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

Super Bowl Blues

The 2018 – 19 NFL season has ended with a familiar conclusion:  the New England Patriots having won (their sixth such championship).

Are you among the people who watched the game and found it boring (‘worst ever’)*?  Did you forego viewing entirely? Are you among the majority (reportedly) of fans disappointed because those Patriots won?  Sad simply because the season is over?

February can be a slog for all of us in the Northern Hemisphere — sports like the NFL can keep us going, and so perhaps you, my dear reader, are a bit blue for any number of reasons?

Well, I do not have something to cheer you up per se — rather I have something, perhaps, that will make you more blue….but it is an issue of vital importance to our profession.  And we can’t turn our eyes askance.

Recently published ‘ahead of print’ is headline-making original research: Reasons for Prescription Opioid Use While Playing in the National Football League as Risk Factors for Current Use and Misuse Among Former Players.

Headlines indeed. Over the Super Bowl weekend the New York Times published an article profiling former NFL players and their struggle with chronic pain and opioid addiction. It referenced the CJSM study authored by Dr. Eugene Dunne of Brown University and his team of authors.  Some of the more important findings reported are that among “….retired NFL players with exposure to prescribed pain medication during their playing career 26.2% reported recent use of prescription opioids (past 30 days).”  Moreover, the authors found that the past may be midwife to the future: use of opioids to manage pain during their career was associated with a 30% increased risk of present-day use of opioids in retired NFL Players.

Opioid use and abuse is a public health crisis of unprecedented scale in the USA according to JAMA.  Sports are not untouched by this epidemic.  CJSM has always striven to publish important and relevant research which can be translated into practical use — we provide this platform for clinicians helping individual patient-athletes, and we provide this platform for public health advocates as well.  We devoted an entire issue (Sept 2018) recently to the oft-neglected subject of pain management in athletes.  Guest Editor Prof. Wayne Derman of Stellenbosch Univ., South Africa emphasized in our podcast with him that it is imperative that clinicians seek holistic methods of pain control and that researchers look more intentionally at the issue of analgesia in athletics. An over-reliance on pharmacology, most especially opioids, is a potential recipe for problems (to wit, the experience of former NFL players in this new CJSM study).

Join us in this work and the global conversation on issues of importance to athletes, clinicians, researchers and public health advocates by checking out some of these references and following us on Twitter. We’ll always keep you abreast of what’s new and breaking in our world of sport and exercise medicine.

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*P.S. I really enjoyed the Super Bowl. Though low scoring, I loved watching Pats’ defense flummox such a great Rams’ offense, and I thought the game was tense until the very end. How about 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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