Scott Webb (Host): If you've ever wondered what the difference is between an annual well child physical exam and a sports physical, you came to the right place today. Pediatrician Dr. Kiara Hodge is here and she's going to explain the differences and similarities between the two types of physicals.

Welcome to BayCare HealthChat. I'm Scott Webb.

Doctor, it's so nice to have you here today. I was just mentioning that my daughter is a basketball player. She's 17. She just had a sports physical. Physicals in general are, you know, on my mind. And that's what we're going to do today is talk about annual physicals, like well child exams versus sports physicals.

So as we get rolling here, let's just start there. What's the purpose of a well child exam and what types of things or what areas do you focus on?

Kiara Hodge, DO: Yeah, so a well child exam really is the comprehensive evaluation of overall health and kind of development. So usually when we're doing just a regular child exam we'll be doing a full exam head to toe and talking about all things preventative health and screening, looking for things that could potentially be wrong before they become a problem.

So we focus mainly on growth and development, preventative care, looking at how the child is eating and different nutritional assessments. That's also the time that we'll review immunization status and see what immunizations are coming up or due, especially depending on the season.

And then some mental health screening for our teenagers especially, and then screening for other chronic conditions and any laboratory evaluations that they may need. We don't check blood work often in kids, but there are specific times that we do, just to make sure everything's okay with cholesterol and hemoglobin, making sure no one looks anemic. So, those are the kind of things we focus on in the well child exam.

Host: Yeah. So just kind of overall health, of course folks, parents and kids may bring up sports and that kind of thing, but we have that separate sports physicals, which all of us, parents of athletes know that your kid can't play the sport they want to play without the sports physical, even if they've had a regular physical sometime fairly recently.

So let's compare and contrast a little bit. When we think about sports physicals. How do they differ from the well child exam and what areas specifically do you focus on?

Kiara Hodge, DO: Yeah, so the sports physical, and there is some overlap because a lot of times parents and, you know, patients will try to schedule them around the same time, which is perfectly fine. We oftentimes end up doing a well child exam and a physical exam for sports at the same time. In the sports physical, we focus on the patient's ability to perform well in the sport that they're interested in. So that includes a comprehensive history and focusing on any activity-focused physical exam components. For instance, we're mainly focusing on the musculoskeletal system.

So looking at all the joints, looking at the patient's ability to do squats or run or the different things that they may need to do well in their sport, as well as looking at the cardiac system, making sure there's no red flags that would prevent them from being able to participate in their sport.

Host: Yeah. And you know, as you say, sometimes folks, maybe they uh, one stop shopping and they get the well child and the sports physical and just a little bit different area, different focus, different form, of course, for the sports physical got to have that specific form for that.

So, what I've always found is nice is that our pediatrician often has that form for us. So if we forget to bring the form, you have them there, right?

Kiara Hodge, DO: Yes. And especially over the summer, we're usually trying to ask like, “Oh, do you need a sports physical coming up?” Because then we'll have the front desk provide that to the patients. So that way we can just knock it out all at one time.

Host: Yeah, that's awesome. I'm sure, Doctor, and it's been my experience as well, that sports physicals are a great time to really educate young athletes, so I want to go over like, what are some of the key points that you stress with them? Our daughter, especially being a basketball player, we've talked with the pediatrician and even gotten a referral for physical therapy to try to help her to get ahead of some of these injuries, like the dreaded ACL injuries for basketball and softball players. So it's just a great time to educate. So maybe you can talk to us about that. Tell us about the types of things you go over with young athletes.

Kiara Hodge, DO: Yeah, definitely. So I think the most important thing when it comes to childhood sports is that when you're participating in one sport and you do it vigorously, the biggest risk is an overuse injury because you're just doing the same thing all the time, especially some of our year-round sports like cross country where you really have no breaks in between.

So that allows the time for us to go over some of the things that they're doing repetitively and looking specifically at those areas to make sure that we're not seeing any signs of overuse or pain or just any kind of little ailment that may prevent them from performing well in their sport.

So we look at safety, looking at proper equipment use, how it fits. And then looking at things like endurance and we always promote stretching before and after activities to help limit any injuries during their sport. And then it also is the time that we kind of educate on patients being well rounded and maybe engaging in multiple different sports so that they're using different parts of their bodies and not always just using one arm if they're playing softball or only using their legs if they're running. That's a time that we address some of those things too and look for other interests.

