Definition and Overview

A pre-sports physical is a medical exam which goal is to determine whether a person is fit to engage in a particular activity or sport. This is crucial for athletes or aspiring athletes especially if they are entering major sports competitions. In some places, it is even a requirement. It involves a medical history evaluation and a physical exam designed to determine an athlete's health risks so he can be given the appropriate medical advice and in some cases, medications, to ensure that he is physically fit to join strenuous activities.

Who Should Undergo and Expected Results

A pre-sports physical examination is beneficial for all individuals who plan on joining a new sport, participating in a tournament, or starting a new competitive season. It is strongly recommended for all athletes, aspiring athletes, and trainees. The goal is to promote health and safety among athletes, from the training all the way to the competition. This goal is achieved by:

  • Ensuring that all athletes or players are in good health and appropriate fitness level
  • Identifying and preventing health risks
  • Assessing the athlete’s level of physical maturity
  • Identifying and resolving existing health problems that may interfere with the athlete’s activities


The exam adheres to certain guidelines set in place by sports medicine organizations that determine whether a person can be given clearance to play. At the end of the pre-sports physical evaluation, the doctor will fill out a clearance form stating that the patient is in good condition to play.

If the patient does not pass the evaluation, the doctor may prescribe some tests, treatments, and medications, and will schedule follow-up physical examinations to assess whether there is an improvement in the patient’s condition when the prescribed treatment plan has already been implemented. If necessary, the patient may also be referred to a specialist, such as a physical therapist or orthopedist. All these medical professionals can help an individual become a better and stronger athlete.

How the Procedure Works?

As mentioned above, a pre-sports physical involves the review of the athlete’s medical history and a physical exam.

  1. Medical history - This is important in assessing the individual’s risk of certain illnesses, allergies, or injuries and thus looks into the following factors:
  • History of serious illnesses in the family
  • History of illnesses from childhood
  • Allergies
  • Status of immunizations
  • Previous injuries, including all sprains, fractures, and concussions
  • Previous surgeries
  • Hospitalization record
  • History of losing consciousness i.e. passing out or feeling dizzy, and what caused such events
  • History of chest pain and breathing difficulties experienced during exercise or strenuous activities
  • Medications currently being taken, including all prescription drugs, over-the-counter medicines, vitamins, and herbal supplements
  • Usage of performance-enhancers or steroids


2. Physical exam – The physical exam involves some tests and procedures designed to determine whether the patient is currently in good condition to engage in sports. This is similar to the standard physical exam that doctors typically perform but with a few additions and special considerations. These include:

  • Height and weight measurement
  • Blood pressure reading
  • Pulse (heart rate and rhythm) check
  • General checkup of lungs, eyes, ears, nose, throat, and abdomen
  • General evaluation of strength, flexibility, posture, joint range of motion, knee extension, gait, activity level, and diet

Possible Risks and Complications

It is very rare that a pre-sports physical results in a person’s disqualification from a sport as its main goal is for doctors to help the athlete overcome any health issues, which include:

  • Risk factors - By highlighting certain risks or weak points that the patient should pay attention to while performing sports, the patient and his training team will know how these risks and possible injuries can be prevented. To do so, the doctor may prescribe stretching and strengthening exercises.

  • Existing health problems - Doctors can provide medications to enable the athlete to perform sports with minimal interference. For example, an athlete who sometimes has asthma attacks may be given a specific type of inhaler.

Due to the possibility of requiring treatment in case some health issues are identified, athletes are encouraged to undergo the physical exam around six weeks before the start of training or of the sports season. This way, there is enough time for follow-up checks. If there is no time to address and improve the identified weak spots, the patient will not be given the clearance to play.

In order to ensure the accuracy of results and to protect patients’ health and safety, they are encouraged to be transparent in answering all questions and providing all details regarding their health while undergoing a pre-sports physical exam.

References:

  • Bird R. Nutrition. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 30.

  • Drezner JA, Harmon KG, O'Kane JW. Sports medicine. Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 8th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 29.

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