Approximately 45 million American children between the ages of 6 and 16 are involved in organized after-school sports activities. On average, 12 million of these youngsters will receive treatment for injuries in hospital emergency rooms or medical offices. The reason for these large numbers of injuries is primarily because children are getting involved at much younger ages and with higher levels of physical intensity in their chosen sport.

None of the above is meant to imply that children should be denied these activities. On the contrary, organized youth sports serve many valuable purposes. Participation in sports enhances confidence, self-esteem and promotes the learning of social skills, cooperation and teamwork. And then, of course, participation in sports provides all the benefits of physical exercise, such as healthy development of muscles and bones and a healthy heart.

So how do we get a balance between the benefits of sports and exercise with the risks of injuries? The answer is the traditional sports physical or pre-participation evaluation. Parents and their children must begin to look to the sports physical not as a pesky inconvenience, but as an opportunity to uncover potential medical problems. Since most children generally don't have the need to routinely seek medical care after they've completed their childhood immunizations, the sports physical becomes an ideal opportunity for the medical provider to initiate risk assessments for heart disease, at-risk behaviors (smoking, alcohol or drug use, sexual involvement) and to explore the presence of familial or inheritable medical problems. The time spent doing a sports physical allows the medical provider the opportunity to initiate health education and health promotion.

Both parents and medical provider should familiarize themselves with the particular sport the child will be involved in and what potential risks and injuries are prevalent to that sport. Parents or guardians familiar with the family history should accompany the child to provide information regarding medical history of any type of cardiovascular, neurological or musculoskeletal disease.

Theoretically, the purpose of the sports physical is to detect conditions that put the school-aged athlete at risk for the most disturbing exercise injury, that of sudden death. Sadly, however, they have not been shown to be highly effective in this regard. Hypertrophic cardiomyopathy, the culprit here, generally does not produce symptoms before its catastrophic appearance and so is elusive in its detection. Be that as it may, the pre-participation evaluation remains a crucial contribution in assuring a child's safe participation in sports.

Agnes Oblas is a nurse practitioner with a private practice and residence in Ahwatukee Foothills. For questions, or if there is a topic you would like her to address, reach her at (602) 405-6320 or Her Web site is


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