Host: Doctor, I'm sure you would echo this, that so many sports, like when I was a kid, you played this sport. So football was in the fall. Basketball was in the winter. Baseball was in the spring and the summer. But all of these sports have become year-round sports. My daughter's a basketball player, but it's a year-round sport.

She maybe gets a month off the entire year when she's not playing some form of organized basketball between high school and travel and all of that. Is that something that you talk to young athletes about, is just the importance of knowing when to say when, when to take breaks, trying to mix things up a little bit, it's hard for them to understand because they're kids, but they're gonna, those bills come due later in life when you overuse your body at a young age, right?

Kiara Hodge, DO: Yeah, so that's a very key point is always educating and empowering, especially our adolescents that are at the high school level of sports, and some are getting ready to go to college, and they're looking at scholarships. But always listening to your body because it will tell you when something's wrong, and you can ignore it, but at some point it will become a bigger issue that then it's unavoidable to ignore.

I always empower my teens especially when they're looking at things like scholarships is, if it's early in the season, early in the year, and you're feeling a little bit of anything weird going on, always listen, always get it looked at, and see what we can do to prevent it from becoming a big problem later on down the line as they get closer to when those big decisions really are important.

Host: You were talking about some of the crossover that there's some similarities between the two types of physicals. Maybe you can go through that, highlight some of the similarities.

Kiara Hodge, DO: Yeah, so I would say the biggest similarity is that most of the time I would say parents might not even notice the difference between the two exams. Because even during our normal well child visit, we do emphasis on the musculoskeletal system, looking for things like scoliosis and just overall looking at how the kid is developing.

And so in that sense, it could look similar. Of course with more of a little bit of an emphasis on looking at specific joints and things when we're doing the dedicated sports physical, but there is definitely a lot of overlap because just as important as their ability to do their physical sport, we also want to know how their sport is affecting them in all other aspects of their life. So of course we want the sport to be something that helps to relieve stress and not add stress. We want to make sure that they're eating well for their sport. We want to make sure that they're getting enough sleep and staying well hydrated. So a lot of those things that we address at the well child check, also gets addressed at the sports physical.

Host: Yeah, some of those things are just human things, right? Just eat well, stay hydrated, all that good stuff. How about some of the key differences?

Kiara Hodge, DO: Yes, I'd say the biggest differences is in the well child check, we focus a lot on milestones and where kids are at in their developmental journey. Of course, this is very apparent when they're young and we're like, okay, are they walking yet? Are they talking yet? Of course, most kids aren't playing sports. I would say that's a very big difference.

But as they really enter into those adolescent years, the biggest difference is that the well child check focuses a lot on like the well being of the child and then the sports physical will focus more on their dedicated sports.

And especially for boys the sports physical is a time where we screen for hernias. So especially our kids that are playing contact sports and things like that. That's a big component of the sports physical for our teenage boys is looking for things that could end up causing them serious danger, like a hernia.

Host: Yeah, definitely. Well, it's good stuff today, Doctor. It's always great to just go through these things and explain and for folks who are like wait, if I already have this one, why do I need the other one? You just do, but as you say, sometimes you can get them both at the same time, which is really convenient.

Just give you a chance here at the end. Final thoughts, takeaways. I don't know if anybody has any apprehension about coming in for a physical or anything like that. How would you sell them on the idea that it's a good thing and they'll be fine?

Kiara Hodge, DO: Yeah, definitely. So, I think, of course, every parent's biggest hope and dream is that their child just grows up and is healthy. And so, I think the biggest selling point for well child checks is that it's all about preventative medicine. Our goal as a pediatrician is to prevent problems before they occur. And so really all the things that we're focusing on during the well child check and kind of digging into those questions of the day to day nitty gritty is really to try to help and prevent any serious problems from arising, keeping kids out of the hospital, keeping kids healthy, keeping them in their sports.

And so I think that's one of the biggest things overall. And then the sports physical is really just so that your kid can continue to do the thing that they love. Nothing is more disheartening than having to tell a child that they cannot participate in their sport because of an injury or an illness. And so our goal with the sports physical is to try to screen for those things and prevent them from happening. So that way we don't have to have that conversation.

Host: Yeah. That's awesome. Well, I appreciate your time and your expertise today. Thank you so much.

Kiara Hodge, DO: Thank you so much.

Host: And for more information, go to BayCare.org. And that wraps up this episode of BayCare HealthChat. Always remember to subscribe, rate and review this podcast and all of the other BayCare podcasts, so we can share the wealth of information from our experts together. I'm Scott Webb. Stay well.