The AMSSM, one of our affiliated societies, is having its annual meeting coming up in Dallas April 15 – 20, and we’re looking forward to joining in those proceedings [the official hashtag of the meeting is #AMSSM16 — keep that in mind you Twitter folks]. The physician membership is not infrequently surveyed about a variety of matters of interest to practicing sports medicine clinicians; the results of these surveys often provide invaluable data to researchers who have published in the CJSM pages.
Regarding the study on dietary supplements (DS), the authors looked at a variety of issues. Of note, they found that majority of survey respondents (71%) reported that athletes under their care had experienced an adverse event associated DS use.
Not all of us who read this blog or subscribe to the journal are AMSSM members, of course, and so I thought it might be time for a poll, asking this very question: have you ever taken care of an athlete who has experienced an adverse DS event? Please, take the poll, and if you can, send us a comment on this blog identifying the DS, the adverse outcome, and possibly the sport in which your athlete was participating.
Rugby Sports Med panel (L to R): Drs. Kerr, Gerber, Viljoen, Cantu, Akhavan, Mjaanes, Landry
There is an ever-increasing debate on both sides of the Atlantic regarding contact and collision sports for youth. In particular, the issue of tackling (whether in rugby or American football) is in the cross-hairs of many. I’ve written about this recently after Dr. Bennet Omalu, the subject of the movie ‘Concussion’ and the pathologist who first described CTE in an American professional football player, wrote an op-ed piece in the New York Times arguing that contact football should be banned in those under age 18 [‘Don’t Let Kids Play Football’].
My impetus for this blog post is two-fold: 1) I am currently attending a rugby sports medicine conference, where the issue of tackling and brain injury is a ‘hot topic’ for discussion; 2) the issue of tackling in youth rugby has exploded after recent events in the UK.
USA Rugby sports medicine hosts a conference each year around this time, and this year there was a panel of experts who entertained the question: when should youth athletes take up contact/collision sports? There was a variance of opinion and a recognition that more research needs to be done to give an informed answer to this question.
In the background, occurring in the ‘real world,’ this same question was being debated in the media and social media after a group approached the UK government asking for a ban on tackling in youth rugby. The Sport Collision Injury Collective (@sportcic on Twitter) circulated a petition signed by 70 academics asking that touch rugby only be taught to schoolboys in the UK [“Our message is simple: Prevent injury, remove contact. Replace contact with touch in school rugby.”]
This is an important and healthy debate, one where I find most if not all stakeholders have the health and welfare of our youth foremost in mind as we try to gather more information and make decisions now, the ramifications of which may not be seen for years to come.
And so, I thought I would use this blog as one more platform where concerned folks could weigh in on their opinion of this question. Take the poll below,* ** follow the links above, and engage in the discussion which is taking place in the media.
*There have been many ages proposed for initiation of contact in youth sports, ranging from age 10 to 18. For the purposes of the poll, I have tried to give a variety of options, though I recognize the choices are not exhaustive.
**I have intentionally given poll takers the option for a limited number of answers, recognizing that there is room for many more (e.g. ‘we need more information’, ‘yes, allow contact, but we need to reduce the amount kids get’, ‘football and rugby are different, and my answers would be different for each sport’ etc.)
The topic of screening to prevent sudden cardiac death (SCD) in athletes, in particular young athletes, is a perennial ‘hot button’ issue in our field — we’ve written about the issue here in the blog, and we have published several studies on the subject in the journal. As most readers of the blog will know, in the USA (in contradistinction to Europe, Japan, Israel and elsewhere), there is no recommendation for inclusion of an ECG in PPE screening.
There are many interesting aspects to the Stanford study. The main outcome measures in the screen of 1596 high school and college athletes were i) the 8 personal and family history questions from the AHA 12-elements; and ii) ECGs using three separate criteria for interpretation: Seattle criteria, Stanford criteria, and European Society of Cardiology (ESC) criteria. The different criteria had different rates of abnormal ECGs, but what was most concerning was the nearly 25% of athletes who screened ‘positive’ using AHA questions.
The authors conclude, “In a patient population without any adverse cardiovascular events, the currently recommended AHA 12-elements have an unacceptably high rate of false positives. Newer screening guidelines are needed, with fewer false positives and evidence-based updates.”
What do you think? Take the poll, and let us know!
The Court of Arbitration in Sport (CAS) made a major ruling yesterday with broad implications. Dutee Chand, an Indian sprinter, had been fighting the International Association of Athletics Federation (IAAF) policy which would have required her to undergo surgery, take medicine, and agree to other interventions if she were to compete as a female. Ms. Chand has naturally higher levels of testeosterone than most women; she had never identified in her life as anything but female. She and her legal team fought the IAAF policy in the CAS, and won.
The CAS questioned the advantage of naturally high levels of testosterone in women’s sport, and ruled that Ms. Chand must be allowed by the IAAF to compete as a woman, essentially overturning the current IAAF policy. A New York Times article makes for fascinating reading.
This is a victory for Ms. Chand, and many would argue that it is a victory for women’s sport, and for sport in general. Nevertheless, many athletes, including marathoner Paula Radcliffe, supported the IAAF policy and worry that women’s sport may now be conducted on a less level playing field, if you will.
We thought we’d repost (below) a very popular commentary which includes discussion of this issue of testosterone in women’s sport: ‘The Sports Gene: How Olympians are made (or born).’ And we thought we’d include a poll on what you, the reader, think of this most recent CAS decision on IAAF policy. Vote, and let us know what you think!
The venues at Sochi are still, it seems, a work in progress. Nevertheless, before the week’s end, we will (should?) see the Winter Olympic games start up. Soon, we’ll get to watch some of the finest athletes in the world compete at their sport.
I’ve not been consciously preparing for this elite sporting event, but rather coincidentally recently picked up a book that highlights elite athletes and has received a great deal of positive ‘buzz’: The Sports…
James MacDonald, M.D., M.P.H. Clinical Journal of Sport Medicine (CJSM) Deputy Editor
"The CJSM blog offers the opportunity for clinicians with a primary interest in sports medicine practice to discuss current issues in the world of sport and exercise medicine. The blog acts as a community platform for knowledge sharing; its goals are the promotion and dissemination of best clinical practices for our patients."
Clinical Journal of Sport Medicine Blog 