Sport physical essentials and medical malpractice

Most school districts and private schools require student athletes to have a physical for playing on a school sports team. Quite often, many people view the sports physical, or pre-participation screening, as a check-the-box exercise that has little importance. Sometimes schools have a rushed assembly line for sports physicals, just before the deadline.

Thinking back to when I played high school basketball, I think I understand why this frequently happens. I was like most young people, thinking that I had no physical limitation that would prevent me from engaging in sports. More recent medical studies, though, show that many students are at risk, and sports physicals play an important role.

Risks in student athletics

Living in Texas, where football reigns supreme, one of the first things that comes to mind for me is the risk of heat-related injuries, like heatstroke, during practices in the sweltering Lone Star State summers. This is not the type of risk, though, that would be picked up in a sports physical, but rather requires careful planning and attention by the coaching staff. As parents, I recommend becoming familiar with how your children’s coaches handle this risk. You could get this information either by asking questions or by being a spectator at some practices.

Another significant risk posed by football, as well as some other sports, is getting a concussion. A concussion is basically a bruise to the brain caused by an impact to the head. Neurologists believe that concussions pose a particular risk to young people because their brains are not fully developed.

Concussions have become such a significant issue that the Texas legislature enacted provisions in the Education Code to implement student protections.

Section 38.155 requires both students and their parents or guardians to sign a form—before sports participation begins—acknowledging that they received and read written information concerning concussion prevention, symptoms, treatment, and oversight.

Section 38.156 requires students to be removed from playing immediately if a coach, doctor, license healthcare professional, or parent believes the patient might have sustained a concussion. Section 30.157 prevents a student from returning to practice or games until being evaluated and released by a physician, following the return-to-play protocol also established by statute.

When it comes to sports physicals or screening, I believe the most life-threatening risks that are looked for are cardiovascular abnormalities that could lead to sudden cardiac death. Cardiology experts have explained that undiagnosed cardiovascular disorders are the most common cause of sudden cardiac death in student athletes.

Because many young people with these hidden cardiovascular conditions may have never experienced symptoms, the sports physical, if done properly, can help avoid devastating injuries that can lead to death.

Components of a proper sports physical

A good initial question is who should provide the sports physical for a child. Experts recommend going to your son or daughter’s primary care physician for an office appointment, rather than a mass screening at school done at the last minute.

The goal of a pre-participation screening is to identify any serious conditions or illnesses that may prevent safe participation in sports. Of course, this often starts with conditions of an orthopedic nature, like musculoskeletal injuries, and continues with a valuation of illnesses such as asthma, epilepsy, and sickle-cell anemia. In addition, the standard of care requires physicians to look for any condition that may increase a child’s risk of sudden cardiac arrest. In addition, doctors must evaluate cognitive function, including considering concussion risk and the impact or risk of past traumatic brain injuries, including concussions.

The standard of care requires doctors performing sports physical to take a comprehensive personal and family medical history, including questions about cardiovascular history, exercise-related symptoms, and previous diagnoses. Taking a history is the process where doctors ask a number of questions to obtain important information from patients and family members.

 Medical experts have recognized a tendency of some students and parents to minimize or not fully disclose past personal or family medical issues, out of a fear of being disqualified from playing sports. This is a very dangerous choice that could put a child’s life at risk.

The sports physical does not end with taking a history, though. A proper sports physical includes an assessment, which may include checks of blood pressure, pulse, heart, lungs, vision, reflexes, abdomen, skin, bone growth, musculoskeletal system, and genitals. In addition, some doctors may order blood work to check for hemoglobin and cholesterol levels.

We are here to help

If your child has been seriously injured as a result of a poor sports physical, call the experienced medical malpractice lawyers at Painter Law Firm, in Houston, Texas, at 281-580-8800, for a free consultation about your potential case.


Robert Painter is an attorney at Painter Law Firm PLLC, in Houston, Texas. He represents patients and family members in medical malpractice and wrongful death cases against doctors, physician assistants, nurse practitioners, hospitals, pharmacies, and other healthcare providers. In 2017, he was named as one of Houston’s top lawyers by H Texas magazine.

Robert Painter
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Robert Painter

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm Medical Malpractice Attorneys in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him for a free consultation and strategy session by calling 281-580-8800 or emailing him right now.