Dreams of South Africa


With Wayne Viljoen (@BokSmart), one of the authors of new rugby research in CJSM

It was just a year ago that I was preparing to travel to South Africa on an American Medical Society for Sports Medicine (AMSSM) Travelling Fellowship — dreams of Cape Town and safaris danced in my mind [see post reblogged below].

I haven’t stopped dreaming of South Africa. Should I ever have a mental lapse and not think of the Rainbow Nation for a day or two, I have only to turn to my Twitter feed or my medical journals to be reminded — the country punches well above its weight in both sports and sports medicine. I enjoy reading of the exploits of current South African Sports Medicine Association (SASMA) President Phathokuhle Zondi as she takes care of Paralympic athletes in Rio, for instance — she is a definite follow on Twitter….

And I most certainly enjoyed reading some recent rugby research just published in our September 2016 CJSM: Incidence and Factors Associated With Concussion Injuries at the 2011 to 2014 South African Rugby Union Youth Week Tournaments.  It was a delight to read this epidemiological study, whose authors include good friends Sharief Hendricks, Clint Redhead, and Wayne Viljoen — researchers all of whom most definitely have made their mark internationally.


Partying with Sharief Hendricks (@Sharief_H), author of new rugby research in CJSM, in Johannesburg

In the authors’ words, the “….study provides the first published incidence of concussion, per player-match-hours, in South African youth rugby union and falls well within what was previously published elsewhere for youth rugby.”  They found the incidence of concussion in youth rugby to be 6.8/1000 player match-hours.  Importantly, and what for me was new information, was that under-13s and under-16s had higher incidence rates than under-18s.  The younger kids were at greater risk for concussion.  This may have important implications for rules and policy making in youth rugby.

For anyone with an interest in rugby, or South African sports and sports medicine, the study, in our newest edition of CJSM, is a definite read.  And it’s never too early to start dreaming of the 2017 SASMA biennial congress, which will take place in Cape Town 2017.  To stay ‘in the know’ for the timing and details of that pre-eminent conference, follow President Phathokuhle Zondi and SASMA itself on Twitter.

Clinical Journal of Sport Medicine Blog

IMG_1630Every so often, sports takes a back seat to other world events. So too for sports medicine.

We all know this, whether in our personal lives or in our interactions with the world at large.  There is the NFL player who is torn between performance on Sunday and ‘being there’ for his young daughter with leukemia.  There are cases where the athlete him- or herself is felled with illness–think of Lou Gehrig and amyotrophic sclerosis.  The issues of who won the last game, the intricacies of a salary negotiation, or the season missed from a knee injury pale in comparison with such ‘real world’ contingencies.

In sports medicine we sometimes experience directly the intersection between serious illness and athletics.  I think immediately of the young gymnast I saw with anterior knee pain that turned out not to be Osgood-Schlatter’s but osteogenic sarcoma of the tibia…….a ‘game changing’ event…

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The Most Dangerous Sport in the World?


A Bull Tamer in Australian Rodeo Event. Photo: Amcilrick


“Sweetheart of the Rodeo”

I’ll confess I don’t know much about rodeo.  To the extent the word triggers a response in my mind, I think of Gram Parsons and the Byrds:  “Sweetheart of the Rodeo.” Click on the link and take a listen:  it’s a great album!

Back to sport….it’s my own cultural myopia that overlooks rodeo when I think of the word ‘sport.’ I didn’t grow up participating in it, and in central Ohio I have not attended to any rodeo injuries (equestrian, yes; bull riding, no). I imagine my situation would be different if I practiced in Wyoming or Alberta…..or parts of Mexico, Argentina, and Australia (rodeo is truly international).

As I grow older, I delight in learning more about other sports; my involvement with CJSM certainly has expanded my horizons. Last year, for instance, I wrote (and learned) about the ice sport of ringette after the journal published a study on the injury epidemiology of this largely Canadian activity. I had previously never heard of rignette. Shame on me.

