Hello Dallas!

April 17, 2016 by 1 Comment

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Current president of the South African Sports Medicine Association (SASMA) Phathokuhle Zondi (L) & AMSSM member Alison Brooks enjoying Dallas

I’m in Dallas for the annual American Medical Society for Sports Medicine (AMSSM) scientific conference, and I would typically be sharing a photo of the town in this post.  There is the small problem of a veritable tsunami of rain doing its best to keep me indoors.

I have no complaints.

AMSSM is celebrating its 25th year, and it has every reason to pat itself on the back.  The conference it’s putting on right now (hashtag: #AMSSM16) is so well put together that I am quite happy I do not have a pleasant, sunny day tempting me to head outdoors.  I’d much rather be inside catching all the proceedings.

Among the especially interesting aspects of the conference are the research and case study abstracts being presented both in poster-form and as podium lectures.  Our on-line version of the March 2016 issue has these abstracts available and there is some very interesting sports medicine information to be found there.  I am actually presenting a case on spinal muscular atrophy in a high school runner later this afternoon, and I’ve been listening to some other very interesting talks all through the day.

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The AMSSM “Wall of Honor,” giving a shout out to so many of the members who have contributed to the organization’s success

The keynote talks are emphasizing the all-important value of collegiality in our profession, and I couldn’t agree more. Read more of this post

Filed under General Interest Tagged with ,

5 Questions with Dr. Jon Divine, AMSSM President

March 31, 2016 by

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Dr. Jon Divine, in action as Team Physician for the Univ. of Cincinnati Bearcats

March is wrapping up, and that means that the annual scientific meeting of the American Medical Society for Sports Medicine (AMSSM) is just around the corner.  That meeting has been an April highlight on our calendar for years — #AMSSM16 is taking place in Dallas, Texas April 15 – 20 .  We’ve had our tickets for months.

On a personal note, there is so much I am looking forward to — reuniting with AMSSM colleagues like Alison Brooks, Irfan Asif, Holly Benjamin and also seeing Phatho Zondi, current president of the South African Sports Medicine Association (SASMA), who is coming all the way from Pretoria, South Africa.  I’m looking forward to catching up, as well, with AMSSM past presidents — Jon Drezner, Chris Madden, Doug McKeag, Cindy Chang — as well the incoming president, Matt Gammons.

And there is AMSSM’s current president, whose tenure is over 95% complete and will be handing on the reins to Dr. Gammons.  That would be Jon Divine, M.D.,  Professor of Orthopedic Surgery and Medical Director of the University of Cincinnati athletics.

Preparatory to the AMSSM meeting, I thought it high time CJSM sat down and interviewed the president of our affiliated society, to get a sense of what this past year has meant to him and the organization.  And so I present to you:  5 Questions, with Dr. Jon Divine.

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  1. CJSM: We have to begin by asking you about your year as President of the AMSSM. What were your major challenges this year?  What were your high points?

JD: Thanks for giving me this opportunity to share my story with your readers. This year has gone by fast. I’m very proud of the work done by our Board. Under Chris Madden we generated our third organizational strategic plan, the road map our leadership utilizes to guide the working priorities of AMSSM, with a goal of completion in 5 yrs. As of now, we’re more than half way completed on the current plan. I half-jokingly mentioned to Kathy Dec and Chad Asplund this week that they will have to seriously consider developing the next strategic plan because the objectives for the organization spelled out in the current plan will be met ahead of schedule! As president, you could not be happier than when your team is skilled and willing to take on these tasks, do them very well, and complete them ahead of schedule.

Two other moments were very special for me. Read more of this post

Filed under General Interest Tagged with

A Sharapova Moment

March 11, 2016 by 1 Comment

The world of sports medicine is never boring, but who knew things could get this interesting?

In the first weeks of March, there have been at least two major stories that have transcended the borders of ‘sports medicine’ and become topics of debate for the world at large — I speak of the proposed ban on tackling in schoolboy rugby (and the continued debate on tackling in American football) and Maria Sharapova’s admission that she failed a drug test at the recent Australian Open.  For both stories, the boundaries of the discussion have gone well beyond the lines of the playing fields and the walls of the academy.

Social media has seen these topics trending. The mainstream media have been profiling the issues as well.  The Economist weighed in on the debate about tackling. And this morning I found the New York Times prominently featuring Ms. Sharapova’s story, including articles on the drug meldonium [for which Sharapova tested positive] and on the issue of the World Anti-doping Agency’s (WADA) use of emails to notify individuals about changes on WADA’s banned substance list.

Many people have an opinion on the subjects.   We’ve been running a poll on this blog regarding the issue of tackling, while our friends at the British Journal of Sports Medicine (BJSM) have been running a Twitter poll on the Sharapova issue: who is responsible, the player or her support staff [currently the poll is 74%/26% stating it’s the athlete’s responsibility].

In the New York Times article and in the BBC, former WADA-president Dick Pound has stated his opinion that Sharapova’s failed drug test was ‘reckless beyond description.’

I must say I take issue with this and empathize with Ms. Sharapova, who stated that she received in December the WADA email noting that meldonium was now on the banned substance list, but “…I did not look at that list.”  Meldonium was a PED legal until 2016, when it was placed on the ‘banned substances list.’ As a professional inundated with emails, alerts, pronouncements, and more, I confess to a certain degree of information overload even when it comes even to items vital to my licensure and ability to practice.  Have I ever received an email from the Medical Board that I have deleted?  Have I ever received notification from my hospital staff office of some new change in policy which I glossed over?  Yes and yes.

Regarding the WADA emails, other athletes in the NY Times article have offered this opinion: “Some dismissed the messages as irrelevant to their own regimens or too complicated to be useful.”  That certainly resonates with me and my professional world.

I am not writing this to absolve Ms. Sharapova, and I applaud her for her prompt and open admission of personal responsibility. That stance is right and proper.  But I would hardly deem her action “reckless beyond description.”

In CJSM we have published over the years several studies on banned substances. One of the pieces of original research just published in our March CJSM sheds some further light on this issue, I think: Dietary Supplements: Knowledge and Adverse Event Reporting Among American Medical Society for Sports Medicine Physicians.  Read more of this post

Filed under Doping in Sport, Drugs and Doping in Sport, Elite sport, Ethics and probity in SEM, Female Athletes, General Interest, Women in Sport Tagged with , ,

To Tackle or Not: That is the Question

March 4, 2016 by 3 Comments

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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.”]

The media response has been vigorous:  check out these stories from the BBC and the Guardian.  Opinions have come from players, parents and coaches as well as physicians  [the Royal College of Paediatrics and Child Health wrote a response to this proposal ] and sports scientists.

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.)

Filed under CJSM Polls, Concussion in Sport, General Interest, Injury Prevention Tagged with

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