Pre-participation exams were provided to student athletes like Emanuel Highley, who is examined at an Eau Claire High School football game by Dr. Brian Keisler.

The numbers were impressive: 47 volunteers, 22 high schools, 16 physicians

What it all added up to was a total of 519 pre-participation examinations performed for high school athletes at the Family Practice Center. The exams, which are required by South Carolina law before any student can take part in school sports, were provided free of charge on a single Saturday in April. The April blitz was the fourth time the community service was made available to adolescents in the Midlands by the USC School of Medicine.

“We wouldn’t want anyone not to be able to participate because they couldn’t afford a physical,” said Dr. Thomas Armsey, a primary care sports medicine physician and an associate professor in the Department of Family Medicine. In addition to the other three physicians on staff at the USC Sports Medicine Center, Dr. Armsey was assisted by two sports medicine fellows as well as Orthopaedic Surgery and Family Medicine residents.

Since many of the teens were returning to the pre-participation exams, their physicals only required an update since their last visit. Other athletes required a more extensive exam to determine their readiness to get out on the field. “Obviously we look for anything that would be potentially harmful such as any kind of cardiac or pulmonary disease or a disability that might cause an injury on the field of play,” said Dr. Armsey.

Over 50 athletes were not immediately cleared for play. In many of these students the issue was a heart murmur. Follow-up EKGs and echocardiograms were done after which the murmurs were all determined to be benign. Other teens needed to complete healing from recent surgery or required rehabilitation for a particular problem. For some athletes, equipment had to be modified. While it is unusual for an athlete to be held out of participation, even in extreme circumstances there are protective measures that will still allow adolescents to play. “If you just had one kidney we could put you in a flack jacket to protect that kidney,” said Dr. Armsey, describing a special pad to wear around the abdomen and lower back so players couldn’t injury the remaining kidney.

A number of teenagers were found to have elevated blood pressure, which the doctors will continue to follow. “We talk to them about weight loss and hopefully are impressing upon them the benefits of aerobic exercise and a healthy lifestyle,” Dr. Armsey said. The physicians also took the opportunity to talk to the students about other health management topics including diet, drugs, sex, and sexually transmitted diseases – “all the things that adolescents worry about,” said Dr. Armsey. He stresses the importance of these discussions, citing studies that indicate many adolescents’ only contact with doctors is during their pre-participation physicals.

Sold on the many benefits of athletics, Dr. Armsey continually educates teenagers and parents on the risks involved in sports as well. “If you are out on the football field with 11 guys who can run into you, you’re at an increased risk of an ankle, knee or shoulder injury. Working on balance, coordination and strength, and making sure all your equipment is safe, can make you much more resistant to injury.”


Reprinted from Connections newsletter, February 2004

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