CJSM Podcast 15 — Dr. Lyle Micheli on ACL Injuries in Young Athletes

jsm-podcast-bg-1Today we have as our guest on the podcast Dr. Lyle Micheli, the Director of Sports Medicine at Boston Children’s Hospital and Clinical Professor of Orthopaedic Surgery, Harvard Medical School.

Dr. Micheli is one of the godfathers of sports medicine, with a career that began in the sixties and shows no signs of slowing down.  He still outworks almost any other physician I know, and still performs high volumes of surgical procedures, including ACL reconstructions, the subject of this podcast.

He also finds the time to have published innumerable manuscripts, and CJSM has been the recipient of many of his excellent studies.

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L to R: Myself; Dr. Lyle Micheli, Dr. Pierre d’Hemecourt (Boston Children’s), Dr. Jeff Vaughn (Phoenix Children’s)

The focus of the podcast is on a study just published in our July 2016 CJSM, Return to Sport after Anterior Cruciate Ligament Reconstruction in the Skeletally Immature Athlete.  We had the chance to discuss how ACL injury management in the young athlete has changed over the course of his career, and we got to explore with Dr. Micheli the radical new direction in which ACL injury treatment may be headed:  with repair, as opposed to reconstruction — the Bridge-enhanced ACL Repair (BEAR) trial is a hot topic in the world of orthopaedic sports medicine.

You can access the podcast at iTunes (where you can also subscribe to all our podcasts for free) or on our journal’s main website. And the study on CJSM is free. Let us know what you think!

Getting Published — a “Junior’s” Perspective

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The newly published, Dr. Dawn Thompson

A regular contributor to this blog is Dawn Thompson, who most recently wrote a very well-received post on gender and our profession of sports medicine.  She is a Sports Medicine physician in training and one of our Junior Associate Editors.

I had several CJSM tasks for the day, including preparation for an upcoming podcast with Dr. Lyle Micheli and doing some CJSM peer review, and so I was delighted to find Dawn was ready and able to volunteer her time to share with us this post, penned shortly after her success of having her first manuscript accepted for publication.  Congratulations Dawn:  keep the publications (and the blog posts) coming!

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Dawn Thomposon

Yes! I can finally say I have a genuine original article published in my name! More than 2 years in the making and I have to say it has been a fairly frustrating experience! However, thanks to good colleagues and perseverance we have got there.

Back in April 2016, CJSM wrote a blog post following the American Medical Society for Sports Medicine conference on getting published and peer review. This blog provides some excellent further resources, however for those new to the world of research and getting published, here are my top 10 hints and tips to try to make it slightly less of a frustrating experience!

  1. Choose something you are passionate about – you will be devoting a significant amount of time to this topic!
  2. Choose a good supervisor to guide you and a colleague/peer to work with – things are better shared!
  3. It doesn’t have to be something huge or groundbreaking but if fairly novel or of importance it is worth pursuing
  4. Select your journal wisely. Be realistic and target your papers strength to that of the journal you choose. It’s probably worth considering whether or not you want to aim for open access which will likely encounter a fee.
  5. Follow the submission instructions of the journal – sounds simple but all journals have slightly different instructions and may reject your paper if these are not followed.
  6. Check, re-check and triple check your manuscript before submission!
  7. Be prepared to rework large parts of your paper if needed in response to reviewers comments.
  8. If not accepted initially, try to work out why and make appropriate amendments. It may be that the reviewers give comments which you can act upon or it may be that your paper wasn’t right for the selected journal.
  9. If despite best attempts your paper doesn’t get published consider writing it up as a presentation for a conference or as a letter to the editor. It will still look great on your CV and get you points in job applications!
  10. Develop broad shoulders! Don’t take it personally if you do not get accepted right away – journals have set criteria for accepting papers and it might just be yours doesn’t fit these or their current direction. You will get there eventually and likely the finished product will be better for it!

 

Happy researching!

Doctor, Doctor — Give Me the News!

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CJSM at CASEM 2014 with Pierre Fremont [L], former CASEM President & one of the authors in the new CASEM Position Statement

CJSM has always had a close relationship with the Canadian Academy of Sport and Exercise Medicine (CASEM).  CASEM is, after all, our mother — we were ‘born’ 25+ years ago as the “Canadian Journal of Sport Medicine.”   In the journal, on the podcasts and on these blog pages, CASEM shows up frequently.

