The Importance of Regular Physical Exams

Regular physical exams are especially important in physically demanding work and sports environments.

Workers in industries such as construction, law enforcement, firefighting, and truck driving should undergo regular physicals to ensure they are fit for work and can complete job-related tasks without risk to health and safety and in compliance with Occupational Safety and Health Administration (OSHA) standards. Certain industries, such as those regulated by the U.S. Department of Transportation (DOT), mandate employee physical exams as a condition of employment.

The purpose of a sports physical exam is to detect health problems and physical limitations that may interfere with an athlete’s participation in sports, such as past injuries, heart problems, allergies, strength, vision, and hearing issues.

Regular evaluations can also detect early signs of disease, drug and alcohol use, and more. In addition, physical exams provide a medical baseline that is used to track an individual’s health or injuries over time. 

Physicals offer additional benefits, especially in the workplace. Physicals can decrease absenteeism, increase productivity and performance, and improve the overall health and well-being of employees, making for a happier workforce.

What is a Physical Exam

Physicals are intended to assess an individual’s ability to complete certain tasks. 

A physical exam assesses the overall health of the individual and can include the following tests and screening.

• Vital signs (heart rate, temperature, blood pressure, height, and weight)
• Hearing and vision
• Muscle strength and flexibility
• Bone health
• Posture
• Drug and alcohol use
• Psychological health
• Physical ability and stamina
• Reproductive health

An individual will also be asked about their personal and family health history, medications they take, drug and alcohol use, reproductive health concerns and other lifestyle questions. Various laboratory tests may also be ordered, including drug and alcohol screening.

An evaluator may also assess a person’s ability to handle stress and inquire about other behavioral factors or even conduct a full psychological evaluation.

Physical and stamina ability will also be tested if the job involves heavy lifting or labor.

The exam is performed by a DOT-certified medical examiner. 

A DOT physical is not mandated on an annual basis; its validity extends for a period of 24 months. However, a medical examiner may issue a certificate for less than 24 months if a health condition, such as high blood pressure, requires monitoring. If an employer were to request an annual physical from a driver without reasonable cause to suspect any health issues, they could potentially be in violation of employment laws.

Regulatory Requirements for DOT and OSHA-Related Work Physicals

Similar to FMCSA rules, the requirements for Occupational Safety and Health Administration (OSHA) physicals were established by the U.S. Department of Labor to ensure that employees work in a safe and healthful environment. 

By setting and enforcing guidelines and providing training, outreach, education and assistance, employers are required to comply with all applicable standards. In addition, they must also comply with the General Duty Clause of the OSH Act, which requires employers to keep their workplace free of serious recognized hazards, and evaluate whether an individual is physically, mentally, and emotionally fit to work.

Differentiating Between Types of Physicals

There are many types of physicals that individuals can undergo, including sports physicals, annual physicals, and pre-employment physicals. Let’s take a closer look:

Sports physicals: Sports physicals evaluate the health of athletes – both adults and children – before they can participate in sports (although they are not required for adults who take part in recreational team sports). Also known as pre-participation physical examinations (PPE), these physicals focus on key physical characteristics, such as blood pressure, heart health, muscle strength, flexibility, bone health, vision, and hearing. A sports physical is an important aid in clearing an individual for strenuous physical activity. Ideally, they should be performed before each sports season and following an injury. These physicals are also a great time for kids and adults to baseline their health, receive the appropriate vaccinations, and update their health information.

Annual physicals: A primary care provider typically performs an annual physical to assess overall health and detect chronic conditions. A provider will check blood pressure, weight, skin, reflexes, breathing, heart rate, and more. They may order a complete blood count; kidney, liver, and thyroid function tests; a lipid panel (cholesterol screening); and more.

Pre-employment physicals: A pre-employment physical exam is often required by employers before an offer is extended to a job applicant. These exams help ensure that a candidate has the physical ability to perform a job safely and without risk of injury. They may also screen for drug and alcohol use. Importantly, a pre-employment exam helps employers make informed, objective decisions about hiring based on an applicant’s physical and behavioral health. Employers can also monitor employee health over time to ensure they have the best-performing team.

