Ovid Concussion to consequence Webinar – Managing Sport-related Concussion On & Off the Field – Tuesday 18th October 2011 12:00pm EST

September 18, 2011 1 Comment

 Many of our readers will be involved on a regular basis with the management of sports participants with concussion, whether that is at the pitch side, at the training ground, or in a secondary or tertiary care environment.

As part of the Ovid webcast series, there is a forthcoming event on the Management of Sport-related Concussion both on and off the field on  Tuesday, October 18, 2011 at 12:00PM Eastern / 9:00AM Pacific time.


Margot Putukian, Director of Athletic Medicine at Princeton University, Past President of the American Medical Society for Sports Medicine, and member of the NFL’s Head, Neck and Spine Committee will be joining John D. Corrigan, Professor in the Department of Physical Medicine and Rehabilitation at Ohio State University and Editor-in-Chief of the Journal of Head Trauma Rehabilitation for a 60 minute discussion on what is known, and what is not known about managing concussion as an acute event – particularly in the context of sports, and as a marker within a person’s lifetime history of effects on brain functioning.

You can register for the Concussion to Consequence Ovid Webcast here.

For those of you who are not familiar with the Ovid Webinars and podcasts, these resources highlight a wide range of current issues in the health sciences and medicine and are well worth checking out. Archived Webinars can be found here, and the iTunes series of Ovid podcasts has free podcast downloads here.

Most of you will be familiar with the Consensus statement on Concussion in Sport from the 3rd International Conference on Concussion in Sport held in Zurich, 2008 which is available in full text online from CJSM, together with appendices including the second full Sports Concussion Assessment Tool (SCAT2) and Pocket SCAT2.

Some questions I have for our blog readers include :

1) How useful do you find the Pocket SCAT2 in practice? What are it’s pros and cons?

2) Are you using SCAT2 as part of preparticipation evaluation baseline screening and, if so, how useful do you find it?

3) What improvements do you think could be made to SCAT2 and the Pocket SCAT2?

CJSM would like to hear your views.

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Abuse, Harassment and Bullying in Sport

September 10, 2011

 This month marks the publication of an important article in CJSM, the Canadian Academy of Sport and Exercise Medicine Position Paper on Abuse, Harassment and Bullying in Sport, and highlights the issue of safeguarding within the sporting environment.

I am sure that if we reflect on our own experiences whilst working within sport, most of us will be able to recollect incidents highlighting the important issue of safeguarding within the sporting environment. The problem of unacceptable behaviours is probably more widespread than we realise due to the likely under-reporting of events, longstanding cultural precedents, and the fine line that exists between acceptable strategies aimed at getting the best out of sports participants and unacceptable behaviours.

There have been some recent important claims and disclosures of unacceptable behaviours from prominent sporting personalities, including the legendary American boxer Sugar Ray Leonard,  UK Olympic diving hopeful Tom Daly, and Australian umpire Daryl Harper amongst others.

The CASEM paper highlights the definitions of the terms abuse, harrasment and bullying, citing the paper by Stirling published in the BJSM in 2009 ‘Definition and constituents of maltreatment in sport: establishing a conceptual framework for research practitioners.’  Risk factors and signs and symptoms of unacceptable behaviours are discussed together with recommendations for healthcare professionals working in sport, and practical advice on what to do in the event of disclosure and suspicion is given. In addition, there is advice on primary prevention, and on protecting oneself from spurious allegations of unacceptable behaviours.

There are a wide range of resources available for those working in sport on safeguarding issues including the following :

1) Respect in Sport

Sheldon Kennedy, former NHL player with Detroit Red Wings, Calgary Flames and Boston Bruins, is perhaps as famous for his disclosure of sexual abuse by his former coach and his work as a spokesperson for the prevention of unacceptable behaviours as he is for his fame as an NHL star. Sheldon founded Respect in Sport in 2004 together with Wayne McNeil, and their website provides an online certification program, together with links to other resources.

2) The UK-based National Society for the Prevention of Cruelty to Children website has a section devoted to safeguarding children and young people in sport, although the general principles and issues highlighted are equally applicable to adults. The NSPCC child protection in Sport Unit (CSPU) was founded in 2001 to work with UK Sports Councils, governing bodies and others to reduce risk to children of abusive behaviours during sporting activities. The website has a number of excellent resources including a series of videos of scenarios highlighting unacceptable behaviours to raise awareness.

3) The Bullying UK website, has a section devoted to the issue of bullying in sport and discusses amongst other things, important issues to consider when introducing a sports club anti-bullying policy.

4) The youth sports psychology website blog has a section devoted to bullying in sports, and offers an opportunity for parents and others to share their experiences of unacceptable behaviours within the sporting environment and for mutual support.

5) Women Sport International’s sexual harrasment task force discuss sexual harassment and signpost to resources on their website. They also offer support for victims and for those who require further information.

6) The UK Government charter for action against homophobia and transphobia in sport, with signatories including the UK Football Association, Rugby Football League, Rugby Football Union and Law Tennis Association have their own facebook page which seeks to raise awareness of issues particularly relevant to these forms of unacceptable behaviours within sport.

The responsibility for safeguarding individuals within the sporting environment rests on the shoulders of all of those who are involved in sport, and this month’s CASEM position paper in CJSM acts as an significant resource and a reminder of this important issue. It’s free, so please signpost your colleagues to it as raising awareness is one of the most important steps we can all take. Awareness, planning, vigilance and effective action when necessary are key when it comes to preventing and dealing with unacceptable behaviours within the sporting environment.

