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Introduction

A sports physical — formally known as a pre-participation physical evaluation (PPE) — is a medical examination required before a student athlete can participate in organized school sports. Whether your child is joining the soccer team, basketball squad, swimming team or track and field, understanding what happens during a sports physical helps parents and athletes prepare for the appointment and make the most of the visit.

Sports physicals serve a critical purpose: they evaluate whether a young athlete is healthy enough to safely participate in their chosen sport. The exam identifies existing health conditions that could put an athlete at risk, screens for previously undetected issues (particularly cardiac conditions) and provides an opportunity to discuss injury prevention, nutrition and training practices.

This guide explains every component of the sports physical, what forms you will need, how to prepare and why this exam matters for your child’s safety and performance. We also cover Illinois-specific requirements and answer the most common parent questions about the process.

Sports Physical Exam Components

Why Are Sports Physicals Required?

Sports physicals are required by virtually all school districts and state athletic associations — including the Illinois High School Association (IHSA) — to protect student athletes from preventable health emergencies during athletic activity.

The primary goal is to identify conditions that could be dangerous during intense physical activity. Sudden cardiac arrest, while rare, is the leading cause of death among young athletes during sports. A thorough sports physical includes cardiovascular screening that can detect warning signs of conditions such as hypertrophic cardiomyopathy, arrhythmias and other structural heart abnormalities.

Beyond cardiac screening, sports physicals identify musculoskeletal issues that could be aggravated by athletic activity, undiagnosed conditions like exercise-induced asthma, incomplete recovery from previous injuries and other health concerns that may affect safe participation.

The exam is also an opportunity for the physician to provide guidance on nutrition, hydration, proper training techniques, protective equipment and mental health — all of which contribute to a safer, more successful athletic experience.

Two Parts of a Sports Physical

A standard sports physical consists of two main components: the medical history review and the physical examination.

Part 1: Medical History Review

The medical history is often considered the most important part of the sports physical. Research shows that approximately 75 percent of conditions that affect athletic participation are identified through the medical history rather than the physical exam.

The history questionnaire asks about previous injuries or surgeries, chronic medical conditions (asthma, diabetes, seizures), medications and supplements currently being taken, family history of heart disease or sudden cardiac death, history of dizziness, fainting or chest pain during exercise, concussion history, allergies (including exercise-induced allergies), menstrual history (for female athletes) and any symptoms that occur during or after physical activity.

Parents should complete the medical history form honestly and thoroughly. Even conditions that seem minor or unrelated to sports can be important. A history of fainting during exercise, for example, may indicate a cardiac condition that requires further evaluation before the athlete can safely participate.

Part 2: Physical Examination

The physical examination evaluates the athlete’s overall health and fitness for sports participation. Here is what the doctor checks during each component of the exam.

Vital Signs

Height, weight, blood pressure, pulse and vision are measured. Elevated blood pressure in young athletes can indicate underlying conditions that need evaluation. Vision screening is especially important for sports that require visual acuity and depth perception.

Cardiovascular Examination

The doctor listens to the heart with a stethoscope to check for murmurs, irregular rhythms or other abnormalities. The athlete is typically examined both lying down and standing, as some heart murmurs are only audible in certain positions. The doctor also checks pulses in the arms and legs to assess circulatory health.

Musculoskeletal Examination

This is often the most sport-specific part of the exam. The doctor evaluates joint flexibility, strength and stability. They check for signs of previous injuries that may not have fully healed, assess range of motion in the neck, shoulders, elbows, wrists, hips, knees and ankles and look for muscle imbalances or structural abnormalities that could increase injury risk.

Respiratory Examination

The doctor listens to the lungs and asks about any history of breathing difficulties during exercise. Athletes with exercise-induced asthma may need an action plan and rescue inhaler to safely participate in sports.

Abdominal Examination

The doctor palpates the abdomen to check for organ enlargement, particularly the spleen and liver. An enlarged spleen (which can occur with certain infections like mononucleosis) is a contraindication for contact sports due to the risk of rupture.

Skin Examination

The doctor checks for contagious skin conditions such as ringworm, impetigo or herpes simplex that could spread to other athletes through contact sports. These conditions may need treatment before the athlete can participate.

Neurological Screening

A basic neurological screen assesses reflexes, coordination and balance. For athletes with a history of concussions, the doctor may perform a more thorough evaluation and discuss return-to-play protocols.

How to Prepare for a Sports Physical

Proper preparation makes the sports physical appointment more efficient and thorough. Here is what parents and athletes should do before the visit.

Complete the medical history form in advance. Most schools and athletic departments provide the pre-participation physical evaluation form that must be used. In Illinois, the IHSA provides a standardized form. Fill it out completely and bring it to the appointment.

Bring a list of all current medications, supplements and vitamins your child takes. Include prescription medications, over-the-counter products and any herbal or sports-performance supplements.

Bring your child’s immunization records, as some schools require verification of up-to-date vaccinations alongside the sports physical.

Have your child wear comfortable, loose-fitting clothing and athletic shoes to the appointment. This allows for easier physical examination, particularly during the musculoskeletal assessment.

