Joey Wahler (Host): It is a key part of preparing to compete in school athletics. So we're discussing sports physicals. Our guest is Dr. Jerrod Feldman. He's a Pediatrician with Woodlawn Health. This is Woodlawn Health Doc talk. Thanks for joining us. I am Joey Wahler. Hi there, Dr. Feldman. Welcome.

Jerrod Feldman, MD: Hi there. How you doing?

Host: I'm good. Yourself?

Jerrod Feldman, MD: It's a good day.

Host: Excellent. So first, what time of year is generally considered prime sports physical season, and what specifically is required?

Jerrod Feldman, MD: So we're in that season now. We're at the tail end of the school year, and the IHSAA says that kids have to have a pre-participation school physical or sports physical performed by a doctor, a nurse practitioner or a physician's assistant that's licensed in the state of Indiana before the first practice.

And, that practitioner will review the completed medical history on the form and go over the history with the patient and or parent, guardian and do the physical.

Host: And speaking of which, does it need to be a certain type of physical? What exactly is done? What's required?

Jerrod Feldman, MD: So as far as the physicals go, there is a specific form outlined by the IHSAA in regards to specific medical history, things that need to be reviewed, and that's helpful with the person performing the physical, knowing more about the medical history and any risk factors for the patient, and looking into those things as well as other screens.

Now besides high school sports, there are other groups, club teams, clinics, summer camps. We see kids that do a lot of different activities, and those things may have either they utilize the same IHSSA form or some of them have their own specific form for their organization. So we follow whatever that organization dictates.

But there's a general consensus of medical history and any risk factors that we like to review, including family history. That's very important when it comes to cardiac history and things like that.

Host: Absolutely. And you just mentioned something interesting, Doc, which is you don't necessarily have to be preparing for sports in school. You basically just need to be of school age and even elsewhere you may need, well, you will need this, right?

Jerrod Feldman, MD: Correct. Anyone who is interested in being athletically active, sports training, has had an injury in the last year, things like that, there's a lot of different things that might come up, and so it can be helpful to see your physician once a year and get these evaluated.

Host: And so having said that, explain if you would please just a bit more about why this is so important. You mentioned, for instance, possible cardiac issues, which oftentimes, especially in younger people, am I right, can go undetected until something is noticed during a routine checkup. Right?

Jerrod Feldman, MD: Yes, sir. There are certain types of conditions, and in particular some of the cardiac ones, the biggest clue can be family history. There are some new tests and things that I see, arrive in my office periodically, where a family member comes in and someone else has been diagnosed with a condition and the specialist informs the family that other people need to get evaluated for the same condition, despite the fact that they don't have any obvious symptoms and maybe are very, you know, young, healthy, and active. But it's something that we need to screen for because it can have a sudden and very detrimental presentation. So we'll do evaluations or make referrals if needed.

Host: So what would be some other examples besides heart conditions that would be underlying and a sports physical could reveal them, but they may have been unknown prior?

Jerrod Feldman, MD: Well, there are definitely chronic injuries, things that kids play a lot of sports year round anymore. And, the burden on the athletes anymore is joint instability or pains. Things that maybe the child thought was just a normal finding or didn't realize was something that was an indication of a bigger problem.

We can make referrals for things like physical therapy or get further evaluations done, as well as there are certainly other what I would consider non-athletic concerns. This is our chance to often see kids where we can review things like mental health concerns, including athletes, a lot of times, they'll  be interested in things like diet and supplements and getting good advice from their physician can be very helpful.

Host: Absolutely. And so you mentioned there, Doctor, the fact that seasons are longer now than they used to be for sports, and many kids play multiple sports, several sports and compete practically, or including training certainly, are active literally year round. How has that changed your role in treating them?

Jerrod Feldman, MD: I think chronic injuries are a much bigger problem now where kids will go to tournaments during the summer and play a tremendous number of games in a very short window, and I think we've got to be advocating for those kids to, number one, have a healthy experience. I think there's a lot of burnout for some kids and by a young age, they're losing their love of being a kid.

And so we have to make sure that they're enjoying the sport, that they're there for the right reasons, and that it's done in a healthy way. I also think that we need to make sure that we're doing things to take steps to prevent some of the chronic problems and talk to parents about how much it helps to limit some of these activities at times of the year or even be a little more diverse in their activities, not doing one thing over and over to cause those chronic aches and pains and allow them to be a little bit more of a kid and do some different activities.

Host: So how often do you see a situation where that burnout is a problem? And what do you attribute that to? Is it social media and the fact that many kids nowadays, perhaps more than in years past, think they're going to be the next Michael Jordan or Kaitlyn Clark? What's going on there?

Jerrod Feldman, MD: I think there's a little bit of that, but I also think that anymore it seems that everything we do, we do to extremes and social media, certainly, it makes you feel like if your child plays baseball, they need to play 150 games a summer and at 10 years old, that's a lot. And some kids just want to go swim with their friends and that's okay.

So I think there's a pressure there that it's not okay to just be a kid and have fun for the joy of just playing the game. And a lot of seeking the trophy, I guess would be a term. But I think that there's a lot of different pieces there as well as I think sometimes we have to ask ourselves and ask the child, are you enjoying this?