Something else that shows up frequently in CJSM media:  research on the benefits of physical activity.  And so it’s not surprising to see in our current issue that CASEM is taking a hard look at the issue of “Exercise is Medicine” and is publishing with CJSM (and other journals) a position statement on the “Physical Activity Prescription:  A Critical Opportunity to Address a Modifiable Risk Factor for the Prevention and Management of Chronic Disease.”

The list of authors involved is a list of sports medicine heavyweights, including several MD/PhDs who have a presence on social media:  if you are not currently following folks like lead author Jane Thornton MD, PhD and former CASEM President Pierre Frémont MD, PhD and BJSM Editor-in-chief Karim Khan MD, PhD….you should.

These ‘doctor doctors,’ as I like to call my colleagues who have fought the good fight to earn an MD and a PhD, have produced a powerful statement that will have significant influence on how physicians can play a role in addressing the worldwide crisis of sedentary behavior.  The global problem of inactivity especially in children has been an ongoing concern of mine, and it has puzzled me that when I have spoken on this issue I frequently find that physicians feel as if they are on the sideline of this battle.  We collectively throw up our hands and say the problem is too big, or it’s not a clinical medicine problem it’s a public health issue.

But our patients are looking to us for guidance on this issue.  They really do ‘want the news.’ As the authors note in the position statement, “Over 80% of Canadians visit their doctors every year and prefer to get health information directly from their family physician. Unfortunately, most physicians do not regularly assess or prescribe physical activity as part of routine care,  and even when discussed, few provide specific recommendations.

They continue, “Physical activity prescription has the potential to be an important therapeutic agent for all ages in primary, secondary, and tertiary prevention of chronic disease.”  Indeed, Robert Palmer, the singer of “Bad Case of Loving You (Doctor, Doctor)” fame, could not have known how prescient he was when he penned the lyrics, “no pill’s gonna cure my ill…..”  He was talking about love, but he may as well have been talking about the chronic diseases associated with physical inactivity. Prescribing a pill won’t cure this ill: the physical activity prescription, delivered and acted upon, is required.

The beauty of this position statement is that it gives evidence-based tools that primary care physicians as well as sports and exercise medicine physicians can use in their practice to stem the tide of the inactivity epidemic.  I know this statement will be widely read and disseminated; it will be referenced frequently.  I am looking forward even more to seeing its principles put in action by me and my colleagues, around the world–both in our clinics and in the venues where we train future physicians.

Look it over now.  It’s free!  What’s stopping you?

 

Cannabis and sports

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Recent tweet from @dmorg91

The intersection of social media and sports medicine has been an interest of mine (and CJSM) for some time. Today, that relationship provides an opportunity to have the blog readers take a poll about a controversial subject: the potential medical benefits of marijuana (cannabis) for active National Football League (NFL) players.

Last week Derrick Morgan (@dmorg91), an NFL player for the Tennessee Titans, tweeted, “It’s time for @NFL to take an HONEST look into the potential medical benefits of Cannabis for its players #CBD #Research.” He and colleague Eurgene Moore were also interviewed by Katie Couric about the issue.  You can see the video here.

The tweet generated a great deal of, er, buzz on social media. In the United States, 25 states and the District of Columbia have legalized marijuana for medicinal purposes, but such legal protection does not contravene employer law — that is, it may be legal to use marijuana for chronic back pain in California, but your employer can still terminate you from your position if they perform drug tests on their employees.  That is, the legal right to avoid criminal prosecution for use of marijuana does not prevent one from the requirement to participate in (and abide by) employer drug testing programs.

There are so many dimensions to this issue including the science itself about the purported benefits of cannabis, and the substance’s listing as a prohibited substance by anti-doping agencies.

But today I wanted to poll you, the readership, on the question somewhat narrowly drawn:  are you in favor of NFL players using marijuana for medicinal purposes?  I don’t intend by this poll to extend the question beyond the NFL (e.g. to Olympians), nor do I intend to enquire about the decriminalization of marijuana for recreational purposes for NFL players.  Like the Brexit vote, you get only two options: yes or no.

Let us know!!!!

And don’t ‘Bregret’ your decision, bro.

p.s. By all means, aside from voting, if you want to comment on the broader issues of marijuana use in sports (is there science behind the claims, should other sports be open to use, etc.) please do so below in the blog comments section.  Thank you!

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