Write down any questions or concerns you or your child have about sports participation, injuries, nutrition or training. The sports physical is an excellent opportunity to discuss these topics with the doctor.

What Happens After the Sports Physical?

After completing the examination, the doctor determines the athlete’s clearance status. There are three possible outcomes.

Cleared for Participation

Most athletes are cleared to participate without restrictions. The doctor signs the clearance form, which the athlete submits to their school or athletic department.

Cleared with Recommendations

Some athletes are cleared to participate with specific recommendations — such as wearing a knee brace, using an asthma inhaler before exercise or following a concussion monitoring protocol. These recommendations are documented on the clearance form.

Not Cleared / Further Evaluation Needed

In some cases, the doctor may identify a condition that requires further evaluation before clearance can be granted. This might include additional cardiac testing, orthopedic consultation or monitoring of a specific health issue. This does not necessarily mean the athlete cannot participate — it means more information is needed to ensure their safety.

Sports Physical vs. Well-Child Visit

A sports physical and a well-child visit serve different purposes, though they overlap in some areas. A well-child visit is a comprehensive, age-appropriate health assessment that includes developmental screening, mental health assessment, immunizations, anticipatory guidance and a broader evaluation of the child’s overall health.

A sports physical is focused specifically on determining fitness for athletic participation. It emphasizes the cardiovascular and musculoskeletal systems and does not typically include immunizations, developmental screening or the breadth of counseling provided at a well-child visit.

The American Academy of Pediatrics recommends that a sports physical should not replace the annual well-child visit. Ideally, both should be completed — the well-child visit for comprehensive health monitoring and the sports physical for sport-specific clearance. Many pediatric practices can combine both visits into a single, efficient appointment.

Illinois Sports Physical Requirements

In Illinois, the IHSA requires that student athletes have a current physical examination on file before they can try out for, practice with or compete on any school sports team. The physical must be performed by a licensed physician (MD or DO), physician assistant or advanced practice registered nurse.

Illinois sports physicals are valid for approximately one year from the date of the examination and must cover the entire school year of participation. For fall sports, the physical is typically due before the start of the school year. Check with your school’s athletic department for specific deadlines.

The exam must be documented on the IHSA-approved Pre-Participation Physical Examination form, which includes both the medical history and physician clearance sections. Your pediatrician should have these forms available or they can be downloaded from the IHSA website.

Common Conditions Found During Sports Physicals

While most sports physicals result in full clearance, certain conditions are commonly identified during these exams.

Heart murmurs are frequently detected during sports physicals. Most heart murmurs in children and adolescents are innocent (harmless) and do not affect athletic participation. However, some murmurs warrant further evaluation with an echocardiogram to rule out structural heart conditions.

Exercise-induced asthma affects a significant percentage of young athletes. With proper management — typically an inhaler used before exercise — most athletes with asthma can participate fully and safely in sports.

Previous injuries that have not fully healed, particularly sprains, stress fractures and concussions, are commonly identified. The doctor may recommend physical therapy, modified training or additional recovery time before full participation.

Vision problems, elevated blood pressure and scoliosis are other conditions that may be detected for the first time during a sports physical.

Key Takeaways

✔  Sports physicals are valid for 395 days in Illinois

✔  Your pediatrician can perform the exam — no need for a separate clinic

✔  Bring a completed medical history form to speed up the visit

✔  Uncontrolled asthma or heart concerns may require additional clearance

✔  Schedule the physical well before the sports season begins

✔  A sports physical is not a substitute for an annual well-child visit

Frequently Asked Questions

What does a sports physical check for?

A sports physical checks vital signs, cardiovascular health, musculoskeletal function, respiratory health, abdominal organs, skin conditions, neurological function and vision. It also reviews the athlete’s medical history, medications, previous injuries and family health history to identify any conditions that could affect safe sports participation.

How long does a sports physical take?

A typical sports physical takes 15 to 30 minutes, including the medical history review and physical examination. If additional testing or discussion is needed, the appointment may take longer.

When should my child get a sports physical?

Schedule the sports physical at least six weeks before the sport’s season begins. This allows time for any follow-up testing or clearance issues to be resolved before tryouts or the first practice. In Illinois, the physical must be current for the entire school year of participation.

Can a pediatrician do a sports physical?

Yes. Pediatricians are qualified to perform sports physicals and are often the best choice because they know your child’s complete medical history. In Illinois, sports physicals can be performed by MDs, DOs, physician assistants or advanced practice registered nurses.

What should my child wear to a sports physical?

Wear comfortable, loose-fitting clothing such as shorts and a t-shirt, along with athletic shoes. This allows the doctor to easily assess joint range of motion, muscle strength and overall physical condition.

Conclusion

A sports physical is more than a box to check before the season starts — it is a critical safety screening that protects your young athlete. Understanding what the exam involves and preparing properly ensures that your child gets the most thorough evaluation possible.

Schedule your child’s sports physical well in advance of the season, bring complete medical history information and use the appointment as an opportunity to discuss any health concerns with your pediatrician.