I was reading the New Yorker earlier this week when I came across this tantalizing entry: “The Ride of Their Lives: Children Prepare for the World’s Most Dangerous Organized Sport.”  The focus of the article is a particular event in rodeo, bull riding, and the kids and families who participate in this sport….which is, indeed, very dangerous.   “It’s not if you’re gonna get hurt; it’s when,” one parent is quoted.  As a pediatric sports medicine physician, I was bound to be hooked.

I was delighted to see the New Yorker author use the work of Dale Butterwick as one of his chief sources for the article’s epidemiologic data. Mr. Butterwick is a faculty member of the University of Calgary, Alberta, and has written extensively on injury patterns in rodeo.  Among his more important works is the CJSM 2011 study, “Rodeo Catastrophic Injuries and Registry:  Initial Retrospective and Prospective Report,” which reported on 20 years of data collected by the only, international registry for catastrophic injury in rodeo, which he maintains. Read more of this post

Breakfast at Wimbledon


2012 Olympics Men’s Tennis medalists. In 2014 Wimbledon, only Federer remains.

The 4th of July here in the States, where I live, has for me always gone hand in glove with something so very British….

I do not refer to the Revolution, to Washington and King George, to Yorktown……No, it’s Wimbledon that is on my mind!!!

Growing up in the late 70’s there were many, many “Fourths’ which I spent in front of the television, with a bowl of cereal, watching some tennis greats in either the semi-finals or finals of the tournament:  Borg, McEnroe, Evert, Navratilova, Connors, Vilas…..and later Becker, Graff, Seles, Wilander, Edberg…..When my friends and I would later go to the public courts to play in those holiday afternoons, we’d imitate the serve and volley style we had just watched, using the contemporary technology of wood or aluminum rackets!  What great memories!

On this holiday, with the men’s first semi-final already begun, I will be brief.  It’s time to get out those Froot Loops and find out if Djokovic and Federer will book their ticket to an epic men’s final; to see if youth will be served:  might Dmitrov or Raonic win it all?  For that matter, will Eugenie Bouchard or Milos Raonic bring home a Wimbledon trophy to Canada?

During the bathroom breaks on court, you may want to hone your own sports medicine tennis knowledge.  I’d encourage you to take a look at the excellent epidemiologic study on tennis injuries treated in U.S. emergency departments, written by a group including the senior author, a frequent contributor to CJSM, and my colleague at Nationwide Children’s Hospital, Dr. Gary A. Smith.  Or you may want to catch up on our most recent podcast, a conversation with Dr. William Meehan on the relative safety of Chiari malformations in athletes.  And by all means, take a peek at the July 2014 issue of the journal, with the headlining article on cardiovascular screening practices of U.S. team physicians.

If you reside in the USA:  happy Independence Day.  And for all our other friends and colleagues around the globe, may you have a safe, active, and happy weekend.  Enjoy Wimbledon, enjoy the World Cup, and enjoy your own sporting activity!

Snow Worries: Sochi Olympics, Second Week


Winter in Sochi 🙂

I was reading the Washington Post the other day, and came across an article with a clever title:  “At Sochi Olympics, Finding Risk is Snow Problem.”

It took your less than clever blogger here a moment to get that…….

Now that I do, I’m modifying the word play for this post’s title.

But the story under the headline I ‘got’ right away.  The Post reporter was arguing that the Sochi snow (quality and quantity) was a danger to competitors, and was possibly increasing the incidence and severity of injuries seen this Olympics.

Like most of you, I have followed the Sochi Olympics with great interest.  The sport is central to my enjoyment; but I also am intoxicated by the scenes of the beautiful Caucasus mountains set so close to a warm, subtropical coastline.  I don’t know if any other Winter Games have been hosted in a city with palm trees.

So, the snow:  so central to a Winter Olympics.  Is it a problem?  We can wait to tally up IOC medical charts, but you can also weigh in with your opinion on our poll below!

And if you’re especially enterprising–and you’re collecting data on this or other epidemiologic issues central to the Sochi Olympics–by all means submit a manuscript to the journal!  We frequently publish studies looking at the Olympics or the effect of sporting surface on injury rates.  We’d love to hear from clinicians/researchers/epidemiologists who have written up their studies and are looking for a quality journal to review their work.

Until then:  take the poll!

*poll can also be found on the journal’s main website

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