Making a Good Thing Better — The Healthy Sport Index & Youth Sports

I have the great privilege of taking care of many outstanding young athletes in my sports medicine clinics

Youth sports is of special interest to me — I practice pediatric sports medicine at Nationwide Children’s Hospital, and perhaps 90% or more of the patients I see regularly participate in youth sports.

The topic is of great interest to this journal as well:  for example, CJSM will publish later this year a themed issue on topics in youth sports medicine, guest edited by my friend and colleague, pediatrician Alison Brooks M.D. of the American Medical Society for Sports Medicine (AMSSM).

Youth sports has long been recognized as a valuable activity for the individuals and families who choose to participate.  An abundance of evidence points to the health benefits — physical, mental, academic — that can be achieved by children and adolescents engaging in sports.

There has been growing concern over the last decade or two (or three), however, of the potential and possibly growing risks of youth sports.  The concerns range from early youth sports specialization and overuse injuries to early professionalism. The concerns include the youth sports culture itself – a culture manifest in nightmare form by the myriad incidents of abuse seen in USA Gymnastics or Swimming.

On April 12 2019, the AMSSM will be hosting a pre-conference prior to their annual meeting, entitled the Youth Early Sports Specialization Summit (YESSS!)   Among many of the subjects up for discussion is the “Healthy Sport Index (HSI),” an instrument developed by the Aspen Institute’s Project Play initiative and made public in October 2018. The HSI was designed to help kids and families answer the important question:  what sport is right for my child?  As a physician caring for thousands of these athletes a year, I can’t tell you how often I’m posed that question.  Now there is a tool to help.

One of the physicians who served on the Advisory Group for the development of the HSI was Michele LaBotz, M.D. She is a pediatrician and sports medicine physician in a large multi-specialty group in southern Maine, who serves on the American Academy of Pediatrics’ Council on Sports Medicine and Fitness (COSMF) and is a member of the AMSSM.  She kindly volunteered to give an overview on the HSI for the CJSM blog, and we’re delighted we can share her thoughts in the run up to YESSS!

________________________________________________________________________

HEALTHY SPORT INDEX:  A UNIQUE TOOL FOR YOUTH SPORTS

Michele LaBotz MD FAAP

As health care providers, we rightfully emphasize safety and injury risk when discussing sport participation in young athletes.  We recognize the potential risks of sports that are contact vs. non-contact, or those that are high impact vs. low impact.   But, sport selection and participation is about more than just injury risk, and there is under-recognition that different sports exert a variety of influences on young athletes.  The Healthy Sport Index (HSI) presents this information in an appealing format and is a valuable resource for families and other stakeholders when considering sport-related issues in children and adolescents

HSI aggregates evidence-based data on physical activity, psychosocial effects, and safety on the 10 most popular high school sports for boys and girls in the U.S. Read more of this post

When it sees you but you don’t see it

Do Not Miss!!!

All of us who practice clinical care — who actively treat athletes and other patients — are keenly aware of the perils of a medical missed diagnosis.  The issues of concern can range from the relatively obvious — an Achilles tendon rupture for instance — to the more subtle.  In the case of an Achilles tendon rupture [or a scaphoid fracture or slipped capital femoral epiphysis (SCFE)], the outcomes from a medical misdiagnosis can be severe for both the patient and clinician:  significant morbidity for the former, and a possible medical malpractice suit (most especially in our litigious United States) for the latter.

Early in my training it was hammered home to me that if I let a patient with an Achilles tendon rupture walk out of my room with some bland assurance that one should give his or her acute posterior ankle pain a couple of weeks of rest and ice, and a message of ‘come back and see me if you’re not feeling better in a few weeks,” well….I could say hello to a suit which I would most certainly have to settle out of court.

Don’t want to be ‘that guy’ who doesn’t see the Achilles tendon rupture when it sees me.

