DEAR DR. DONOHUE: I belong to the parent-teacher association of my son’s school. I am writing you for guidance on what constitutes a good physical exam for children participating in school-sponsored sports. We had a near tragedy last year. What are your suggestions? – H.K.

ANSWER: A one-on-one physical examination – one doctor, one student – is the best way to conduct any exam. If that is impossible, then a team of doctors can examine prospective athletes at different stations, with one doctor positioned at each station, until all the children have been examined.

All body systems need a going-over. You can obtain official guidelines from the American Medical Society for Sports Medicine, the American Academy of Family Physicians, the American Academy of Pediatrics and the American Heart Association. I don’t have space to give you all the details.

I can give you some details about two heart conditions that are worthy of particular attention.

Hypertrophic cardiomyopathy is one. It’s an inherited problem where the heart muscle has grown too large and the muscle fibers are laid down in a haphazard fashion. This condition can be responsible for sudden death in athletes. In some cardiomyopathy patients, exercise generates serious and even fatal heart rhythms. Often it is detected by hearing a murmur. For that reason, if large numbers of children are examined in one large room, quiet must reign.

The second heart condition that can be troublesome for athletes is Marfan’s syndrome. It too is an inherited problem. Signs of it include a tall, thin body with very long arms and legs. The fingers are elongated and spindly. There are other Marfan signs, but not every Marfan patient exhibits all of them. Changes can be quite subtle. Even if there are only subtle changes, people with Marfan’s can have an aorta that is vulnerable to rupture. Examining doctors have to be on the lookout for this disorder.

DEAR DR. DONOHUE: Several times you have stated that it is not wise to exercise the same muscles day after day. Does this include walking? I am 68 and began walking 20 minutes every day. Should I be doing this on a daily basis or take a day off every few days? – B.G.

ANSWER: People should not engage the same muscles in resistance exercise – weightlifting – day after day. They should let the exercised muscles recuperate for 24 hours. They can weightlift daily, but they should exercise different muscles on consecutive days.

For aerobic exercise – walking, jogging, biking, swimming and on and on – people not only can exercise every day, they should do so. This is different exercise. It is heart exercise.

DEAR DR. DONOHUE: I am a well-conditioned runner and have gone out of my way to acclimate myself to hot weather. All the same, I find I am not able to perform like I can when it’s cooler. Is this something peculiar to me? What can I do about it? – I.M.

ANSWER: This is not unique to you. Hot weather drains body energy regardless of a person’s hydration, acclimation or physical fitness.

When body temperature rises to 101.6 F (38.7 C), even the fit become exhausted sooner than they normally would.

At that temperature, the brain’s arousal system slows. Muscles don’t function as well.

There’s not a whole lot you can do about this other than exercise at times of the day when the temperature is at its lowest.

You have to pay attention to humidity as well as temperature. If the temperature is 90 F but the humidity is only 10 percent, the toll on your body is the same as it would be if the temperature were 80 F and the humidity were 80 percent.

Readers, I don’t want this information to confuse you. This is not information relating to heat injury, such as heat cramps and heat stroke. This is information tailored to the writer’s specific question.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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