Healthy Living

Sports Physical: When, Where, Who Should Do It?

By: Chris Koutures, MD, FAAP

The form is due, what do you do? We've all been there. Paperwork piles up, and sports physicals sneak up on us just before our children's sport and activity begins.

To make life easier (and what parent wouldn't like that), the American Academy of Pediatrics (AAP) recommends asking to have a sports physical when scheduling your child's next routine well-child visit.

Why all middle-school through college kids benefit from a sports physical during well-child visit:

The answer is simple: All kids are athletes―the high school soccer player, the junior high performer in the school musical, and the skateboarding middle schooler down your block. You don't have to play an organized sport to be an athlete. Many children participate physically demanding activities like snowboarding, skiing, jogging, climbing, and hiking. Other children are not physically active at all. All these children should receive a sports physical from their pediatrician, also known as their medical home.

More than a forced "check the box" evaluation.

The Preparticipation Physical Evaluation (PPE) form developed by the AAP and other medical and sports medicine groups looks not to just check boxes, but to give athletes the best opportunity for full and safe sports participation.

The PPE form includes an in-depth health history form that should be filled out by both you and your child (if he or she is old enough) before your routine well-child visit for more discussion during your exam.

Download Your Child's Health History Form (PDF) -

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Answer the questions honestly and thoroughly, especially the family history and heart-related questions, to help your doctor give the best advice and recommendations for many conditions.

If you already have a medical eligibility form from your child's sport or activity, bring it with to your appointment. Most organizations send forms home for athletes before the season begins. The AAP recommends you also complete your child's health history form to guide your child's pediatrician in the exam.
If you don't have a medical eligibility form, you may be able to use this one. Check with the governing body of your child's sport or activity.

Why see the pediatrician for a sports physical:

Seeing your pediatrician for routine well-child visits and sports physicals helps keep your child's medical records and health history up to date. Pediatricians are also trained to identify and treat both medical and bone/joint problems that are commonly seen in children and adolescents who play sports. And they can ensure your child is caught up on immunizations and discuss any concerns in a confidential setting. If your child is not as active as they should be, they counsel on the benefits of physical activity.

The AAP recommends making appointments at least 6-8 weeks before starting a season to give time for any additional evaluation or new treatments.

The AAP is against mass physicals (such as in a school gymnasium) and using urgent care settings.

These places often lack privacy and a healthcare provider who knows your child and has access to past medical records.

If your child is seen by someone other than his or her pediatrician for a sports physical, it is very important that you provide the clinic with accurate and complete medical information to receive the most appropriate care. Request that information regarding the visit be sent to your pediatrician so he or she can maintain a complete picture of your child's care. If the clinic does not offer this service, be sure to get copies of the services your child received and share this information with your pediatrician as soon as possible.

What are some of the most important things examined in sports physicals?

Heart health. Sudden cardiac deaths are rare in athletes, but they shock communities and are in the backs of parents' and pediatricians' minds. A sport physical exam should ask the athlete a list of questions about any symptoms that may suggest problems with the heart. The athlete should also report any past heart evaluations or history of high blood pressure. Questions should also be asked about any family history of heart problems or heart disease. Most athletes are cleared without restriction. Ultimately, the majority of those referred with red flag conditions are still cleared, but it may be important to get the pediatric cardiologist's opinion.
Mental health. Many children and adolescents have concerns with emotional health, and athletes are no exception. In fact, pressures seen in sports and performing arts may lead to special mental health demands―depression, anxiety, perfectionism, stress, and attention deficits. Healthcare providers now ask questions about these sensitive and important issues in a private and safe setting to discover and recommend treatments.
Unique concerns of female athletes. Sports physicals can help find unique concerns that may be found in female athletes and performers. These concerns, known as the female athlete triad, can include menstrual health, bone health, and nutrition/calorie intake. Young females are at a higher risk for certain bone and joint injuries, including ACL tears of the knee. Certain screening questions and tests can lead to treatment and prevention programs that will help keep athletes safer.
Unique concerns of disabled athletes. Children with special needs deserve the opportunity to compete and participate in sports just like any other child. This includes children and teens physical disabilities such as lack of full vision, loss of use of arms or legs, or muscle control problems. A careful sports physical can help select the most appropriate activities and reduce the chance for problems that can occur during exercise.

If your child has a physical disability, your pediatrician is a great resource for finding the right fit if he or she wishes to participate in sports and can also help you with the medical form for the Special Olympics.. As with all children, the goal is to focus more on what "can" a child do rather than what "can't" a child do.

Concussions and head injuries. Any athlete with a known or possible concussion should not return to any exercise or sports without being cleared by a healthcare professional. A child who has had one or more prior concussions is at a greater risk for more concussions. A sports physical from your pediatrician can help determine best treatment if your child is still having problems from a past concussion―including headaches, trouble concentrating, trouble sleeping, and irritability. Your pediatrician can determine if your child needs any adjustments with school and social activities.

Editor's Note: Six organizations contributed to the PPE's development: the AAP, American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine and American Osteopathic Academy of Sports Medicine. The National Athletic Trainer's Association and National Federation of State High School Associations endorsed the resources.

Additional Information:

About Dr. Koutures:

Chris_Koutures Chris Koutures, MD, FAAP, is a pediatric and sports medicine specialist with ActiveKidMD in Anaheim Hills, CA. In 2008, he served as the Medical Team Physician for USA Volleyball and Table Tennis in the 2008 Beijing Summer Olympics. Currently, Dr. Koutures is the team physician for the U.S. Men's and Women's National Volleyball Teams, Cal State Fullerton Intercollegiate Athletics, and Chapman University Department of Dance. Within the American Academy of Pediatrics, he is a member of the Council on Sports Medicine and Fitness Executive Committee. He has also authored over 25 published articles.

Last Updated: 8/3/2021

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.