Summer vacation has arrived, but soon enough young athletes from across the region will be getting ready to participate in school sports. The annual mad dash to get those pre-participation sports physicals done before school starts is right around the corner.

The state of Washington requires that all students participating in organized sports have a physical examination by a qualified provider every two years to make sure they are healthy enough to participate in sports.

Have you ever wondered why student athletes need to have a pre-sports physical? Do we need them? Absolutely.

As a physician who performs these examinations regularly, I believe they are an excellent tool in which to look for any risk factors that could cause serious problems for the athlete during the season.

Keep in mind that the earlier the examination is performed, the more time we have to investigate any problems that may be found.

Before taking your child to the doctor for his or her sports physical, make sure you make a list of the following items:

• Questions for the doctor about your child’s health

• Chronic medical problems

• Past orthopedic problems or fractures

• Current medications

• Allergies

• Family history of any heart disorders or sudden death (especially family members under 50)

• Any history of a concussion (or having their “bell rung”)

Athletes will also have their weight, pulse and blood pressure checked to make sure it is in a healthy range for their age.

Sports physicals are an important tool to evaluate injuries in the past that may be warning signs of future problems. Some of the more common injuries among student athletes include:

Sprains and strains : These injuries are very common in active children and adolescents. A sprain is an injury to a ligament, a tough and fibrous connection between two bones. Sprain injuries typically involve stretching or tearing of the ligament. A strain is an injury that occurs to a tendon, another type of connective tissue that connects muscle to bone. During an examination, we look for lumps or bumps that look different than the uninjured side, buckling that occurs when attempting to use an injured joint, numbness around the injury or evidence of multiple injuries to the same area or joint.

Growth plate injuries: All growing bones have an area called the physes or “growth plate” where special cells cause lengthening of bone in children and adolescents. These areas are very susceptible to injury, and can often mimic a simple sprain or strain. Injuries to the growth plate may cause a problem with bone growth, therefore it is very important to have these injuries identified and treated as they occur. The specific amount of injury to a growth plate can be determined with a basic X-ray, which also gives us an idea how susceptible the area might be to future injuries.

Repetitive motion injuries: Active children can be at risk for repetitive motion or “overuse injuries” in the same manner as adults. All major joints of the body are at risk for developing repetitive motion injuries, although in children the shoulders, elbows, knees, and ankles are most at risk. Overuse injuries may occur if a child participates in a specific sport or activity on a very regular basis. Pain will typically develop slowly over time, often getting to the point where playing is no longer possible. It is very important that children in organized sports learn proper techniques related to their sport in order to protect their growing bodies and avoid future injuries.

Concussions: A concussion is caused by a direct blow to the head. Physical symptoms may include headache, nausea and vomiting, difficulty with balance and sensitivity to light and sound. It is also very important to be aware of changes in memory, “thinking speed” and emotion that were not present for the athlete prior to their concussion. Difficulty with concentration, memory, and emotional changes are all signs that symptoms can persist even if headache has resolved. Sleeping more or less than usual is also typical of an athlete that has sustained a concussion. A new Washington state law now requires any athlete suspected of having a concussion during a game be removed from play and evaluated by a physician familiar with concussion. Recent guidelines also state that a concussed athlete must complete a five-step protocol before returning to play. Make sure to check with a sports medicine physician if you are not sure if your athlete is safe to return.

School preparticipation sports physicals are available all summer from the physicians with MultiCare throughout the south Puget Sound.

For more information, visit multicare.org. To schedule an appointment, call 253-446-0750.

Dr. Jason D. Brayley practices sports medicine at MultiCare Orthopedics aned Sports Medicine in Puyallup and Covington, WA. Dr. Brayley attended medical school at Loma Linda University, completed his internship and residency at Naval Hospital Camp Pendleton and his fellowship in Primary Care Sports Medicine with the Cleveland Clinic Foundation. Dr. Brayley is a member of the American Medical Society for Sports Medicine, American College of Sports Medicine, American Association of Cycling Team Doctors and the American Board of Family Medicine.