Shedding light on the dark

It’s January and winter has at last arrived in North America. It officially started several weeks ago, but it took a while to really get going.  After a balmy December (for most of the country, anyway), the first month of 2016 has given us, as expected, single digit temperatures and snow:  the Minnesota vs. Seattle playoff game earlier this month was the third coldest NFL game in history. This month is also giving us the shortest days of our year north of the equator.

ACSP 2016

ACSP meeting coming up — Come to Surfers’ Paradise if you can!

[sidebar and shout out to our colleagues in the Australasian College of Sports Physicians (ACSP)–I am so looking forward to the warmth and long, sunny days of Surfers’ Paradise, in a mere 4 weeks!!!]

But the days are lengthening, and the sun will get stronger each day, of course. And metaphorically, at least, I can find light in this darkness by sitting down with this month’s edition of CJSM.  You can, too.

Yes, ‘shedding light in the dark,’ that’s the image I hold as I enjoy this privilege of being one of a group of editors managing one of sports medicine’s premier journals.  The on-going process of scientific investigation continues to expose the dark corners of our knowledge base, and journals like ours–disseminating this knowledge via print, internet, and other media vehicles–help practicing sports medicine clinicians bring the latest evidence-based research to the sidelines, training rooms and clinics.

In truth, I recently wrote about being ‘in the dark’ (literally and figuratively) as I watched the movie ‘Concussion’ and reflected on how much we still lack in our understanding of this clinical entity, in almost all aspects:  diagnosis, management, treatment, prognosis.  I am reading now with pleasure three pieces of original research about concussion just in our January issue, bringing their light to bear on the issue:

And as I have begun to prepare my talk for the upcoming ACSP conference (“School sports and youth injury: the promise and the peril”), I find myself leaning heavily on research published in CJSM. To wit: Read more of this post

November…….already

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Transitions: November in the USA.

Really?  Can it be that November is here?

I just covered my last high school football game of the fall, a loss in the playoffs. A season which began in the heat and humidity of August [with its attendant muscle cramps and concerns of exertional heat illness & exercise-associated hyponatremia] is now over, and injuries sustained on wrestling mats and in basketball gymnasia are beginning to show up in my clinic.  Before you know it, the skiiers and snowboarders will be filling out the waiting room.

November also brings with it the publication of our last CJSM of 2015, and it is a good one.  We have profiled two offerings in particular, both of which currently are freely available on line:  original research looking at potential limitations of American Heart Association recommendations for pre-participation cardiac screening in youth athletes; and a provocative editorial [and just right for the change of seasons] arguing for adult autonomy in deciding whether or not to wear helmets when skiing.

Both subjects are among the more controversial in sports medicine.  Whether or not to consider pre-participation screening with ECG when taking care of our younger athletes–well, that’s a question whose answer can vary depending on what side of the Atlantic one is on, or what part of the United States you may live in.  It’s a question whose answers may lie in much of the research we publish in our journal, with luminaries such as Jonathan Drezner and William Roberts weighing in.

Whenever we publish research or commentary on the question of mandatory personal protective equipment, I sometimes feel as if we have entered the ‘blood sport’ arena of sports medicine.  This issue’s editorial  on the ‘Ethics of Head Protection While Skiing’ has already generated some buzz on our twitter feed. Two years ago, we published the Canadian Academy of Sport and Exercise Medicine (CASEM) Position Statement on the Mandatory Use of Bicycle Helmets, and our social media feeds erupted.  I have never seen so much discussion on the blog site.

There is much more to be read carefully in this November 2015 issue.  A very interesting piece of original research, from one of our more prolific authors (Dr. Irfan Asif), looks at the potential psychological stressors of undergoing pre-participation cardiovascular screening.  As a pediatric sports medicine specialist, I’ll be reading with great interest a study on the potential prognostic implications of post-injury amnesia in pediatric and adolescent concussed athletes–lead author Johna Register-Mihalik continues to make major contributions to our understanding of that injury in that population.

So, enjoy this issue.  And brace yourself–2016 is on its way.  It will be here before you know it!

Alphabet Soup: Concussion Assessment in Youth

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Chicken soup: good for the soul….good for concussion? Photo: strawberryblues Wikimedia

SCAT2, SCAT3, Child-SCAT 3, SAC, BESS…….as those of us in sports medicine know, concussion assessments have become an alphabet soup!

Our July 2015 edition of CJSM contains an interesting study looking at baseline SCAT2 assessments of healthy youth student-athletes; it also included some preliminary evidence for the use of the Child-SCAT3 in children younger than 13.

The 4th International Consensus Statement on Concussion in Sport introduced the SCAT3 and Child-SCAT3 instruments.  The Child-SCAT3, in particular, was a significant advancement as there had been no pre-existing instrument for pediatric concussion assessments prior to the 2012 Zurich conference.  If you have not ever looked the Child-SCAT3 over, take the chance now by going to the freely available consensus statement–the Child-SCAT3 PDF is readily downloadable.  Among the differences between the SCAT3 and Child-SCAT3:  a different set of Maddocks questions (is it before or after lunch?); days of the week (as opposed to months of the year) in reverse order; a parent- as well as a self-assessment of symptoms (and the self-assessment is written in more age appropriate language).

Throughout the year, but especially at this time of year (late summer–football has begun) we do assessments like this for the large number of kids we see with concussions or suspected concussions.   Read more of this post

CJSM Podcast 8: A Conversation with South Africa’s Jon Patricios

Our newest podcast guests jsm-podcast-bg-1Jon Patricios, M.D., the current president of the South African Sports Medicine Association (SASMA) and the 2015 Travelling Fellow of the American Medical Society for Sports Medicine (AMSSM).

Dr Patricios is currently Director of the Morningside Sports Medicine Unit and a sports physician at The Centre for Sports Medicine and Orthopaedics in Johannesburg. He is a Fellow of the American College of Sports Medicine, the Faculty of Sports & Exercise Medicine (UK), and the International Sports Medicine Federation.

Dr. Patricios has been a team physician to school, club, provincial and international sports teams in rugby, cricket, soccer, athletics and basketball.  He is a member of the Cricket South Africa and SA Rugby medical committees and the Rockies Comrades Marathon Panel of experts. He is chief medical officer for the MTN Qhubeka cycling team and the Kaizer Chiefs Football Club; founder and Director of Sports Concussion South Africa; sports concussion consultant to World Rugby; and serves on tribunals for the South African Institute for Drug Free Sport.

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Dr. Jon Patricios, President of the South African Sports Medicine Association

He has authored a case report on thoracic outlet syndrome in CJSM and is someone I have collaborated with on a talk focused on the use of social media by sports medicine clinicians, given in Orlando, Florida  at the 2014 meeting of the American College of Sports Medicine.

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Jon Patricios, Speaking at ACSM 2014 on Social Media for Sports Medicine Clinicians

Somehow, among these many duties, he found the time to sit down for a chat, which you will find here in the podcast.  Thanks Jon, and we’re looking forward to seeing you soon in Hollywood, Florida at #AMSSM15 !

[check out all of our podcasts and subscribe to the feed too, on iTunes]

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