The AAP recommends that all children undergo a pre-participation physical evaluation (PPE) before the first preseason practice. The frequency and details of PPE will be determined by each state.
Most schools and pediatricians evaluate children according to systems developed by other organizations such as the AAP and the American College of Sports Medicine. This system typically requires annual documentation on a standard paper form. Doctors note that even children who do not participate in organized sports may benefit from a sports physical exam during their annual well-child visit.
A standard sports physical exam includes a detailed medical history considering cardiovascular, neurological, respiratory, musculoskeletal, and mental health, among others. The goal is to identify symptoms that may be warning signs of potential risk. These symptoms may include fainting (syncope), unexplained seizures, chest pain, and shortness of breath.
In addition to examining your family history, your primary care doctor will check for physical findings that may indicate a risk, such as abnormal heart sounds that can be heard with a stethoscope. “These sports physical exams can identify many children who require additional evaluation,” says Dr. Beach.
A standard sports physical exam does not include an electrocardiogram (also known as an ECG or EKG). This test measures the heart’s electrical activity and detects some of the symptoms that can put you at risk for life-threatening arrhythmias and hemodynamic collapse (unstable blood pressure and insufficient blood flow to organs). Heart disease can be detected.
Although the AAP does not recommend routine electrocardiograms for all children, routine electrocardiograms should be performed if the physical exam, medical history, and family history suggest a risk of sudden cardiac death or sudden cardiac arrest. It is recommended that you do so.
However, some experts believe that ECGs should be used regularly to detect heart problems that may be missed by standard sports physicals. “It’s a simple test that only takes a few minutes, but it provides valuable information and, in some cases, saves lives,” says Dr. Beach.
