Military Medicine — AMSSM 2017, San Diego

Drs. Eric Schoomaker, Matthew Gammons, and Francis O’Connor (L to R), at the Military Medicine session #AMSSM17

I have been in San Diego at the 2017 American Medical Society for Sports Medicine (AMSSM) annual meeting.  There is always so much going on that I sometimes wish I could clone myself — doing so I could go to simultaneous meetings, hit every session on the program, etc.

Well, the second best thing to cloning — get on social media.

An AMSSM colleague, Dr. Devin McFadden, reached out to me on Twitter about a black hole in my #AMSSM17 social media feed.  I had not yet made any mention of Session #2 on Tuesday, “Military Medicine — Lessons Learned.”  My neglect to mention this session had reflected my failure to attend the session: I had conflicting obligations (hence, the need for a clone).

I am grateful, then, to Dr. McFadden for stepping up to give this overview of what was a very well-received session.  Thanks Devin for following @cjsmonline on Twitter, and stepping up to author this blog post!

_________________________________________________

Major Devin McFadden, M.D.

The United States Military is the world’s largest athletic team, composed of a diverse group of individuals unified in mission to defend the Constitution. While the physical demands vary by job, each Soldier, Sailor, Airman or Marine must be capable of responding to fire, helping to evacuate wounded compatriots, and passing a biannual physical fitness test.

The second session of the AMSSM meeting focused on the military athlete. Colonel Missy Givens, United States Army (USA), led off with an update on Selective Androgen Receptor Modulators (SARMs), an investigational new drug with potential to aid in the development of lean body mass. Already banned by WADA, potential benefit remains for the American Warfighter, where the trophy at the end of the day is sometimes life or death. The jury is still out on the long-term safety and efficacy, and despite their regulation by the FDA, they’re still being illegally marketed as nutraceuticals, so be aware.

Colonel Anthony Beutler, United States Air Force (USAF), shared that noncombat musculoskeletal issues are the leading cause of lost productivity in the Military, accounting for 1.6 million encounters annually, and the top cause of disability for the Department of Veterans Affairs (VA). He highlighted the allure of prevention programs in reducing these figures. Unfortunately while promising, the costs in dollars, manpower, and lost training time can be prohibitive, and in the end, the greatest predictor we have of future injury remains previous injury.

Major Nathaniel Nye, USAF, discussed his role in changing the paradigm on the prevention, recognition, and treatment of exertional heat stroke following a training related death. With the help of the Consortium for Health and Military Performance (CHAMP) and the Korey Stringer Institute (KSI) he completely revised the way heat stroke is treated, and optimized local response to mirror current best practices. More work is needed however, for example, our EMS standards of practice still do not reflect the importance of on-site cooling. Continued attention to this fact is needed at the national level.

Past AMSSM President Professor Francis O’Connor, Colonel USA (retired), followed with a summary of CHAMP’s approach to working-up exertional rhabdomyolysis (ER). He proposed the following red flags as indications of patients who require additional workup: anyone with recurrent ER or an event triggered with a low exercise load, patients with a high resting Creatine Kinase (CK) of over 1000, and people with a family history of myopathy.

The Presidential Keynote Speaker was Lieutenant General (retired) Eric Schoomaker. He highlighted the epidemic of chronic pain and opiate addiction and the need to adopt complementary and alternative techniques for pain management. Pointing out the effectiveness of mindfulness, meditation, biofeedback, and acupuncture and the multiple guidelines recommending their use, he emphasized that we need to shift the way our health system looks at these therapies and work to better apply them to patient care.

The session was enlightening and motivating. I will return invigorated to apply the lessons learned to the care I provide. Follow #AMSSM17 for additional conference updates.

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Major Devin McFadden, MD is currently a Sports Medicine Fellow at the Uniformed Services University of the Health Sciences. He has deployed to Afghanistan and worked within the Special Operations community. His passions are the care of the military athlete and the education of the next generation of military medical professionals. You can follow him on twitter or Instagram @ArmySportsDoc

The opinions above are those of the presenters and blogger alone and do not represent the official policy of the Department of Defense, United States Military or United States Government.

 

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About sportingjim
I work at Nationwide Children's Hospital in Columbus, Ohio USA, where I am a specialist in pediatric sports medicine. My academic appointment as an Associate Professor of Pediatrics is through Ohio State University. I am a public health advocate for kids' health and safety. I am also the Emerging Media Editor for the Clinical Journal of Sport Medicine.

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