CJSM would like to hear your views on safeguarding, and your experiences.

Keep safe.

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Groin problems keep two prominent 100 meter sprinters out of the World Championships

August 25, 2011

The Jamaican 100 meter sprinter and former twice world record holder at that distance, Asafa Powell, is the latest big name to pull out of a forthcoming event with a groin problem. Powell apparently originally developed symptoms following a race in Budapest in July this year, and later pulled out of the London Grand Prix hoping that things would settle in time for him to be able to compete at the World Championships in Daegu, South Korea later this month. However, he was forced to pull out of the 100 meter heats, although may make himself available for the 4 x 100m relay on the 4th of September.

Powell is the second high profile athlete who is unable to compete at the World Championships at the 100m distance, with Tyson Gay having previously undergone arthroscopic surgery on his hip earlier this year. Gay was reported to have been suffering from hip impingement, according to his surgeon Dr Marc Phillipon.

Groin pain is surely one of the most frustrating conditions suffered by those who participate in sport, and presents one of the trickiest diagnostic challenges for Sports Physicians, especially in its chronic presentation. Acute hip and groin pain often occurs in those sports that require quick changes in direction and kicking such as soccer, and chronic groin pain similarly tends to occur in those who participate in sports in which explosive sprints are combined with twisting and kicking. The diagnostic challenge of chronic groin pain presents due to a combination of factors, including complex regional anatomy, the heterogeneity of sites where pain occurs and tenderness can be elicited, and often the co-existence of a number of different pathologies including some of the more obscure, less well-recognised conditions such as obturator nerve entrapment, described here in CJSM by Bradshaw and McCrory.

In a paper published in BJSM in 2007, Per Hölmich identified 3 primary patterns of longstanding groin pain amongst 207 consecutive athletes involved in a number of different sports using a standardised clinical examination programme, categorising patterns related to adductor-related dysfunction, iliopsoas-related dysfunction, and rectus abdominis-related dysfunction together with combinations of these patterns. This concept of clinical entities was later extended in the 3rd Edition of Clinical Sports Medicine by Brukner and Khan to include pubic bone stress-related dysfunction, but how useful this concept is in Clinical Practice continues to be a subject for debate.

Falvey and colleagues, in a paper in the British Journal of Sports Medicine, more recently attempted to make sense of the so-called ‘groin triangle,’ suggesting a ‘novel educational model based on patho-anatomical concepts’ in order to assist in the diagnosis of chronic groin pain in athletes.

Even more recently, Bizzini described the groin area as the ‘Bermuda triangle’ of sports medicine, and I think that it is fair to say that most clinicans will continue to find themselves lost from time-to-time when assessing their patients with groin pain.

Any tips from our blog readers on the assessment of chronic groin pain? CJSM would love to hear your practice pearls.

(picture by Chell Hill, 2010)

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Brave fighter Scott LeDoux succumbs to Lou Gehrig’s disease

August 19, 2011

I was saddened to hear of the death of the ‘Fighting Frenchman,’ Alan Scott LeDoux last week. LeDoux died of Amyotrophic Lateral Sclerosis (ALS), also widely known as Lou Gehrig’s disease, which was originally diagnosed in 2008. He had a distinguished and colourful career having fought many famous heavyweight fighters including George Foreman, Larry Holmes, Leon Spinks, Ken Norton, and Gerry Coetzee. He also fought Muhammad Ali in a five round exhibition match, and his final bout was against Britain’s Frank Bruno in 1983 which ended in a technical knock-out. LeDoux ended his career with a record of 33-13-4, with 22 knockouts.

Arguably his best boxing achievements were his draws with Leon Spinks just two months prior to Spinks’ defeat of Ali for the World Heavyweight Championship, and with Ken Norton. During his controversial fight with Norton, he had his opponent on the canvass twice in the tenth round. Following his boxing career, LeDoux entered the world of politics and was a commissioner in Anoka County, Minnesota, until he stepped down from his role due to his declining physical health.

LeDoux and his wife Carol became advocates for research into neurodegenerative diseases, particularly supporting research programmes at the University of Minnesota. The brave fighter can be seen alongside his wife Carol talking about his hardest ever fight, against ALS, and promoting the importance of research into neurodegenerative diseases in this emotive video. LeDoux is survived by his wife Carol, two sisters Denise and Judy, two children from his first marriage, Molly and Joshua, a stepdaughter, Kelly, and four grandchildren.

McCrory discusses the issue of Sports Concussion and the Risk of Chronic Neurological Impairment in this article published in CJSM earlier this year, in which mention is made of the possible association of ALS in association with head injury. McKee and colleagues, in their study published in the Journal of Neuropathology and Experimental Neurology,  recently claimed to be the first authors to have found pathological evidence indicating that repetitive brain trauma may be associated with motor neuron disease, finding abundant TDP-43-positive inclusions in the spinal cords of 3 athletes with chronic traumatic encephalopathies.

Most of our American and Canadian readers will be familiar with New York Yankees’ first baseman Lou Gehrig, whose career was cut tragically short by ALS. Over a 15-season span from 1925 to 1939, Gehrig played in 2,130 consecutive games – a record which stood for 56 years until being finally broken by Cal Ripken Jr in 1995.

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Filed under Basic Sciences in SEM, Concussion in Sport Tagged with ,

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