“I’m not familiar with any kind of chiropractic program where the use of a stethoscope is extensively taught, much less the interpretation of what you’re hearing.”
Taking another look Dr. Spinks says school sports injuries, particularly concussions, became a hot topic in the legislature because of recent media interest in the issue. “We’ve had so many high-profile concussions; there has been so much talk about concussions in the media that it’s increased aware- ness everywhere.” Mr. Alexander says the National Foot-
ball League (NFL) also pushes policies to address concussions in young athletes before they reach the NFL. “I wouldn’t be surprised if there is
is up to that board to determine what chiropractors can and cannot do. In 2011, State Rep. Eddie Lucio III
(D-Brownsville) filed legislation that would have given UIL the authority to decide who can administer school sports physicals. That bill, House Bill 52, did not pass, but Troy Alexander, associate director of TMA’s Legislative Affairs De- partment, says similar legislation prob- ably will be filed again in 2013.
Where’s the training? Dr. Cousins says UIL has no data on how many chiropractors are doing school sports physicals, but the organization, which oversees all school sports activi- ties in the state, knows that some chiro- practors are doing them. And, Mr. Alexander says at least one
Austin chiropractor puts out a sign each year advertising sports physicals. Dr. Terk and Austin pediatric neuro-
surgeon T.J. Spinks, MD, say chiroprac- tic training simply does not cover many organ systems included in the sports physicals.
44 TEXAS MEDICINE July 2012 “Their training is focused solely on
manipulation of the musculoskeletal sys- tem,” Dr. Spinks said. The required physical does cover the musculoskeletal system, including the neck, back, shoulders, arms, joints, and more. But it also examines organs such as the heart, eyes, ears, lungs, abdomen, and others.
“I’m not familiar with any kind of
chiropractic program where the use of a stethoscope is extensively taught, much less the interpretation of what you’re hearing,” said Dr. Terk, who himself does a significant number of physical exams each year for student athletes. He describes the sports physical exam he performs as a “complete head-to-toe examination.” “It’s a pretty extensive assessment,”
he said. “The bottom line is my name is going on that form, and I need to make sure that if this person participates in sports, I’ve done whatever I can to make sure that any condition that could poten- tially affect the athlete’s safety or health is identified and dealt with.”
more attention on concussion issues next session,” said Dr. Spinks. “And I think heart issues are becoming more promi- nent in the public perception, as well.” In fact, TMA recommended an inter- im legislative study of heart conditions in student athletes to determine if cur- rent UIL guidelines for sports physicals provide adequate screening of student athletes with serious conditions such as heart irregularities, asthma, and related concerns. That study, however, was not included among interim charges issued by either House Speaker Joe Strauss or Lt. Gov. David Dewhurst. Mr. Alexander says data show an in-
creasing number of students being iden- tified with some type of heart condition that could affect their ability to partici- pate in sports. Dr. Terk, however, says the issue of whether echocardiography should be a required part of the sports physical is “an open question.” He says he’s not aware of any authoritative body that recom- mends more extensive cardiac screening. And, Dr. Cousins says the UIL-re-
quired physical already meets the 12 recommendations of the American Heart Association for pre-participation cardio- vascular screening. Those recommendations include tak- ing a medical history for exertional chest pain or discomfort, prior recognition of a heart murmur, elevated systemic blood pressure, family history of premature death from a heart attack, and more. Dr. Cousins says the UIL Medical Ad-
visory Committee is “trying to stay on top of” cardiac issues, but is not pre- pared to recommend changes in the pre- participation physicals.
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