Physical Exams

All student-athletes must undergo an annual medical examination to ensure safety during practice and play. To support student athletics, we are pleased to be able to complete these examinations at a minimal charge to the student and parents.

We require an appointment for the examination, which is relatively brief (unless some condition is found that requires more attention). A parent or legal guardian must accompany the student under 18 years to the office for check-in. 

What to expect at the appointment

First, there is some state-mandated paperwork that both student and parent/guardian are required to complete, and some office paperwork.   

Once the paperwork is complete, the student is established as a patient of the clinic, and if some need arises to see a doctor later, just call for an appointment and we can see you without additional paperwork.

Please dress comfortably; disrobing is not usually required. If for any reason disrobing is indicated, we will provide an ugly, ill-fitting and not-at-all-flattering paper gown to protect your modesty.

When you are called from the waiting room, our back-office assistant will take you back to our “Vitals Station” and get your weight, height, temperature, blood pressure and oxygen concentration.  We will also check your vision with an old-fashioned eye chart. Finally, you will be given a specimen jar and asked to use the restroom to collect a urine specimen.

Next, in the exam room, the doctor will check the following: 

· HEENT: Head, eyes, ears, nose, throat;

· Lymph nodes in your neck and head;

· Heart: Listening to the four valves (it’s okay to quiz the doctor if you like). The doctor is checking for unusual sounds that indicate an abnormal flow of blood in the heart. Such a sound is called a murmur.

· Pulses will be checked in your wrist, feet, legs, and throat.

· Lungs: Listening for clear airways and no abnormal sounds in the lungs.

· Abdomen: The doctor will first look for scars and striations, then listen for normal sounds, and      finally, palpate to check for enlarged spleen or tenderness that indicates an abdominal hernia. In males, the doctor will also use this time to check for an inguinal hernia.

· Urinary: Mostly, the information needed comes from a urine specimen. However, please ask any questions you may have, such as any burning sensation with urination. Only at the request of a parent, guardian or school official, we can add a drug screen.

· Skin: The most common skin issue in student athletes is acne. If severe, there are safe, effective treatment options. Other skin lesions should not be ignored. Even if only cosmetic, we may be able to remove the lesion in-office safely and painlessly.

· Musculoskeletal Evaluation: This is a check of major muscles at risk of injury during athletic training or competition, including: Neck, back, shoulders, arm, elbow, forearm, wrist, hand and fingers, hip, thigh, knee, leg, ankle, foot and toes.

What happens if something is “wrong”?

First, in student-athletes it is rare for something to be really wrong. But if it does happen it is much better to know before you (or your student athlete) is on the field or court.

There will be several options if we find something is a bit off. First, we can refer you to a pediatrician or other specialist for a consultation and any necessary treatment. Alternatively, we may be able to assume the role of primary care provider.

What if a parent or guardian wants additional evaluation?

Obviously, this type of evaluation is regarded as mostly a screening exam. And, just as obviously, we can do more evaluation if needed or desired. Here are some of the conditions which may suggest additional evaluation or treatment, but only if requested:

Eyes: A saccadic rhythm to the movement of the pupils (sometimes called nystagmus) may indicate the presence of a blockage in the semicircular canals which allows us to be balanced when upright. Dizziness or vertigo are common indicators of this. Sometimes, this can be treated quickly and effectively without any medication in the office.

Heart: If a murmur is detected when listening to the heart, an electrocardiogram (EKG/ECG) is the next most obvious step. We can do that in the office. While there are now lots of readily available, albeit grossly inadequate testing options readily available online, we provide a comprehensive 12-lead evaluation, similar to what would be done in a hospital cardiac unit.

Lungs: If abnormal sounds are heard, it may be an indication of asthma which typically requires an inhaler medication, but it may be a form of pneumonia which requires a totally different treatment. This may be treated in office, but referral to a pulmonologist is sometimes a better idea.

Breast: Breast examinations are not frequently required in young women, unless she is experiencing a noticeable lump or pain, although early conversation and instruction is self-evaluation is absolutely worthwhile.

Abdomen: Some conditions require more attention than others. For example, the spleen is a hand-sized, blood-filled sack that is normally well protected by the ribcage. When it is enlarged, however, which may be the result of some viral infections, it is more vulnerable to injury during athletic training or competition. An enlarged spleen requires an ultrasound image to be certain it is not at risk of serious injury. We can write that order, if desired.

Genitourinary: While a simple urinalysis is beneficial for some conditions, by itself it is inadequate for others. If a student athlete is experiencing a burning sensation with or after urination, we must consider the possibility of a urinary tract infection or a sexually transmitted infection. Whether male or female, this should be checked even though the check may be uncomfortable or embarrassing. Think of it as another introduction to adulthood and making responsible personal decisions. Treatments are safe, easy and effective. Not treating it may be deadly.

Female student athletes should undergo an evaluation of the pelvic region once they become sexually active. Disease conditions such as herpes (both I and II) and the Human Papilloma virus (HPV; there are more than 100 types!) can have significant and life-threatening complications. Early detection leads to early treatment.

Skin: Some lesions are merely aesthetically unpleasing; others are indicative of a more serious issue. If you are concerned, just let us know. Even if it is “just a skin tag” you don’t need to endure it.

Musculoskeletal:The most frequent musculoskeletal complaint in young women is mid-back pain, usually associated with moving one or both arms, or twisting the upper body. More often than not, the cause will be a displaced rib head which is easily replaced. In young males, the most common musculoskeletal complaint is a knee or ankle, although low back pain is also common. We can usually assess that, too.

Some of these "extra" evaluations are done at no additional charge.  Others may have a fee.

If you need a physical before an elective surgery, we can help.  We'll do a thorough check-up from head to toes and everything in between.  We'll order any necessary labs and prepare a report for the surgeon.  Some surgeons also require an EKG/ECG, which we include at no extra fee.

Typically, labs will include a complete blood count, comprehensive metabolic profile, clotting studies, and evaluations for diabetes. Other test may also be advised.

If you just want an electrocardiogram or need it as part of a physical, we can do that for you.  We'll provide a basic reading and a copy of the strip.  If we find something unusual, we will refer you to a cardiologist.