Joey Wahler (Host): They're needed to compete. So we're discussing youth sports physicals. Our guest Dr. Scott Burger. He's Chief Medical Officer for University of Maryland Urgent Care. This is the Live Greater podcast series, information for a healthier you from the University of Maryland Medical System. Thanks for joining us.

I'm Joey Wahler. Hi, Dr. Burger. Welcome.

Scott Burger, DO: Thank you for having me.

Host: Great to have you. Appreciate the time as always, Doc. So first, what are, for those unaware Maryland's requirements regarding sports physicals for school age athletes?

Scott Burger, DO: Yeah. So every school age athlete needs to have an annual physical performed, to make sure that they are healthy and safe to participate in athletics.

Host: And so that means kids starting at what age?

Scott Burger, DO: Around, most kids it starts at around age eight depending on what sport they're participating in. But there are some subtle differences. Um, some programs, private programs require it maybe a little bit younger or a little bit older, but generally we start seeing them around eight, somewhere between eight and 10 years of age.

Host: And explain if you would please, why are sports physical so important for kids and teens who play even if they feel healthy?

Scott Burger, DO: Yeah, it's really important to make sure that kids are physically prepared and safe to participate in athletics and also to review their history as well as their family history to make sure that they're safe from that perspective, and I'll go into a little bit more detail. You want to understand about any injuries that a child has had in the past, to make sure that they fully recovered and what sort of impact that could have on their participation in sports.

You also want to make sure that if they have other underlying medical conditions, say a child with asthma, that that's well controlled and that they have what they need to safely participate in sports. Do they have their inhalers? Are they using them consistently and regularly? Making sure that all these things are lining up for them to be able to be successful in their athletics.

If they need to bring any of their medications to sports; making sure that the coach and the school or the program is aware of that so that they know that they can be safely administered. Counseling if they're kids who aren't quite sure how to use them correctly, showing them how to use their medications correctly.

So all those things are really important for it. In terms of history, it's also really important to make sure that these kids don't have anything that we would consider what we often call red flags. So is there any family history of something that could be genetic, right? Or could, is there anything in that child's history? You know, or have they had repeated episodes of passing out while playing athletics? Did they get chest pain, with athletics? Anything that could potentially need further evaluation. And thank goodness, the frequency with which those things are identified is relatively small, but if you miss them, they can be absolutely catastrophic.

And I think we've all heard those stories, from time to time and for something like and that's why we do this, to just make sure all, every kid is as safe as they can be to participate in those sports.

Host: Absolutely. So when is the best time to get a sports physical, and how far in advance should families plan for that?

Scott Burger, DO: So ideally you want to start doing it as they're getting ready to start, if they are training for it, right? So say they are a high school athlete and they're training for a season. You want to do it probably a month in advance. That's plenty of time to get into your pediatrician. You can walk into University of Maryland Urgent Care and do it at your convenience.

Often schools offer a sports physical clinic day, but some, give enough time in advance so that if any is needed, you have the time to do that. It's always challenging when somebody comes in the day before a sports season begins. Heck, I've had kids come in wearing shoulder pads that were pulled off the practice field because the coach realized that they didn't have their sports physical and they're walking into the clinic and you're telling them, I remember one kid, I was telling him, Hey, take your cleats off.

I don't need my waiting room all muddied up from you, but we're doing a sports physical then. And thank goodness in that scenario everything was fine. There were no red flags, so we were able to get that kid back to sports the next day. But what happens if we found something? What happens if there was a red flag or there was something concerning? We said, Hey wait, we gotta put the brakes on this. That's incredibly disruptive. And people aren't expecting that, right? And so then when you're telling them, your son or daughter can't participate in this until you go see this specialist.

And we all know how challenging it is to subspecialists these days. It's not like you can just call and make an appointment for the next day. That could be very disruptive for their season. So that's why I say at least a month in advance. University of Maryland has an amazing collection of specialists throughout the system to be able to connect people.

But we have to be realistic about these things, and that's why I say a month in advance is a good timeframe.

Host: So once you get it done, what exactly happens during a sports physical typically, and how might it differ from a regular checkup?

Scott Burger, DO: Sure. So, I had a pediatrician give me a really funny description of it. Said, the sports physical, you are focusing on really things that could impact their athletic participation. You're asking about injuries. We're talking about things like we've referenced before. You know, are you getting dizzy spells when you exercise?

Are you having chest pain? Is there any family history? Do you take any medications? If you've had injuries, how have you recovered from them? And then doing a physical exam around it. What she joked with me about with like a teenager sports physical, which is probably our most common, is a lot of times their annual physicals have a lot more to do with sex, drugs, and rock and roll.

