The Nutcracker


Angelina Sansone, Kansas City Ballet

With the holiday season come a host of traditions. There are tree trimming and the lighting of the menorah; there are caroling and jingle bell runs. And there’s that new favorite: wearing tacky sweaters.

There is, as well, the Nutcracker.

My family and I will be watching this weekend at Columbus’ BalletMet production.  This will mark our fifth year in attendance, and I’ve been impressed with the dancers’ artistry and skill each time I’ve seen the show.

Truth be told, I never went to any ballet until I was an adult.  My affection for the Nutcracker derives not from my own childhood Christmas memories, but from the work I did as a sports medicine fellow, where I ‘covered’ the Boston Ballet for a year.  What a great experience that was!

‘Dance Medicine,’ as many of you know, is a special niche of sports medicine.  Like any sport, dance has its own language, it’s own mental and physical challenges, its own equipment, and its own injury patterns.  I have not managed too many cases of hallux rigidus, FHL tendonitis or posterolateral ankle impingement outside of the dance world.

I grew very fond of this field during my training, and I continue to seek out opportunities to participate in this world.  And so I took extra pleasure in our September 2014 editions, which offered two new pieces of original research in dance medicine: Body Mass Index, Nutritional Knowledge, and Eating Behaviors in Elite Student and Professional Ballet Dancers and a brief report, Early Signs of Osteoarthritis in Professional Ballet Dancers:  A Preliminary Study.  I commend both of them to you. Read more of this post

Year’s End


Reflections (Wells Cathedral)

We are all heading toward the finish line of 2014, and what a year it has been.

I’ll be in something of a reflective mood, I think, over these next several weeks, and I suspect my blog posts will, well, ‘reflect’ that state of mind….I hope to highlight some of this year’s developments in the sports medicine world, especially those that CJSM has contributed to.

The world of media is continuously expanding, and many of us now get our clinical sports medicine information from a multitude of sources besides print.  You may follow us on Twitter as well as get these blog posts delivered to your email inbox, for instance.

One of the exciting innovations we began this year at the journal was the “CJSM podcast,” which you can subscribe to on iTunes.  Our first podcast was with Drs. Oliver Leslie and Neil Craton, and concerned their critique of the Zurich Consensus Statement on Concussion in Sport, which appeared in CJSM’s March 2014 issue.  The conversation regarding the consensus statement and the controversial critique has literally continued this entire year.  In our November 2014 issue, closing out this calendar year, there are a host of ‘Letters to the Editor’ addressing this issue:  these include  one written by the past-president of the Canadian Academy of Sport and Exercise Medicine (CASEM), Pierre Fremont, as well as the reply made by Drs. Leslie and Craton to the various responses they received regarding their piece.

Other podcasts have addressed a variety of issues, including the concussion controversy at the 2014 FIFA World Cup [we had guests Drs. Cindy Chang, former president of the American College of Sports Medicine (AMSSM) and Matt Gammons, current AMSSM VP for that podcast] and the impact neuromuscular training programs can have on reducing ACL injury rates in youth soccer players.

I hope you have a chance to listen to all the podcasts, and to peruse all the contents of the November issue before this month ends.  Soon, we’ll be turning the corner into 2015, when we have a lot more in store to advance the cause of clinical sports medicine.  The January issue will be a good one, packed with new research and an important AMSSM consensus statement as well–highlighted, of course, by a podcast!

The Most Dangerous Sport in the World?


A Bull Tamer in Australian Rodeo Event. Photo: Amcilrick


“Sweetheart of the Rodeo”

I’ll confess I don’t know much about rodeo.  To the extent the word triggers a response in my mind, I think of Gram Parsons and the Byrds:  “Sweetheart of the Rodeo.” Click on the link and take a listen:  it’s a great album!

Back to sport….it’s my own cultural myopia that overlooks rodeo when I think of the word ‘sport.’ I didn’t grow up participating in it, and in central Ohio I have not attended to any rodeo injuries (equestrian, yes; bull riding, no). I imagine my situation would be different if I practiced in Wyoming or Alberta…..or parts of Mexico, Argentina, and Australia (rodeo is truly international).

As I grow older, I delight in learning more about other sports; my involvement with CJSM certainly has expanded my horizons. Last year, for instance, I wrote (and learned) about the ice sport of ringette after the journal published a study on the injury epidemiology of this largely Canadian activity. I had previously never heard of rignette. Shame on me.

I was reading the New Yorker earlier this week when I came across this tantalizing entry: “The Ride of Their Lives: Children Prepare for the World’s Most Dangerous Organized Sport.”  The focus of the article is a particular event in rodeo, bull riding, and the kids and families who participate in this sport….which is, indeed, very dangerous.   “It’s not if you’re gonna get hurt; it’s when,” one parent is quoted.  As a pediatric sports medicine physician, I was bound to be get hooked.

I was delighted to see the New Yorker author use the work of Dale Butterwick as one of his chief sources for the article’s epidemiologic data. Mr. Butterwick is a faculty member of the University of Calgary, Alberta, and has written extensively on injury patterns in rodeo.  Among his more important works is the CJSM 2011 study, “Rodeo Catastrophic Injuries and Registry:  Initial Retrospective and Prospective Report,” which reported on 20 years of data collected by the only, international registry for catastrophic injury in rodeo, which he maintains. Read more of this post

In honour of the Grey Cup


Series 975 - Primary photographs of Gilbert A. Milne & Co. Ltd.

Celebrating with the Grey Cup

The Grey Cup, the ‘Super Bowl’ of the Canadian Football League, is being contested this evening in Vancouver. The Hamilton Tiger-Cats face off against the Calgary Stampeders, and it promises to be an exciting contest.

We are proud of the diverse background of our many contributors to this peer-reviewed journal, who range from academics to clinicians who are ‘in the trenches.’ One of those on the front-lines is David Levy, M.D., the Medical Director for those Hamilton Tiger-Cats.

His piece from the 2012 CJSM, on a ‘risk-tolerance approach’ to assessing athletes undergoing a pre-participation evaluation (PPE), is always worth a read; perhaps never more so than in light of our most recent CJSM piece on advancing the PPE.  While you’re at it, catch our podcast conversation with William Roberts, lead author of that new PPE statement.

And then sit down to enjoy the Canadian football action.  Good luck to Dr. Levy’s Tiger-Cats, and good luck to their opponents, the Stampeders, as well.

Originally posted on Clinical Journal of Sport Medicine Blog:

This month’s Editorial in CJSM by Levy and Delaney highlights the issue of the role of the Team Physician in the process of the Preparticipation evaluation.

Team Doctors are often called upon to make a decision about the suitability of an individual for return to play. In this role, the burden of responsibility for the decision making process is likely to lie with the clinician, at least in the first instance, whether or not the team manager and the player decide to follow their advice.

Few would argue that the clinician is best placed to make a definitive ‘medical’ decision on return to play decisions since they are likely to have the most educated opinion about decisions related to the health of the player within the team environment. However, the question of where the responsibility should lie with the ultimate decision made is a contentious one.

In the context of…

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