pitchers, like the one shown here, are also vulnerable.

Kellie’s son, Luke, 14, a youth baseball catcher, had been complaining for months about pain in his shoulder. But the Woodland Hills mom didn’t give it much thought until last fall, when Lucas had his annual sports physical with his pediatrician, Christopher Tolcher, MD, an affiliate of the CHLA Health Network.

The teenager told the doctor that the pain had first emerged during a tournament at which his team played multiple games daily.

Dr. Tolcher referred him to Curtis VandenBerg, MD, a Children’s Hospital Los Angeles sports medicine orthopaedic surgeon, whose CHLA – Tarzana office was a quick drive from Luke’s school. After an exam, a set of X-rays and an MRI, Dr. VandenBerg identified the source of Luke’s discomfort—an overuse injury common in throwers—and suggested a recovery plan.

“A sports physical enables us to evaluate the patient’s general health, to counsel them on any health-related issues, and to detect conditions that might pose a risk during sports activities,” says Dr. Tolcher, whose practices in West Hills and Agoura typically schedule preparticipation performance evaluations (PPEs) to coincide with annual physicals.

Most schools and leagues require medical clearance forms for participation, and some offer referrals to clinics for athletes to obtain assessments. But there are great advantages to having your child’s primary care physician perform the exam: The doctor usually is familiar with your child’s history and any medications he or she might be taking; the exams are more thorough; and the physician can follow up on any issues that arise.

While a routine annual physical examines general health, a PPE focuses more specifically on heart, lung and musculoskeletal issues. The medical-history questionnaire, for instance, asks detailed questions about the family history of heart disease as well as about the patient’s bone and joint issues and general medical conditions that might affect participation in sports—such as seizures, diabetes or eating disorders.

Bhavana Arora, MD

If the sports physical reveals a condition such as asthma, the physician will make sure it’s well-controlled before recommending sports participation. If the patient reports experiencing dizziness, chest pains or fainting during exercise, the physician typically orders an electrocardiogram (EKG) or refers the patient to a cardiologist for a more thorough exam to ensure participation is safe.

It’s important for parents to know that if a child has an injury, continued participation risks further injury. Better to catch it early. If there’s a significant musculoskeletal injury that hasn’t improved, the physician might refer the patient to a sports medicine specialist for a more detailed assessment and a treatment plan.

That’s what happened to Luke, the baseball player. After he visited Dr. VandenBerg, the orthopaedist diagnosed that the injury caused changes in Luke’s throwing motion, resulting in shoulder impingement. He first suggested that Luke ease off playing if he felt pain. When a long break didn’t help, the doctor prescribed physical therapy to strengthen shoulder muscles and improve Luke’s range of motion.

Now on the mend, Luke is working toward trying out this fall for his high school baseball team.

As for his mom, Kellie, she’s grateful her CHLA Health Network pediatrician caught Luke’s injury before the condition worsened. “You want someone who really knows your kid to evaluate them as an athlete,” she says. “Because we did that, we’re hopeful that my son will be back on the field before you know it.”

To find a CHLA Health Network pediatrician in your community, go to www.CHLA.org/HealthNetwork