Why sports physicals are important – especially after a COVID-19 diagnosis

With league and school sports beginning to resume after a prolonged COVID-prompted off season, many young athletes are heading back to the field again.

Having a sports physical is an important step before getting back into the game – especially after a having COVID-19 symptoms or a diagnosis.

But what exactly is a sports physical and why are they needed? In this Q & A, Dr. Matthew Kornswiet, a sports medicine pediatrician in the CHOC Primary Care Network, answers these questions and more.

Coaches and parents should continue to follow safe return to sports guidelines from the Centers for Disease Control & Prevention and locally, the California Interscholastic Federation and California Department of Public Health.
Does having COVID-19 affect my child’s ability to play sports safely?

If your child had symptoms of or tested positive for COVID-19 at any point, it is important that they see their provider before returning to sports.

Research shows that sometimes after a COVID-19 infection, a patient has a small risk of developing myocarditis (inflammation of the heart) or multisystem inflammatory syndrome in children, also known as MIS-C, an inflammation of multiple areas of the body.

Even if your child had a sports physical recently, it is important that children have another physical exam after a COVID-19 infection before returning to sports.

In some cases, providers may recommend additional tests for your child’s heart or that they see a cardiologist, or heart doctor, for further evaluation. This is to ensure that children are safe to return to sports.

What is a sports physical and why are they important?

A sports physical helps determine whether it’s safe for a child to participate in a sports or athletics. They can also help uncover and treat health problems that might interfere with participation. The provider may also offer tips to help with training and injury prevention.

What should I expect at a sports physical?

A sports physical is divided into two halves: the medical history and the physical exam.

During the medical history portion, the provider will ask key questions about serious illnesses among family members; current or previous medical conditions, such as asthma, epilepsy or diabetes; past injuries; and more.

During the second half of the visit the provider will perform a physical exam. The physical exam will measure the athlete’s vital signs; check the athlete’s heart and lungs; evaluate strength and flexibility; vision; and more.

The provider will also ask questions about the athlete’s mental health, use of drugs, alcohol or dietary supplements, including steroids or other so-called “performance enhancers” and weight-loss supplements.

What happens after the physical?

When the exam is over, the provider will complete and sign a form indicating fitness to participate in the sport, if all is well. In some cases though, the provider may recommend a follow-up exam, additional tests, or specific treatment for medical problems.

Young athletes shouldn’t worry that additional follow-up care means being benched. A sports physical’s ultimate goal is to ensure athletes are safe while playing sports – not to stop them from playing.

Additional follow-up could be as simple as rechecking blood pressure in a few weeks. A referral to a specialist could ultimately help athletic performance, such as in the case of slight knee pain during running that an orthopedic or sports medicine specialist can demystify and treat.

If my child has a sports physical, do they still need a regular physical or well check?

It’s critical that patients of all ages undergo a regular physical every year, whether or not they also have a sports physical. Depending on when your child had their last physical, it can be done at the same visit as the sports physical.

While sports physicals focus on well-being as it relates to athletics, regular physicals are more comprehensive, addressing broader physical and mental health concerns, and helping to ensure patients are up-to-date on vaccinations.

Where can my child get a sports physical?

Families usually have many options for receiving sports physicals. Your child’s physician or a sports medicine physician can provide a sports physical exam.

Remember, your pediatrician knows your child’s medical history thoroughly, can make referrals if needed, and will play a critical role in any ongoing care plans – not to mention, is one of their biggest fans.

A pediatrician’s tips for promoting a safe return to sports during COVID-19

With some kids and teens returning to team sports after an extended break amid the COVID-19 pandemic, parents and pediatricians alike have safety top of mind.

Taking care of your physical and mental well-being will lead to more achievement and fun on the field, says Dr. Matthew Kornswiet, a sports medicine pediatrician in CHOC Primary Care Network.

How can you keep your kids safe on the field after so much time off?

Coaches and parents should continue to follow safe return to sports guidelines from the Centers for Disease Control & Prevention and locally, the California Interscholastic Federation.

Remembering the acronym SPORTS can also help support a safe and healthy return to play and participation in athletic activities during the COVID-19 pandemic.

With support from Dr. Chris Koutures, a CHOC pediatrician and sports medicine specialist, Dr. Kornswiet offers these tips for parents, guardians and coaches:

S – Start slowly

It’s been a while since your child has played sports, so do not expect them to start where they left off. It may take several weeks to get back into shape. Start with a review of basic skills and techniques and build up to more advanced skills. Plan shorter workouts to give them time to build up endurance. And limit repetitive movements such as throwing, swinging and jumping.

P – Pay attention to your body

Quickly returning to athletic activities after time off increases the risk of overuse injuries. Follow your instincts – if you are hesitant to return to your activity, then wait or slow down. Also, maintain adequate sleep of eight hours or more per night, and stay hydrated to help your body perform at its best. Early in conditioning, especially during hot days, watch for signs of overheating. If you feel more tired than everyone else, or experience dizziness or confusion, seek medical care immediately.

O – Open mind

Reset expectations and short-term goals. You may not be able to practice like you usually do. Be mindful of your mental health and well-being during this extraordinary time. Think of ways to cross train or do alternative workouts.

R – Red flags

See your pediatrician, sports medicine physician, athletic trainer or physical therapist if you experience pain in a small, confined area; if you are limping or not able to move normally; if you feel pain/soreness greater than four on a scale of one to 10; if you experience pain or soreness when you are not playing sports; or if you feel pain or soreness that lasts two to three days after activity.

T – Take steps to limit the spread of COVID-19

Never practice or play when you are feeling sick. When possible, train outside to limit the risk of transmitting/catching infections. Wear a mask or face covering when possible (i.e. in team meetings and when on the sideline). Bring hand sanitizer and use on your hands often. Try not to share equipment. If that’s not possible, then limit the number of people using that equipment and plan how to clean between uses. Bring your own water and snacks. And avoid high-fives, fist/chest bumps, and hugs – create your own hands-free celebration. 

S – Stay positive

Sports are fun, social and make us stronger physically and mentally. Playing sports can help us through challenging times.