Concussions take time — CJSM Blog Post Journal Club

Our Jr. Assoc. Editor Jason Zaremski MD looking for some help from a friend with the newest CJSM Blog Post Journal Club

Our March 2020 issue has just published, and right out of the gate one of the studies that has received the most buzz is one from a team of researchers in New Zealand demonstrating that less than 50% of concussed individuals recover within two weeks of a sports-related concussion.

Jason Zaremski, MD, CJSM’s Jr. Assoc. Editor, explores this new study today in our most recent CJSM Blog post Journal Club.  It is a two year prospective study with some revealing findings. We’re sure you will enjoy the blog post and the study itself!

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Jason Zaremski MD

Kara S, et al. Less Than Half of Patients Recover Within 2 Weeks of Injury After a Sports-Related Mild Traumatic Brain Injury: A 2-Year Prospective Study. Clin J Sport Med 2020;30:96–101. doi.org/10.1097/JSM.0000000000000811.

Introduction:  Sports related concussion (SRC) is a common and significant concern, challenging not only sports medicine practitioners, but also athletes, coaches, family members, and all sports performance team members. While diagnostic skills and research in this area have dramatically improved in the past 10 years, our patients still have several questions, including: How long until I can go back and play? Some data has suggested the majority of SRC patients recover in approximately a 2-4 week recovery time frame. According to the consensus statement in concussion in sport (5th iteration) held in Berlin, Germany, in October 2016—“the expected duration of symptoms in children with SRC is up to 4 weeks.” (McCrory, et al. BJSM 2017).  Kara and colleagues  have looked into the validity of this stated time frame.

Purpose: To describe clinical recovery time and factors that could impact recovery after a sports-related mild traumatic brain injury (SR-mTBI, aka “concussion”).

Methods/Design:  This is a prospective cohort study with level IV evidence. Read more of this post

AMSSM Mental Health Position Statement — The CJSM Podcast

Not often one gets to hang out with TWO past AMSSM presidents. R to L: Cindy Chang M.D. and Margot Putukian M.D.

CJSM has just published a new position statement (and executive summary) from the American Medical Society for Sports Medicine (AMSSM): Mental Health Issues and Psychological Factors in Athletes: Detection, Management, Effect on Performance, and Prevention.

These publications are fruits of a project several years in the making and requiring the labor of several individuals.  The co-chairs of the committee charged to do this work, and the two co-lead authors of the CJSM manuscript, are Cindy Chang M.D. and Margot Putukian M.D.

Drs. Chang and Putukian are, as many of the readers of the blog and listeners of the podcast know, past presidents of the AMSSM. The group they headed has produced an outstanding resource on a topical subject: the mental health of the athletes we treat.

I have always been happy to count Drs. Chang and Putukian, Cindy and Margot, as friends as well as esteemed colleagues.  Moreover, for anyone who knows them personally, it will not come as a surprise that the two have known each other for a long time and share a particularly close bond.

And so it made for a lively conversation to have them both as guests on the podcast so that they could discuss this new position statement.  It’s not often I have two guests to chat up — come to think of it, the last time that happened Dr. Chang teamed up with yet another past-president of the AMSSM, Matt Gammons.

Read the position statement and the executive summary, and find the podcast on our journal website or in our iTunes library.  And if you are heading to Atlanta in April for AMSSM’s 29th annual meeting, we’ll see you all there.

 

Treatments for Achilles Tendinopathy — CJSM Blog Post Journal Club

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

CJSM Podcast with Kim Barber Foss and Greg Myer

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!

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