Cassidy Foley, D.O., lead author

But what of some relatively common issues that may have more benign consequences, even if not initially ‘seen?’  What of the issues where missed or delayed diagnosis can result in weeks to months to years of frustration and, perhaps, unnecessary workup and/or misguided and ineffective treatments?

With those thoughts in mind, I was delighted to read an excellent study on the “Diagnosis and Treatment of Slipping Rib Syndrome” in the January 2019 CJSM.  Read more of this post

SportsKongres 2019 — An Overview Courtesy of Dr. Sheree Bekker

SportsKongres 2019, Copenhagen Denmark

Readers of this blog may be familiar with one of CJSM’s recurring collaborators, Dr. Sheree Bekker.  Dr. Bekker is a researcher in injury prevention at the University of Bath, UK,. She is, as well, an outspoken advocate raising awareness of the challenges faced by women in the field of sport medicine.  Finally, Sheree is a friend, and someone who is very active on Twitter:  a definite follow if you are in sport & exercise medicine and are reading this post!

I was following closely her tweets from the recent sportskongres in Copenhagen — what sounds like a fantastic conference just wrapped, and the buzz is on already for #SportsKongres2020.  Dr. Bekker graciously accepted my invitation to share her thoughts on the recent conference.  Enjoy, and hope to see you in Copenhagen in 2020!

___________________________________________________________________________

Dr. Sheree Bekker

Sheree Bekker, PhD

The 2019 edition of the Scandinavian Sports Medicine Congress has wrapped. Colloquially known by just a single name (as all the most famous people are, see: Serena, LeBron), sportskongres has, time and again, been billed by the British Journal of Sports Medicine as one of the Big 5.

This was my first sportskongres (full disclosure: I was an invited speaker), and from afar my biggest impressions of this conference were that the social program is legendary (spoiler: this is true), and that the focus is on clinically-relevant presentations and workshops (also true). Knowing that the majority of delegates at sportskongres are clinicians, I found an audience eager to learn from different disciplines and areas, an audience hungry for new insights and understandings as to what they are seeing and experiencing in everyday practice, and – most of all – an audience highly engaged in doing better. Read more of this post

The 2019 AMSSM Position Statement on Concussion — a Podcast with Dr. Kim Harmon

How to manage concussion in sport in 2019: The AMSSM Position Statement, and the new CJSM podcast

As one of our partner societies, the American Medical Society for Sports Medicine (AMSSM) contributes significantly and regularly to the global sports medicine discussion.  When the AMSSM authors a position statement, it’s a document that should be read by the active sports medicine clinician

Prof. Kim Harmon, past-president of the AMSSM

Hence, the publication of the AMSSM Position Statement on Concussion in Sport is news we want to make sure you all know about.  And if you haven’t had the chance to read it yet, you can now take the opportunity to hear about it from the publication’s lead author, Dr. Kimberly Harmon of the University of Washington.

For the new statement, Dr. Harmon notes that she and a panel of expert authors adopted a very specific focus: what does the practicing clinician need to be current when diagnosing and managing a concussion in 2019. This is a document for the sideline, the training room, the clinic.  A document for ‘now.’

It is evidence-based, but also ready to assist clinicians in the areas of concussion where evidence is currently limited.  That is, the statement makes suggestions for needed future research directions, but also reports current best practices informed by consensus or expert opinion.

After reading it, I found myself immediately referencing the statement when conversing with patients and families, whose questions might range from whether their child should take fish oil after their concussion (no, unless your child is a rat, as Dr Harmon may say….) to whether they are ready to drive (well, that depends….).

Take a listen to all of our podcasts on our main website or on iTunes.

If you want especially to hear interviews we’ve had with authors of previous AMSSM Position Statements, check out as well our podcasts with Dr. Jonathan Drezner (cardiovascular screening) and this one with Dr. Irfan Asif  (best practices for a sports medicine fellowship).

As ever give us feedback on these podcasts at the iTunes page, or in the comment section here!

%d bloggers like this: