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Getting physical: Sports season starts with important health check-ins

The high school sports season doesn't start with a whistle, a starter's gun or the toss of a ball. Instead, under the auspice of a doctor, where blood pressure is monitored, heartbeats are screened and the body is checked for a range of issues fr...

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The high school sports season doesn't start with a whistle, a starter's gun or the toss of a ball.

Instead, under the auspice of a doctor, where blood pressure is monitored, heartbeats are screened and the body is checked for a range of issues from orthopedics to concussions.

For the thousands of South Dakota boys and girls who will play high school sports this season, there's forms to be filled out assuring that they're healthy enough to participate. Those forms include athletic physicals, waivers to play and concussion information.

South Dakota High School Activities Association Assistant Executive Director John Krogstrand said the state's 14-page physical examination form is one that is reviewed every year.

"We're constantly reviewing those forms and the issues surrounding high school sports and health have gotten more and more complex," Krogstrand said. "We have issues like cardiac arrest and heat stroke and you ask yourself, were those really even on our radar 20 years ago and a generation ago?"

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Dr. Nathan Timmer, who is in his second year practicing family medicine at Avera Medical Group Mitchell, does more than 60 sports physicals every year. He said the priority of physicals always starts with the general well-being of the student-athlete. But after that, physicals stand to open the door on many health topics, whether that's with mental health issues, nutrition or vaccinations.

With sports physicals specifically, he said he's always thinking about the heart and the risk factors for sudden cardiac arrest.

"You want to help to prevent those serious situations," Timmer said. "It's always in the news about athletes dying suddenly, and that's what we want to prevent. It's at the front of the mind when we're spending time with each athlete."

The state's packet of forms includes a form for the physical examination, a medical history form that includes 51 questions, a questionnaire about the last year's worth of medical instances, a consent form that both parents and students sign allowing the school to get medical treatment if necessary, a consent form for the SDHSAA and another that releases medical information to the school and forms regarding concussions, including specific sheets geared toward student and parent.

"You try to cover as much as you can," Krogstrand said of the forms. "Safety is our No. 1 concern. It always has been and always will be."

Timmer said the family history form is among the most important, because it can give doctors a background of what sorts of conditions might be in play if they see an issue in the exam.

"It's important to make sure that parents accurately fill out forms that they are to fill out," he said. "That could drastically change what the doctor is going to do as far as testing or what sorts of paths are going to be taken in diagnosis."

Physicians can then clear athletes for participation or make note of any further evaluations or deem that clearance not be given, if that's necessary. Timmer estimated that 10 or 15 percent of athletes might require additional testing while, 5 percent might be referred to a specialist and "very few" are told that they can't participate in contact sports.

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The SDHSAA forms break sports into three categories: collision, contact/endurance and other sports. Collision sports are deemed to be football and wrestling by the SDHSAA, while contact/endurance sports covers every other state-sanctioned sport besides golf: basketball, cross country, gymnastics, soccer, track, volleyball and competitive cheer and dance. Golf falls into the "other" category.

Mitchell volleyball coach Deb Thill, who is entering her 26th year coaching the Kernels, said she hasn't noticed a big change in the process of physicals themselves. She said she feels that concussions and mental health are receiving deserved increased attention.

"I think physicians are being a bit more thorough about hereditary issues," she said. "They've added the concussion-type things and mental health matters and both of those are looking out for the greater good of our students."

In addition, Thill said she's cognizant of auxiliary health issues, such as students who have special dietary needs. For example, she said her team has a policy on hair sprays and perfumes, in part because some players on the team could be at risk to an allergic reaction.

"With physicals, they're trying to make kids more self-aware when they don't feel good and getting kids to take ownership in their own health, which is a good life lesson," said Thill, who teaches elementary physical education in Mitchell.

Timmer is among the Avera Health staff in Mitchell that does what is called impact concussion testing, which essentially sets a baseline for vitals and can be compared after a reported concussion.

"The more we learn about concussion, which is a hot topic in the news and the sports world, we're learning more and more every year and we're getting updated information all the time about risks and numerous studies going on about how to prevent head injuries," he said.

And with girls tennis, boys golf and soccer already underway and with cross country, football and volleyball set to begin this week, Timmer said the ideal time for a sports physical is about six weeks before the season starts.

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Local school districts and their school boards are allowed to decide how often physicals are needed for athletes, as often as every year, every two years or every three years. At least from a medical perspective, Timmer said annual physicals should be the standard and one he takes seriously.

"It's important to me," he said. "I go into each case to find that one athlete who has a problem, so that we can catch it before we might have a problem. I take a lot of pride and get a lot of enjoyment out of that part of my job."

Related Topics: HEALTH
Traxler is the assistant editor and sports editor for the Mitchell Republic. He's worked for the newspaper since 2014 and has covered a wide variety of topics. He can be reached at mtraxler@mitchellrepublic.com.
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