The fall sports season is just around the corner and it's time for another round of sports physicals. Most of the youth in the county participate in some type of organized school sport. The IHSAA requires high school athletes to have a yearly PPE or "Pre-Participation Examination." Many junior highs or middle schools and even grade schools are now requiring them before allowing athletes on the field.

Unfortunately, some athletes and families see the PPE as an unnecessary hurdle and want to get it over with as quickly as possible. This mind set has resulted in schools or other organizations setting up mass screenings for athletes. These involve setting up multiple "stations" to complete the PPE. For example, one station might review the athlete's medical history, another might do the blood pressure, another the heart and lung exam, etc.

While these screening events are convenient, and often less expensive than the child seeing his or her private physician, I am here to make the case against using them if possible. First of all, if an athlete has a family doctor or pediatrician, they have likely followed the athlete for a number of years and therefore have a unique relationship with the athlete that improves the depth and quality of the PPE. If something is discovered during the exam it's also much easier to have it taken care of then and there.

Let me first address the health history. This is without question the most important part of the PPE form - athletes and parents must take the time to fill it out carefully and completely, making sure to give details for any yes answers. Filling out the history part of the form at home before seeing the physician can be very helpful. The form can be downloaded at http://bit.ly/1pRlsqO.

Doctors focus their exam of organ systems based on the answers and explanations given in the history. These histories are often incomplete. This can be due to the athlete or parents not feeling it is important, or more commonly because they have simply forgotten the information.

These omissions are more likely to be discovered by the athlete's private doctor since he or she has access to the health history in the patient's chart. They may not be recalled or discovered in a mass-screening environment.

The actual physical exam portion of the PPE is also very important, especially the heart and lung exam. While this is possible in a noisy gym, I would much rather have my athletes' exams done in a quiet exam room in the doctor's office where subtle heart murmurs may be heard.

Lastly, one of most important reasons for doing the PPE at your doctor's office is that it allows the doctor to address age-appropriate topics in a private environment. Family physicians and pediatricians often don't see pediatric patients after their kindergarten physical unless they have an illness or injury. Teens are often due for vaccines that can be given at the PPE.

The adolescent years, when the bulk of PPEs are performed, are a critical time of physical and psychosocial development. It is very difficult in a room crowded with other athletes to discuss anxiety, depression, sexual development and risky behaviors such as sex, tobacco, alcohol and drug abuse.

During my PPEs I also make it a point to ask what the athlete's aspirations and future plans might be. It's really a great time to gain or re-gain trust and rapport between an adolescent and a health professional that they can come to if they have problems during their teen years.

I hope that you can see that while convenient, mass health screenings are not necessarily the best place to address the complete health of an athlete.



Dr. John Roberts is a Crawfordsville physician and an owner of The Paper. His health tips appear each day in The Paper of Montgomery County.