Treatments for Achilles Tendinopathy — CJSM Blog Post Journal Club

January 15, 2020 by Leave a comment

We’re celebrating our 30th Anniversary!!! Take a look what’s beneath the new, sleek cover.

We are celebrating our 30th year of publication in 2020 and we could not be happier to ring this new year in than with the publication of our January 2020 issue, full of the sorts of offerings that make CJSM a special part of the sports medicine universe. From original research to systematic reviews to case reports, we have several new offerings that help clinicians bring the latest in evidence-based medicine to their patients on the pitch, in the training rooms, and in the clinics.

One of those studies reports research results reported by authors practicing in the UK and deals with a very common problem among athletes: Novel Inerventions for Recalcitrant Achilles Tendinopathy.

Dr. Zaremski & assistant take a break from their writing.

This prospective cohort study is the focus of our first blog post journal club of the year, with CJSM Associate Editor Jason Zaremski M.D. guiding us through the ins and outs of the study.  Take it away Dr. Zaremski!

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Introduction:  As we begin a new decade and say goodbye to 2019, the winter CJSM journal club will be focusing on an issue that is extremely common in all individuals, chronic Achilles tendon injury. As many individuals make New Year’s resolutions to exercise more and live healthier lifestyles, we as sports medicine and musculoskeletal experts must be prepared for an increase in overuse injuries such as tendinopathies.  These conditions can be difficult to treat, and new, novel approaches to these common conditions are always of interest. A new study by Wheeler and Tattersall is a timely publication to review in this new year: Novel Interventions for Recalcitrant Achilles Tendinopathy. Benefits Seen Following High-Volume Image-Guided Injection or Extracorporeal Shockwave Therapy—A Prospective Cohort Study.

Purpose: The authors of this study set out to compare the outcomes for patients with chronic non-insertional Achilles tendinopathy (CNIAT) following extracorporeal shockwave therapy (ESWT) versus high-volume image-guided injection (HVIGI). The results may provide practitioners greater information for patients and to improve patient care. Read more of this post

Filed under Journal Club, Tendinopathies Tagged with

CJSM Podcast with Kim Barber Foss and Greg Myer

January 6, 2020 by Leave a comment

We’re excited to ring in 2020 (and our 30th year of the journal) with both the publication of our January issue and a podcast with two special guests:  Kim Barber Foss MS, ATC and Greg Myer PhD from Cincinnati Children’s hospital, the lead and senior author on a study published in our November 2019 issue, Relative Head Impact Exposure and Brain White Matter Alterations After a Single Season of Competitive Football.

Kim Barber Foss MS, ATC

Kim and Greg are prolific researchers and have published widely. For instance, Kim published one of the seminal papers on youth sports concussion over 20 years ago in JAMA: Traumatic Brain Injury in High School Athletes. Do you remember those hoary days of the late 90’s, a prelapsarian world before iTunes and Twitter????  And Greg has published widely on subjects from ACL injury to concussion.  He has been a frequent contributor to CJSM and a major force in advancing evidence-based sports medicine.

With good friend and frequent CJSM contributor, Greg Myer PhD

I hope you get the chance both to read the study and listen to the podcast.  As ever, the podcast conversation can be an illuminating way to understand the author’s interpretation of their own work — conclusions which can be quite different from those which an individual reader may draw from the same study.  This is most especially true when the underlying subject — brain injury in youth contact sports — is such a controversial one.

As ever, you can find and subscribe to our podcasts on iTunes or at the CJSM website. If you have feedback to give us about the podcasts in general, please take the time to rate CJSM at iTunes.  And if you want to comment on this particular podcast and this particular study, please do so on this blog’s moderated comment section.

Enjoy the January 2020 issue and Happy New Year!

Filed under CJSM Podcasts, Concussion in Sport, Evidence-based Medicine in SEM, Youth Sport

Good-bye 2019

December 24, 2019 by

This CJSM reindeer is resting before her big night on Christmas Eve. While she works, we hope you all have relaxing holidays.

New Year’s day 2020 is just around the corner, and though a year is coming to an end the decade apparently is NOT (I have just read that the ‘teens’ will end on Dec 31 2020 and the new decade will begin Jan 1 2021).

But the end of a year, 2019 in this case, is always a cause for celebration, and for both reflection and anticipation. And so, right now in this blog post, it’s that time to give 2019 a proper send-off.

Reflection

As I look back at the many studies and toher writing that have been published in the six issues of CJSM, it’s hard to pick a favorite (a bit like a parent picking one’s favorite child — it’s simply not done).  But I can say that there are some studies that are perhaps more memorable to me….. Read more of this post

Filed under General Interest

Urine Reagent Strips for Assessing Hypohydration — Do They Work?

December 13, 2019 by 2 Comments

Hydrated or not?

Hydration status is an important issue in sports medicine.  Both ends of the spectrum — hypo and hyperhydration — increase risk for morbidity and mortality in the athlete.  As we all know, maintaining euvolemia is an important step in the prevention of heat illness, as the evaporative effect of sweating is one of the body’s mechanisms for heat dissipation.  Conversely, as my colleague and CJSM author Dr. Tamara Hew-Butler has argued on different platforms, a zeal to overhydrate can lead to hyperhydration, hyponatremia, and in extreme cases, death.

There is another way we concern ourselves with hydration status in sports medicine, and that is when assessing athletes who compete in weight classes, or when doing urine drug testing as a screen at a doping control station in competition.  Typically, such assessments are done using different testing modalities on urine specimens.

I am a Medical Delegate for the Federation Internationale de Natation (FINA) and am involved in doping control at long-distance swimming events.  Urine drug screens cannot reliably be done on dilute urine specimens.  In most settings we use refractometry but in some more remote or less developed venues, we may need to use urine reagent strips [WADA has different standards of specific gravity (SG) suitable for urine testing depending on whether refractometry or urine reagent strips are used].

More commonly, here in central Ohio, is the need to assess for hypohydration in the popular sport of wrestling [wrestlers — and other athletes competing in weight classes — will frequently sweat and minimize fluid intake prior to a competitive weigh-in to ‘make weight’ in the class in which they want to compete].  In Ohio high school wrestling, urine reagent strips only are used, and the standard is any sample with SG >1.025 results in a disqualification, with a minimum time period of 48 hours before reassessment.

Having an interest in all these dimensions of testing an athlete’s hydration status, I read with great interest the Brief Report that was published in the November 2019 CJSM: Urine Reagent Strips Are Inaccurate for Assessing Hypohydration: A Brief Report. Read more of this post

Filed under General Interest Tagged with , , , , , ,

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