Sports Physical Form (Page 4 of 4) in pdf

SUGGESTED EXAM PROTOCOL FOR THE PHYSICIAN

MUSCULOSKELETAL

Have patient:

To check for:

1. Stand facing examiner

AC joints, general habitus

2. Look at ceiling, floor, over shoulders, touch ears to shoulders

Cervical spine motion

3. Shrug shoulders (against resistance)

Trapezius strength

4. Abduct shoulders 90 degrees, hold against resistance

Deltoid strength

5. Externally rotate arms fully

Shoulder motion

6. Flex and extend elbows

Elbow motion

7. Arms at sides, elbows 90 degrees flexed, pronate/supinate wrists

Elbow and wrist motion

8. Spread fingers, make fist

Hand and finger motion, deformities

9. Contract quadriceps, relax quadriceps

Symmetry and knee/ankle effusion

10. “Duck walk” 4 steps away from examiner

Hip, knee and ankle motion

11. Stand with back to examiner

Shoulder symmetry, scoliosis

12. Knees straight, touch toes

Scoliosis, hip motion, hamstrings

13. Rise up on heels, then toes

Calf symmetry, leg strength

MURMUR EVALUATION – Auscultation should be performed sitting, supine and squaring in a quiet room using the diaphragm and bell of a stethoscope.

Auscultation finding of:

Rules out:

1. S1 heard easily; not holosystolic, soft, low‐pitched

VSD and mitral regurgitation

2. Normal S2

Tetralogy, ASD and pulmonary hypertension

3. No ejection or mid‐systolic click

Aortic stenosis and pulmonary stenosis

4. Continuous diastolic murmur absent

Patent ductus arteriosus

5. No early diastolic murmur

Aortic insufficiency

6. Normal femoral pulses

Coarctation

(Equivalent to brachial pulses in strength and arrival)

MARFAN’S SCREEN – Screen all men over 6’0” and all women over 5’10” in height with echocardiogram and slit lamp exam when any two of the following are

found:

1. Family history of Marfan’s syndrome (this finding alone should prompt further investigation)

2. Cardiac murmur or mid‐systolic click

3. Kyphoscoliosis

4. Anterior thoracic deformity

5. Arm span greater than height

6. Upper to lower body ratio more than 1 standard deviation below mean

7. Myopia

8. Ectopic lens

CONCUSSION ‐‐ When can an athlete return to play after a concussion?

After suffering a concussion, no athlete should return to play or practice on the same day. Previously, athletes were allowed to return to play if their symptoms

resolved within 15 minutes of the injury. Studies have shown that the young brain does not recover that quickly, thus the Oregon Legislature has established a rule

that no player shall return to play following a concussion on that same day and the athlete must be cleared by an appropriate health care professional before they are

allowed to return to play or practice.

Once an athlete is cleared to return to play they should proceed with activity in a stepwise fashion to allow their brain to readjust to exertion. The athlete may

complete a new step each day. The return to play schedule should proceed as below following medical clearance:

Step 1: Light exercise, including walking or riding an exercise bike. No

weightlifting.

Step 2: Running in the gym or on the field. No helmet or other equipment.

Step 3: Non‐contact training drills in full equipment. Weight training can

begin. Step 4: Full contact practice or training.

Step 5: Game play.

If symptoms occur at any step, the athlete should cease activity and be re‐evaluated by a health care provider.

Revised May 2010