Published in the Huffington Post
Do remember the horrifying headlines from last year? Ray Rice knocked out his fiancée. Adrian Peterson was indicted for child abuse. Tom Brady lied about deflating balls. Well, my blog post has nothing to do with these stories. There are over 2 million Google hits for those stories. I want to look at the brighter side of the National Football League.
The 2015 NFL Draft happened last month. 256 players were selected. One of the guys who you probably didn’t know much about, Bud Sasser, was selected by the St. Louis Rams in the sixth round. During his team physical, he discovered a heart condition. The Rams released him, but only after signing him so that he could receive his signing bonus of $113,737.
Last year, the Seahawks exhibited similar class. They waived Garrett Scott, a sixth-round draft pick from Marshall, after discovering a heart condition during a team physical. He also signed his contract, and received a signing bonus of $101,000.
These gestures are not limited to professional sports.
In 2012, after being signed by Rice University, David Wilganowski collapsed during one of his last high school football games. He was diagnosed with a heart condition and received an implantable defibrillator. His football career was over. However, Rice honored his full scholarship.
Unfortunately, these stories didn’t get the level of attention of those other ones. There were only 200,000 Google hits for these stories. That’s sad. We should hear more stories like these. We want to hear more stories like these because they restore our faith in humanity (and maybe in the NFL). However, these particular stories also reveal a very serious problem.
How is our medical system missing these potentially-fatal heart conditions in our young athletes?
I’ve never met Bud Sasser, Garrett Scott or David Wilganowski. I only know what I’ve read in the paper. But, I bet that all three of them passed state-mandated physical exams every year in high school and college. I would venture to say that they even had a few wellness visits with pediatricians along the way. So, what gives? Are we being careless?
Yes. We are missing these conditions because our method of examining student athletes is grossly inadequate. We approach the exam as a checklist item instead of an important health evaluation. Shin guards, check. Soccer ball, check. Water bottle, check. Sports physical, check. Now, you’re child is ready to play!
In a country where eight million students play sports, we need to do better.
The sports physical has been around for decades. A group of associations consisting of pediatricians, sports medicine physicians, orthopedists and family medicine doctors created a standard evaluation form called the Pre Participation Examination. It was created to serve as a guideline and set the standards. Despite this effort, there is little consistency in how we screen our student athletes.
A recent study evaluated the sports physical screenings of all 50 states. 23 states used some version of the Pre Participation Examination form. The majority used an outdated or unidentifiable form. And while sudden cardiac arrest is the leading (medical) cause of death among student athletes, only 22 states used the complete set of cardiovascular questions from the PPE.
Another study showed that fewer than 6 percent of doctors who conduct the sports physical follow the sudden cardiac death screening guidelines established by the American Heart Association (AHA). As if that news isn’t bad enough, the AHA standards are arcane. New research shows that adding an electrocardiogram to the physical is much more effective at detecting these underlying heart conditions than a questionnaire. So why won’t the American Heart Association consider the change?
To illustrate how reckless we are being with our children, consider the following scenario. There were 33 cars that raced in the Indianapolis 500 last year. Applying the statistics above, fewer than 15 of those cars would be subjected to the Pre-Qualifying Inspection, and two would have their engines checked. This would never happen! We require a more thorough inspection of our cars than we do our children.
How many more times do we need to be “saved” by the NFL or other professional teams before we improve and standardize the preparticipation exam? How many more student athletes need to collapse and die from undetected heart conditions before we change the cardiac standard of care?
According to Mom’s Team, parents spend $595 per year on hockey equipment, $565 per year on lacrosse equipment, and $558 per year on football equipment. I think that we can afford to invest a few dollars in their health and well-being too.