What are the key components of a sports physical for a 12-year-old, including both subjective (medical history) and objective (physical examination) findings?

From the Guidelines

A sports physical for a 12-year-old should include a comprehensive medical history and a thorough physical examination to identify conditions that may affect safe sports participation, as recommended by the most recent guidelines 1. The medical history portion should include questions about:

• Previous illnesses, surgeries, allergies, medications
• Family history of heart disease or sudden death
• Previous sports injuries, concussions, asthma, seizures
• Menstrual history for girls
• Concerning symptoms like chest pain, shortness of breath, dizziness, or fainting during exercise The physical examination should include:
• Measurements of height, weight, blood pressure, and pulse
• Vision screening
• Examination of the heart and lungs, abdomen, musculoskeletal system (focusing on joints, flexibility, and strength), neurological function, and physical maturation stage
• Special attention to previously injured areas and sport-specific concerns This comprehensive approach helps identify conditions that might affect safe sports participation, such as undiagnosed heart conditions, asthma requiring management, or musculoskeletal issues needing rehabilitation, as emphasized in the latest study 1. Key considerations in the clinical evaluation of symptomatic pediatric athletes include:
• Children may not remember and/or clearly characterize symptoms
• Symptoms, such as chest pain and syncope, are quite common in children and generally not indicative of cardiac disease
• The need for expert assessments in each of these disease processes and requirement for shared decision-making (SDM) when discussing both clinical management options and competitive sports participation, as highlighted in the recent study 1. SDM should be the standard of care for all athletes, irrespective of age, with cardiovascular conditions, and should involve diagnosis confirmation, risk determination, patient education, athlete preference and risk tolerance assessment, decision synthesis, stakeholder engagement, and longitudinal follow-up, as recommended in the latest guidelines 1.

From the Research

Subjective Findings

• Medical history is an essential component of a sports physical for a 12-year-old, including questions about previous injuries, illnesses, and medications 2
• The assessment of musculoskeletal pain is crucial, as it can have a significant impact on a person's quality of life, and a bio-psychosocial perspective should be taken into account 2

Objective Findings

• A physical examination should be performed to help localize the pain and assess for signs of inflammation, tenderness on palpation, pain on motion, joint instability, and malalignment 2
• The examination should also include an assessment of the musculoskeletal system, including the neck, back, shoulders, elbows, and hands, as these are common areas for musculoskeletal disorders 3, 4, 5, 6
• The use of ergonomic supports and proper posture can be effective in preventing musculoskeletal disorders and shoulder injuries 3, 6

Additional Considerations

• The prevalence of musculoskeletal disorders among dental professionals is high, with about seven out of ten having experienced musculoskeletal disorders in the past 5
• Risk factors for musculoskeletal disorders are multifactorial and include static and awkward posture, work practices, and repetitive motions 4, 6
• An interdisciplinary approach with progressive efforts should be taken to address musculoskeletal disorders in dental professionals, including ergonomics improvements, health promotion, and organizational interventions 6