The Hits Keep Coming

May 25, 2013 by 1 Comment

I hope this blog’s readers are enjoying their Memorial Day weekend if they’re in the U.S., or their Spring Bank Holiday weekend if in the U.K.   And if I’m unaware that there is another three-day weekend being celebrated out there, please forgive my myopia.  I do believe it was last weekend that my friends in Canada were enjoying the Victoria’s Day weekend, but this week brings a standard two days off.  However, if I have confused my holidays, again, I submit my humble apologies!

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Wembley Stadium, London. Site of 2013 Champions League Final.

I suspect a lot of you are watching the all-German Champions League final right now, or perhaps you’re napping and waiting for the start of the French Open tomorrow. Maybe it’s the Indy 500 on Monday you’re waiting for…..or, speaking of Indy, you’re hoping for another Pacers upset of the Heat in the NBA playoffs. Regardless, here’s to a great sporting weekend!

I wanted to look at an interesting article from the most recent edition of CJSM in this weekend’s blog post…..which I learned today is something quite different from a blog.  Apparently there is a blogger posting at Slate about his irritation over the misuses of the word ‘blog’ and the phrase ‘blog post.’  It turns out that right now you are visiting the CJSM ‘blog’ but are reading a ‘blog post’ entitled, “The Hits Keep Coming.”  Please do pass this “blog post” on to your friends, and recommend they visit our “blog,” but do not mix up your phrasing or the Slate editor might make you a focus of one of his future rants.

I suspect his irritation might resemble mine, or some of this blog’s (???) readers, when folks mix up ‘incidence’ and ‘prevalence,’ so I want to grant that his irritation may be righteous and I will try my level best as I work on my posts to use correct blog terminology!

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The Rocky Mountains: it’s hard to plug one’s ears to their siren’s call.

On to the article of the weekend: “Epidemiology of U.S. High School Sports-Related Ligamentous Ankle Injuries, 2005/06 – 2010/11,” written by a group including my friends R. Dawn Comstock, PhD.,  the senior author, and Christy Collins, MA., the corresponding author.  This team has been prolific in their publication of sports medicine epidemiology articles, drawing much of their work from the high school injury surveillance project, “Reporting Information on Line” (RIO): “….an internet-based surveillance software developed under the direction of Dr. Dawn Comstock.”  I had the privilege of working with Dawn at my home base, Nationwide Children’s Hospital until recently, when the lure of the Rocky Mountains drew her to the University of Colorado, Denver.

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Filed under Epidemiology, Evidence-based Medicine in SEM, General Interest, Women in Sport, Youth Sport Tagged with

Spondylolysis Part II: Imaging and Radiation Safety

May 21, 2013 by 7 Comments

I’ve wanted to return to the issue I wrote about in a blog post a week ago, “Spondylolysis:  Issues of Incidence and Imaging, Part I.”   In that post and this one, I have been primarily looking at a provocative new study published in the Journal of Pediatric Orthopaedics, “Imaging Modalities for Low Back Pain in Children:  a Review of Spondylolysis and Undiagnosed Mechanical Back pain.”

spectSingle Photon Emission Computerized Tomography, or SPECT scans, like the image to the left showing bilateral L5 spondylolyses, are highly sensitive for detecting spondylolysis but expose the patient to radiation.  This is something I have known, of course, since training.  In my current practice at Nationwide Children’s Hospital Division of Sports Medicine I and my group of fellow clinicians focus on youth athletes, and so we see large numbers of potential ‘spondys’ and, correspondingly, order a large number of diagnostic images.  In 2012 we saw 548 new patients whose chief complaint was back pain; we ordered 227 SPECT images for ‘back pain’  in that same year.

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Filed under Evidence-based Medicine in SEM, General Interest, Radiology in SEM Tagged with , ,

Risk Factors for Injury in Elite Youth Ice Hockey

May 14, 2013 by 1 Comment

I had planned today on writing a sequel to my weekend post on spondylolysis, and I will definitely do so later this week.  But I have hockey on my mind this morning.

Our local team, the Columbus Blue Jackets, fought valiantly this shortened NHL season, and came within a whisker of the playoffs.  The team I grew up with, the Detroit Red Wings, have moved on to the Conference semi-finals, and so if I have any skin left in the game, it is with the Wings.

But I was captivated last night, as I’m sure some of the blog’s readership was, with an extraordinary Game 7 between the Toronto Maple Leafs and the Boston Bruins which brought to mind Jim McKay’s famous line from the “Wide World of Sports”:  “the thrill of victory, and the agony of defeat.”

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Patrice Bergeron scored the goals at end of regulation and in OT to send Bruins to victory

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The Maple Leafs: deflated at the end of a heartbreaking game.

Somehow, the Maple Leafs went from leading 4-1 to losing 5-4 in overtime, as the Bruins, playing at home in Boston, achieved one of the more memorable comebacks in NHL playoff history.

As this was happening, my Twitter feed exploded with #bruins and #leafs posts, as two cities were collectively either shouting with joy or gnashing their teeth.  If you’ve never ‘watched’ a sporting event via Twitter, I commend the experience to you: it’s a bit like tapping into the collective consciousness of whatever group your following. Read more of this post

Filed under Elite sport, Epidemiology, Evidence-based Medicine in SEM, General Interest, Patient Outcome Measures, Psychology in Sport, Youth Sport Tagged with , ,

The Safety of Artificial Turf vs. Grass as a Sport Playing Surface

May 2, 2013 by 15 Comments

I was interviewed last week for a newspaper article which looked at the debate over a local school’s intention to transform a grass playing surface to artifical turf.

Among the controversies in sports medicine, the turf vs. grass wars are not the loudest nor the meanest, but they have been among the most persistent ever since 1966, when the Houston Astros first introduced a synthetic turf playing surface in the Astrodome, and dubbed it Astroturf.

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Reliant Astrodome

The history of the Astrodome makes for interesting reading:  of note, the original intention was for the surface to be natural grass, and the makers of the dome had installed traslucent skylights to allow for grass to grow on the indoor surface.  Alas, not enough light made it to the playing surface, the grass died, and Astroturf was born.

The progress of science and technology have seen Astroturf give way to newer, so-called second-, third-, and even fourth-generation turfs. The  sporting world has even demonstrated that an indoor venue can sustain a natural grass pitch: witness the luminous Forsyth Barr stadium  in Duenedin, NZ, which has hosted matches from the 2011 Rugby World Cup to a recent Aerosmith concert.

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Natural grass surface on Indoor Forsyth Barr Stadium, Dunedin, NZ

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Aerosmith, recent performers on the grass of Forsyth Barr Stadium

So, the question from the interviewer to me essentially reduces to,  ‘Grass:  if its good enough for Steven Tyler and Joe Perry, is it good enough for all of us?’ Read more of this post

Filed under Epidemiology, Evidence-based Medicine in SEM, General Interest Tagged with , ,

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