Key Components of a Physical Exam

During a physical exam, a medical examiner will evaluate an individual’s medical history, including physical, emotional, and mental conditions. Physical exams are often customized to the role, industry, employer requirements, and type of sport. A physical exam can include an assessment of the following:

• Vital signs (heart rate, temperature, blood pressure, height, and weight).
• Physical abilities (vision, hearing, etc.)
• Spine and musculoskeletal
• Neurological
• Strength and stamina (especially if the position involves operating heavy equipment or machinery)
• Mental and behavioral health (such as the ability to handle the psychological pressures of the job)
• Functional limitations
• Nutritional assessment
• Heat and hydration risk factors

Evaluating Primary and Sensory Organs

During a physical exam, a medical provider will use several techniques to capture a person’s medical health. These include:

• Inspecting (observing issues, such as bruising or abnormal eye movement)
• Palpating (pressing the abdomen to monitor the internal organs)
• Percussing (checking the density of certain areas of the body)
• Auscultating (listening to the heart and lungs with a stethoscope)

Vision and hearing tests may also be performed. 

Assessing Physical Strength, Flexibility, and Posture

Occupations and sports that are physically demanding may require a more rigorous screening and involve an assessment of the following:

• Muscle strength and flexibility
• Posture analysis
• Physical agility (to include pull-ups, push-ups, planks, sandbags, step-ups, forcible entry, equipment carry, and dummy drag tests)
• Manual dexterity (including after physical exertion)
• Motion range
• Repetitive movements
• And more

Frequency of a Physical Exam

How long a physical is good for or how often you should get a physical, depends on factors like age, health conditions, sports specific requirements or work regulations as outlined in OSHA or DOT.  For example, a DOT physical exam is valid for up to 24 months, so a CMV driver or other safety-sensitive employee must pass a DOT physical exam every two years. However, a medical examiner may determine that certain individuals – such as those with chronic medical conditions – are monitored and screened more frequently.

Sports physicals are typically performed once each year or following an injury. 

Physical Exams by State

There are state-specific requirements and guidelines for physical exams. For example, most states require that children complete a sports physical before they can participate in their chosen school sport. 

Indeed, many parents have questions such as “How long is a sports physical good for in Illinois?” or “How long are sports physicals good for in Texas?”

In Illinois, a sports physical is good for 395 calendar days from the date the physical was performed. However, in Texas, a sports physical must be completed before the student athlete’s 7^th, 9^th, and 11^th grade years – essentially every two years. Be sure to check the requirements in your state.

Preparing for Your Physical Exam

To prepare for a physical exam, individuals should gather as much information as they can, including:

• A valid form of identification.
• Contact information for their primary care provider or specialist.
• Records of recent office visits, including lab results, prescriptions, and doctor’s notes. These are particularly important if the person has a chronic medical condition, such as diabetes, high blood pressure, sleep apnea, or a history of heart attack or stroke. 
• A signed letter from their physician stating they can perform tasks, including driving, without restrictions.
• Recent bloodwork results, including blood sugar readings.
• List of all medications, including supplements.
• Immunization records.
• Vision glasses, contact lenses, or hearing aids.
• Any history of injury.

Patients should also check whether they need to fast before a physical.

To prepare for a DOT physical, additional preparation is required. This may include avoiding alcohol and any drug (legal or prescription) that could interfere with blood test results for at least 24 hours prior to the exam. The patient should consult their medical provider or examination clinic staff prior to arrival for the exam.

Post-Physical Recommendations and Follow-Ups

Often additional information or testing is required before a person is cleared for work or sports. Exams can also reveal health issues that need to be addressed as a condition of passing the test.

If an individual fails a physical exam, they are entitled to a second opinion. For example, if their blood pressure spikes during the examination, but is typically low, they can request a physical from another medical professional.