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!

Gender Bias in Medicine — the CJSM podcast with Dr. Esther Choo

@choo_ek (a.k.a. Dr. Esther Choo) — a definite follow on Twitter!

We are excited to share the first CJSM podcast of 2019 with you.  Special guest Esther Choo M.D., M.P.H. joins us to discuss issues of gender bias in medicine:  “From Mansplaining to Bromotion — How We Can Move the Needle on Gender Bias in Sports Medicine.” 

For those not familiar with Dr. Choo’s work, I would direct you to a CJSM blog post from December 2018 where I shared with you some of my thoughts about one of her more recent commentaries published in the British Medical Journal (BMJ): “A Lexcion for Gender Bias in Academic Medicine.”

I would also direct you to her Twitter feed and heartily encourage you to follow her @choo_ek to continually learn from her, as I do on a nearly daily basis.  She argues strongly that issues of equality inform all our attempts to deliver high quality medicine; that issues of bias should be of interest to us all, because they affect not only our fellow professionals, but the patients we serve.

She also does this typically with a sense of humor, which has often put me in mind of Mark Twain’s quotation, “Against the assault of laughter nothing can stand.”  This work and this tone can be hard to achieve, because many of the issues Dr. Choo and others are tilting against can be dark.  In thinking of our own word of sports medicine, the complicated and horrific story of Larry Nassar and USA Gymnastics comes to mind.  I’m also mindful of stories like that of Eva Carneiro, former team physician of an English Premiership Club, whose summary dismissal was entwined with these issues of sexism.  Or the exceedingly common phenomenon of attending a sports medicine conference only to find that all the keynote speakers are male

The world we serve is rife with issues of gender bias.  On his recent retirement, Andy Murray was lauded as an all too rare light in men’s sport — a man who would publicly stand up for women’s issues, a #HeForShe.  Or what to make of the arena of NCAA Division I coaching, where the sight of a man coaching a women’s team is common (think Gino Auriemma of UConn Women’s Bball), but the reverse is an exceedingly uncommon phenomenon.

There is light in this darkness.  Dr. Choo and groups like Feminem.org are doing great work.  I am also mindful of the lead that the IOC 2020 Prevention Conference has taken on this — the organizers publicly stated their intention to assemble a gender balanced planning committee, and they got it right, I think, including many luminaries in our field including Margo Mountjoy, Kate Ackerman, Caroline Finch, and Christa Janse van Rensburg, among others. Bravo!

I hope you go to our podcast page on our main website, or subscribe to the podcast on iTunes, to listen to our conversation with Dr. Choo and sample all of our podcasts.  Please let us know what you think. Take the time if you can on our iTunes feed to give us your opinion on the podcast in general, as we always take feedback seriously and use it to ‘tweak’ our media to make it ever better for you.

 

Concussions: The “Injury of 2018”

Concussions remain a dominant subject in the sport medicine literature and media at large — Photo: PET Scan Brain, Wikimedia

As 2018 winds down, the Clinical Journal of Sport Medicine, like so many of its sister media, finds itself in a reflective mood.

Time magazine, for instance, has just named its “Person of the Year”: a group of journalists the magazine notes has been ‘targeted’ for the work they do pursuing the truth.  Time calls them The Guardians. It is an interesting selection:  a media outlet honoring other professionals in its own line of work.

I thought it time that CJSM do its own version of “Person of the Year,” but with a sport medicine twist — Injury of the Year.

I’m naming “Concussion” the Injury of the Year.  In 2019, I’ll have my ‘act together’ and put out a Twitter poll in late November for reader contributions; but in 2018, I’ll have to play judge and jury, given that it’s nearly mid-December. Thanks for indulging me!

Like LeBron James of the NBA, who could probably be named MVP in any year he has played in the league, concussion is a sports injury which could probably earn this distinction in any year over the last decade or more.

In truth, 2018 was a red banner year for the injury, so to speak.  As an example, nearly our entire March 2018 issue was devoted to original research on various aspects of the subject, including a systematic review on the long-term consequences of traumatic brain injury in professional football players.  Continuing this line of reasoning, I would draw your attention to another noteworthy systematic review just published in our last issue of 2018 (November).   This one looks at the utility of blood biomarkers in the assessment of sports-related concussions (spoiler alert:  we have a long way to go in developing these for ‘prime time’).

The dominant theme of our 2018 podcasts was, again, concussion.  Read more of this post

Pain Management in Athletes: A Conversation with South Africa’s Wayne Derman

Wayne E. Derman MBChB BSc (Med)(Hon) PhD, of Stellenbosch University, South Africa

Our guest for our newest podcast is Wayne E. Derman MBChB BSc (Med)(Hon) PhD.

Dr. Derman was the Guest Editor of our September 2018 CJSM, which was a thematic issue focusing on pain management in athletes.  He hails from South Africa, where he is Director and Chair of the Institute of Sport and Exercise Medicine, at the Division of Orthopaedic Surgery, Stellenbosch University. Dr. Derman does research in Sports Medicine, Rehabilitation Medicine and Cardiology and lectures widely around the world.

If you have not heard him speak, now is your chance. We had an exciting discussion about the challenges of pain management (and the challenges of guest editorship) which we have entitled:

No pain no gain? NO WAY!

Take a listen to this episode, and all of our podcasts, at the CJSM link on iTunes or on the journal’s home page on the web.  Then consider reading Dr. Derman’s lead editorial, or any number of the published studies in the thematic issue, and share your thoughts which him or us on Twitter: @wderman @cjsmonline.

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