“Do I have to do the duck walk today?” Sometimes a returning high school athlete would ask this as they walked into the room for their sports physical. There are many parts of a sports physical, but the duck walk seems to be more memorable.
Every year, across the country school-aged kids participate in organized sports. Many times, these sports require a “sports physical,” (also called a preparticipation physical evaluation) an exam done by a doctor or other health care professional in order to make sure the child is healthy enough to participate.
The duck walk is a key part of a sports physical, checking muscle, joint, and bone health, as well as balance.
What exactly does the duck walk test? Why do sports physicals include a duck walk? What happens if a child cannot do a duck walk? This post answers those questions.
What is a duck walk?
A duck walk involves a person bending their knees and lowering their body until they are in a deep squatting position. Then, with their feet apart, they take a few steps. It has the appearance of a waddle, thus the name, “duck walk.” In many sports physicals, the child or teen is asked to attempt this duck walk. Their physician is observing several key things, discussed below.
In my practice, if a child or teen was at all hesitant to try to squat and walk, I would not force it at all. It was a sign that we needed to investigate something further.
The duck walk checks muscle health in sports physicals.
A simple squat is an excellent exercise using many different muscle groups. For clarity, a squat is when someone is standing with both feet flat on the floor, about hip-distance apart. They then bend their knees, lower their body, and then rise back up. A person needs to have adequate core (abdominal and back) muscles in order to do this. This also tests the large leg muscles attached to the hips, also called “proximal muscles.” There are some genetic disorders in which these muscles specifically are weakened. So, if someone isn’t able to lower into the squat or duck walk position, we need to think about muscle strength.
Sometimes, the lack of strength may simply be because someone isn’t “in shape,” but if someone cannot start a duck walk, their physician would likely do a more focused exam or testing.
The duck walk evaluates joints during sports physicals.
The duck walk puts a lot of stress on the knees, hips, and ankles. These joints need to be healthy in order for most athletes to participate in their sports. So, if someone is able to easily duck walk and not have any discomfort in their knees, hips, or ankles, it’s a very general sign that their joints are in good shape.
Of course, a physician examines the joints as the child duck walks. Even if there are no complaints, the doctor may still have concerns. They also may observe the child walking normally in order to check different things.
And, some knee discomfort may be “normal” for that child. Usually, if an athlete has any discomfort or pain, an examining physician would choose to examine the joint more closely before determining if it is serious or not.
It goes without saying that a child with a recent joint injury (especially of the knee, hip, or ankle) would not be expected to easily perform a duck walk.
Orthopedic specialists may also use a duck walk evaluation as part of their evaluation for a knee injury. This has a different purpose than that of a sports physical in which this child is presumably healthy (injury free) and is seeking clearance to participate.
The duck walk checks balance.
Many parts of the sports physical may subtly check for balance issues. While coordination levels vary from child to child, it’s something we think about when deciding if someone is safe enough to play sports.
What happens if a child or teen cannot perform a duck walk?
Do they still “pass” their sports physical? This depends! First, if someone cannot do a duck walk, then the exam becomes more focused. The doctor may ask some specific questions or do some specific joint or muscle testing.
Then, there are 3 possibilities. The athlete:
- May be cleared to participate with no restrictions
- May be cleared to participate with certain restrictions
- Not be cleared to participate
The “restrictions” can mean anything from a child being given more frequent rest breaks to needing physical therapy to needing to see a specialist before participating in their sport. It really depends on exactly why the duck walk is a challenge.
What else is included in a sports physical?
The duck walk is a small part of the sports physical. In case you’re wondering what else is included, here is a brief list. (If you’d like another in-depth post about one of the other parts, please let me know!)
History (information about the child or teen’s past medical history as well as family history).
This may be in the form of a paper the family fills out. Or, it may be a series of questions the doctor asks the child and their parent. Often, it’s a combination of both.
This also includes a list of medications the child takes, any surgeries they’ve had, and information about medical conditions like asthma or head injuries. It may also include menstrual period history, if applicable. Importantly, it also includes any concerning symptoms someone may have had in the past during exercise.
Physical Exam.
The duck walk is just part of the physical exam. Height, weight, and blood pressure are important parts of the exam. (Body mass index or BMI may be relevant). Vision is often checked. Along with the other muscles, bones, and joints, the exam includes heart, lungs, head, neck, and abdomen (belly). An exam of chest and genitalia is included to evaluate for hernias and signs of puberty.
Vaccines
If a child or teen is due for recommended vaccines, these may be administered during the sports physical. Of course, it depends on the office, schedule, and resources. (And yes, teens do need regular immunizations too).
Safety discussion.
Counseling is included in sports physicals in order to make sure kids play as safely as possible. There may be sports-specific advice or specific suggestions or precautions based on other findings. Often, diet and supplements are discussed.
Confidential conversation
Many teen physical exams include time for the teen and doctor to talk privately. Unfortunately, this doesn’t always happen for sports physicals done away from a primary pediatrician.
Summary: The duck walk helps evaluate an athlete during their sports physical.
As part of a complete exam and history, the duck walk provides information about joint, muscle and bone health. It also helps check for balance. If a child or teen is unable to complete the duck walk, their health care professional will ask further questions or perform a more focused exam.
Maya M. Mahmood, D.O., F.A.A.P. is a board-certified pediatrician and mom. She is passionate about parents having evidence-based information to help their families be healthier. Subscribe to the newsletter or follow on social media @mayapeds.