And as she meant that they're checking the overall child and understanding their overall physical, mental health, understanding, making sure that they're safe, and, spending a lot more time with them, to make sure that they're in the right place, they're in, if it's the right age, they're also checking about their vaccination status. All the complexities that go into adolescent care that far exceed what you're doing in a sports physical.

Host: You touched on this earlier, but perhaps some more detail would be helpful. What kinds of issues commonly can a sports physical uncover that parents or their kids may not know about, and how can that head off a potential more serious condition or injury before it happens?

Scott Burger, DO: Sure. A lot of times, what, maybe a child was diagnosed with a sprain of the knee before. Or, not diagnosed, maybe they just took care of it on their own at home. And they come in and you evaluate them and there's some looseness or what we call laxity in a knee joint.

So you're concerned that there could be a more serious injury there. So you want to send them on for some additional testing. Or a child that's had a couple of head injuries in the past and now they're going to participate in sports again. And so you want to talk to them about their risks and what they should do to protect themselves and to be mindful of these sorts of things.

A lot of it is about education and what I call anticipatory guidance for the athlete and their family, to do their best to prevent future injuries. Those are really kind of things we're focusing on. From a history perspective, it's really asking questions about that athlete's history as well as the family history to untangle anything. If there are any medical issues that either were diagnosed and were significant in a family member that could be triggered by exertion, or maybe they were never diagnosed because it happened a long time ago, but you just know that you know your uncle collapsed while running a half marathon at the age of 19 and he died and they said he died of natural causes.

Well, that could be something far more significant that anybody who's an athlete in the family needs to investigate.

Host: To give us an example of that, doctor. The heart would be one, right? If there's been heart trouble in the family. We've seen, unfortunately, you touched on this briefly earlier, without mentioning it specifically, but we've seen athletes pass out, even die on the field in high school, in college, and it turns out they had a heart issue that went undiscovered, right.

Scott Burger, DO: That's right. Yeah. You can have congenital abnormalities that either affect the str, the external structure of the heart or the way some of the, without getting too granular, the way you process some of the, the cellular membrane, of the muscle cells and if you have channels that are incorrect and sodium and potassium and calcium are not flowing the way that they're supposed to, it can cause fatal arrhythmias.

So, these are the sorts of things that you sometimes only find out about when tragedy strikes, but that's why we try to ask as many questions as possible. Just referencing how great the University of Maryland Medical System could be and for our folks, we're having a lecture this month by one, by the head of pediatric cardiology, specifically with this in mind, to make sure that all of our people are aware of all these different things and who are the resources throughout the system that we can tap into when we have a child that we're concerned about.

Joey Wahler (Host): Well, that sounds great. So in summary here, what's your best advice for those joining us that may be putting off a sports physical so that they just go ahead and get it done? And most importantly, Doctor, so that they don't wind up waiting till the last minute and showing up in your office with shoulder pads or cleats, as you mentioned earlier. Right. No cleats.

Scott Burger, DO: Yeah, I mean look at University of Maryland Urgent Care. We try to make it as easy as possible. We're open seven days a week, 12 hours a day. You can walk in at any point in time and we'll take care of your sports physical. I know most of the pediatricians are very accommodating. They set up sports physical days for this where they're going to see lots of kids and make sure they do it.

So I think it's just keeping it in the front of your mind. Okay. Uh, Sarah is going to participate in soccer this fall. I should put something on my calendar to remind me a month before the year begins and just have it repeat every year so that it just reminds you to do that. We want to get these kids in early.

We want to make sure that they're healthy and they can participate safely, but just as we said, come in when you can, but come in as early as possible.

Host: Also once you get it done, and if you've got that clean bill of health, or maybe there was some issues that were properly addressed; it provides peace of mind, doesn't it? I'm ready to go here.

Scott Burger, DO: Yeah, I hope so. Part of the goal is to let them know that they're in a good place to be able to participate, but also to let them know that we're a resource if something were to go wrong. That if they have an injury during the season, they can come into University of Maryland Urgent Care, be seen right away, get the follow-up if anything is needed beyond the care that we can deliver and get them back out on the sports field as quickly as possible safely.

Host: Well folks, we trust you are now more familiar with the importance of youth sports physicals. Dr. Burger, keep up all your great work and thanks so much again.

Scott Burger, DO: Thank you.

Host: Please check out the show notes to learn more about University of Maryland Urgent Care Services and locations. You can find more shows just like this one at umms.org/podcast on YouTube or on your favorite podcast platform.

If you found this episode helpful, please do share it on your social media. Thanks so much again for being part of Live Greater, a health and wellness podcast, brought to you by the University of Maryland Medical System. We look forward to you joining us again.