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Sports physicals aren’t the same as a well-child check-up

Many parents will ask why their child, especially a teenager, needs to have a regular check-up despite a recent sports physical that was normal. The answer is actually pretty simple — your child’s doctor is checking dramatically different things between these two types of visits. Counting one as the other could mean your child is at risk for having a missed complication or an important screening test. 

A sports physical is a thorough examination of your child’s musculoskeletal health. This means we're being extra attentive to the way their body moves, how well their joints function, your child’s strength level, and their coordination. Your doctor should also be asking some very specific questions about your child’s family history — especially about heart problems or unexplained deaths in the family. If your child has ever had a concussion, this requires special attention and potentially some precautions with their sports activities. If your child has certain medical conditions this can change what sports they are eligible to play. Lastly, if your child participates heavily in sports, especially the same sport all year round, the stress they are putting on their growing body could be causing some damage. Enough damage over a long period of time could quickly end your child’s dreams of continuing that sport longer term or even professionally.

Athletics are a great activity for kids to develop good health habits, friendships, and confidence. Help your child’s participation be a fun but also safe experience.

Well-child checks, on the other hand, focus on your child’s general well-being. Early on in your child’s life we're looking for signs of appropriate development of both their body and their brain. For example, are they walking and talking on time? Doctors scrutinize each of the four categories of development: Speech/language skills, social development, fine motor skills and gross motor skills. Delays in any of the categories could impact your child’s school readiness, or worse, could be signs that your child is not healthy.

Once your child is of school age, there is more emphasis on the health habits your child is developing — the foods they eat, their activity level, TV time, etc. We also want to know if they're thriving in school both academically and socially. Once your child reaches about 11-13 years old they are taking on a lot more of the decision-making responsibilities about their health and usually desire a lot more privacy during visits. It can be a difficult transition for many parents, and it can be hard to see your child confide in their doctor instead of you.

Remember that doctors and nurses hold a special place in our society as “secret keepers,” we are meant to be very non-judgmental, and we’re great at providing reassurance to a teenager who wants to know if they’re “normal.” Many teens don't want to disappoint their parents yet they still crave answers to some issues that can be quite scary for them. As physicians we start screening for depression, substance abuse, sexual activity, and future life goals in pre-teens and teens.  

During a well-child check your child is given a thorough head-to-toe exam looking at multiple organ systems and we will ask a long list of questions about their general health and daily life. These visits prompt our offices to offer vaccines and yearly flu shots. Also depending on your child’s age, they may qualify for certain screening tests. Younger children are checked for anemia and excessive lead levels. Children as young as 9-years-old are now recommended to be checked for high cholesterol levels. American diets have become so poor in quality that even active children with no family history of heart problems can still have high levels of bad cholesterol and therefore an increased risk for heart disease at a young age. Sexually active adolescents (and adults) should get screening labs for sexually transmitted diseases every six months or at least once a year.

After we have hopefully reassured you that your child is doing well, we’ll spend time explaining the next steps in development you can expect to see in your child and review the things you can do to keep them safe. These can include reminders like how to safely apply insect spray on an infant, when to lower the mattress in the crib, drowning risks, keeping the water temperature in your house in a safe range, checking smoke detectors, reinforcing keeping the volume on headphones less than “earsplitting,” and wearing seat belts and helmets just to name a few.

About Amy Seery MD

I am a pediatrician with Via Christi Clinic and a faculty member of the Via Christi Family Medicine Residency program.