Back to school means back to pre-season sports physicals.

Q: My son and daughter are very excited to play sports for the first time this fall. I have never taken them in for a sports physical before, and I don't know what to expect. Will this appointment replace their annual physicals? What happens if my doctor doesn't OK one or both of my children?

A: Sports physicals (Pre-participation Physical Evaluations, aka PPEs) have been established in order to promote athletic participation in a safe and healthy manner. Their purpose is not to disqualify athletes, but rather to identify conditions that could potentially put the athlete at risk of injury or sudden death during competition.

PPEs should be scheduled at least six weeks before the start of the season in order to provide adequate time to rehabilitate injuries or further investigate medical problems so as to minimize the likelihood of disqualification. The PPE consists of both a medical history and a physical examination. The history form should be filled out by the parent and child ahead of time. After going over the history form, the medical provider will perform a physical exam and then determine whether the athlete is cleared for participation, is disqualified or needs further evaluation before a final decision can be made.

Overall, less than 2 percent of kids are disqualified, but up to 13 percent may require further investigation before being cleared. If performed in your doctor's office, the PPE may be done in conjunction with your child's yearly checkup, but if completed in a different setting it should NEVER take the place of this annual visit.

-Steven Cuff, M.D., is a Sports Medicine Physician at Nationwide Children's Hospital