The Mental Health Podcast and CASEMCON2019

I hope readers of this blog, and listeners of the podcast, have been following #CASEMCON2019 on their social media feeds this week. The Canadian Academy of Sport and Exercise Medicine (CASEM) has been conducting its annual meeting in Vancouver these past several days, and is scheduled to wrap up today, May 18.  I have learned so much from following this #, as well as following the feeds of CJSM Twitter friends including Drs. Jane Thornton  Margo Mountjoy and Laura Cruz.

The topic of mental health in sport has figured prominently in the CASEM proceedings:  for instance, Clint Malarchuk, a retired NHL player, is scheduled to talk today about the stigma of mental health in sport.

And so one of our more recent publications and our most recent podcast could not be timelier (published in our May 2019 journal): The Canadian Centre for Mental Health and Sport (CCMHS) Position Statement: Principles of Mental Health in Competitive and High-Performance Sport

Krista Van Slingerland, of CCMHS and the University of Ottawa

The CCMHS is a relatively new organization and, along with a similar group in Sweden, represents one of the first such initiatives on the planet.  The co-founder of CCMHS, Ms. Krista Van Slingerland of the University of Ottawa, is the lead author of the position statement. She graciously met me on Skype (she, in Ottawa, and I in Columbus) to conduct a podcast exploring the issue of mental health in sport and the work CCMHS is doing to bring further attention to this issue and begin treating individual athletes for the problems they are facing.

CJSM is committed to providing a platform for this important issue, one which has been relatively neglected for too long in our world of sport and exercise medicine.  In my training — and I would suspect in yours, too — the focus was primarily on musculoskeletal medicine,  Medical issues such as managing diabetes or exercise-induced asthma, screening for cardiac disease, etc. would demand our attention at times.  The issue of concussion and its sequelae have of course become central to our athletes’ lives and our practice.  But identifying and helping our athletes cope with anxiety, depression, suicidality — I received little to no training in sports medicine about this, and have heretofore relied on my training in family medicine to help.

The new position statement as well as the CJSM CME Module we have created will help clinicians, including myself, learn more about the importance of mental health in the athletes we serve, and will help us be better able to identify and address the issues uncovered.  High profile and tragic stories like that of the life and death by suicide of Olympic cyclist Kelly Catlin underscore the vital importance of improving our care.

Besides the timeliness of #CASEMCON2019 wrapping up today in Vancouver with Clint Malarchuk’s talk, there is a bit of additional serendipity to the publication date for the CCMHS statement and this podcast, as well, for May is #MentalHealthAwarenessMonth!

And so…..your action items for this weekend

  1. Follow #CASEMCON2019 on your social media feeds
  2. Listen to the podcast, which can be found on our journal web page and on our iTunes feed
  3. Read the position statement — one of the Editor’s picks for this month
  4. Check out the CME module CJSM has produced on the topic of mental health in sport

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!

It’s a New Year — CSJM Blog Journal Club 2019 Starts Now

Japan (and its iconic Mt. Fuji) will be one of the places on the globe that will be enjoying an exciting 2019 in the world of sport.

We here at CJSM hope all of our readers have enjoyed a festive and relaxing holiday season.  I am sure for most of us reading this post, ‘things’ have picked back up, because the global sports world never sleeps.  From Australian Open tennis to the NFL playoffs to the English Premiership, and beyond, the sports (and sports medicine) scenes have been ushered in with a bang.

2019 promises to be an exciting year in sports all over, but perhaps in no place quite like Japan, as it hosts the Rugby World Cup at year’s end and busily prepares for the 2020 Summer Olympic Games in Tokyo.  I just spent my holidays there and fell in love with the country.  I am looking forward to posting more about the upcoming global events Japan is hosting this year and next.

CJSM has entered the new year with a bang as well, as we begin our 29th year with an issue that is full of interesting offerings.

Among the pieces of original research we have just published in this January 2019 issue is this one: Head Impact Exposure in Youth Soccer and Variation by Age and Sex. This piece has already received a good deal of attention. The accompanying editorial arguing (relatively speaking) against a ban on heading in youth soccer has realized a comparable buzz.

Jason Zaremski MD, Junior Associate Editor CJSM

We thought this would be a particularly good study to ‘de-construct’ in the Journal Club, and so we contacted our regular correspondent Jason Zaremski MD to pen one of his ever popular, recurring posts.  Thanks Dr. Zaremski, as always.

______________________________________________________________________________

Title:

Chrisman SPD, Ebel BE, Stein E, Sarah J. Lowry SJ, Rivara FP. Head Impact Exposure in Youth Soccer and Variation by Age and Sex. Clin J Sport Med 2019;29:3–10. http://dx.doi.org/10.1097/JSM.0000000000000497

Introduction:  

The newest edition of the Journal Club commentary for the Clinical Journal of Sports Medicine (CJSM) will be a review of an original research manuscript highlighting a very interesting topic, heading in “soccer” (referred to as “football” outside the United States) and its effects on our youth athletes. As the authors note, there are more than ¼ of a billion soccer players worldwide. In the USA, there are approximately 24 million soccer players and more than 37% are youth players. In the past few years there have been growing concerns about heading in youth soccer and possible associations with concussions and sub-concussive head impact exposures (HIE). Due to these concerns, individuals and some leagues (from local levels to national) have suggested a ban of heading to limit body contact and potential HIE. However, prior research has suggested that the actual number of youth players heading a soccer ball as well as intentional impacts with head to ball are low and heading restrictions may not be indicated. (Comstock et al JAMA Ped 2015, Lynall et al MSSE 2016, Press and Rowson CJSM 2016). Therefore, in order to obtain more objective data, the authors of this study wanted to objectively measure HIE in males and females at the youth level.

Purpose/Specific Aim(s):

The purpose of this study was to measure HIE using adhesive-mounted accelerometers during 1 month of soccer. Read more of this post

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

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