Is this fun? Because sports certainly are a good way to learn a lot of life skills, but also kids need to be doing appropriate things for their age and spending time with the same age group. For instance, sometimes if a child is exceedingly good at a particular sport, they may get accelerated up that chain of advancement where they're playing with much older kids and that's hard on a kid who's emotionally, their development may still be at their age appropriate level, even though their physical abilities to play a sport is very advanced. And that's hard to be spending your time with other kids that you may not have a lot in common with because you're just different in age.

Host: Yeah, it's a great point indeed. A few other things here. Getting a physical for sports well in advance certainly allows time for possible issues to be addressed well beforehand. Right?

Jerrod Feldman, MD: Absolutely. We like to see kids in a good, timely manner so that if anything needs to be referred or whatnot, we can get that taken care of. In general, the rule is for school sports that the calendar year starts on April 1st. Any physical that's done after April 1st of this year will count for the school calendar of this upcoming fall, winter, and spring. As far as other sports camps, things like that, they may have their own deadlines for these physicals.

Host: What about in the time that you've been practicing, are you seeing any changes in trending sports injuries for kids of school age? What would be, for instance, an injury or two that maybe you didn't see as much of years ago and why?

Jerrod Feldman, MD: I think two of the things we see a lot of are back injuries and shoulder injuries, and simply because of repetitive movements and the volume of activity. Those are two areas of our body that just tend to break down. I would also say that a lot of children when they're playing these high volume sports, and it's sad because it's often the kid who's really good at what they do, they somewhat get overused by the coach and consequently, if they're being called on to do what they're good at over and over again to help the team win, to advance in a tournament, whatnot, then they're going to be trying their best to not let the team down. And then things start to hurt. And then we get in the situation of not giving an injury enough time to rest because the next tournament's coming up.

So I think back problems and shoulders are two that I've been seeing an increasing amount of.

Host: Okay. We also hear sometimes that soccer is kind of underrated, if you will, when it comes to sports injuries and that many do occur on the soccer field in what's generally considered a non-contact sport because there's a lot of cutting and that sort of thing and women are more prone just by nature, am I right, to knee injuries than men are?

Jerrod Feldman, MD: Absolutely. There's been an epidemic of ACL injuries in women's sports, and there's been a big evolution, I think, in terms of the sports that are available and even in small communities, we're seeing a lot more diversity in the sports that kids can play. I think the other thing is people are seeking out more opportunities further from home, a lot of travel, and when that happens, kids are having to adapt to a lot of different factors there.

And say a child maybe who's used to playing local recreation soccer on their local fields, suddenly is driving a few hours out of town to play on a different type of indoor surface or a different turf surface. That's a change in what you're able to do as well as the level of competition may require more demands on your body.

It may be, you know, certainly what's considered a non-contact sport may be a lot rougher and more aggressive or, bigger, stronger athletes that they're playing against. And so consequently, a much higher level of competition leads to maybe a little more frequent injuries.

Host: As you pointed out, oftentimes the surface in just about any outdoor sport can play a major factor, not just the different type that an athlete may not be used to, as you said, Doc, but also it might not be in the greatest condition. Right?

Jerrod Feldman, MD: Absolutely. And I think there again, listening to the child's body, things that hurt, making sure that we're not just looking at wins and losses or points scored, but how do you feel? I think two of the most underrated things in athletics is, a child getting a good diet, good nutrition, and a good night's sleep.

And if we're not getting those, we're more likely to get injured. Because that's the things that help us recover. That's the things that help fuel the engine that makes us go. So good diet and good sleep.

Host: Certainly just as important, if not more so for younger people, as with older folks. And how about insurance? Does insurance cover a sports physical typically?

Jerrod Feldman, MD: That's something that might have to be checked on an individual basis, but in general, most insurances and government provided healthcare programs cover at least one physical a year. And so if they've not had any kind of well child visit or anything recently, there's a good chance that it's going to be completely covered to go see their family physician and get the physical completed.

Host: And then finally here, Doctor, in summary, what should parents be looking for when taking their kid to get a school sports physical done? And what do you and yours at Woodlawn Health really hang your hat on that you're most proud of in that area?

Jerrod Feldman, MD: Well, we would like for all athletes to be able to go and see their primary care provider, and that's a person that's known them often for years, knows their medical history, and can sit down and have a good discussion about what are their goals? How are they doing in school? Are they eating a good diet?

What kind of sports are they doing? What are they interested in going forward? Do they have aspirations of competition at a higher level? Those are things that I think can be done in the setting of a good office visit where they have a discussion. I think that we like to sit down with our kids in our practice and talk about all kinds of areas as well as what their aspirations for sports might be.

Host: It sounds like you're doing a great job of just that, including a little bit of everything, not just the physical, but the mental, the diet and everything that goes along with it that often gets overlooked. Well, folks, we trust you are now more familiar with sports physicals. Dr. Feldman, keep up all your great work and thanks so much again.

Jerrod Feldman, MD: Thank you very much Joey.

Host: Absolutely. And for more information or to schedule your sports physical, please call Woodlawn Pediatrics at (574) 224-2020. If you found this podcast helpful, please share it on your social media. I'm Joey Wahler, and thanks again for being part of Woodlawn Health DocTalk.

​