The Most Dangerous Sport in the World?

December 6, 2014 by

Bull_Tamer

A Bull Tamer in Australian Rodeo Event. Photo: Amcilrick

TheByrdsSweetheartoftheRodeo

“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

Filed under Epidemiology, General Interest, Youth Sport Tagged with , , , , ,

In honour of the Grey Cup

November 30, 2014 by

Series 975 - Primary photographs of Gilbert A. Milne & Co. Ltd.

Celebrating with the Grey Cup

The Grey Cup, the ‘Super Bowl’ of the Canadian Football League, is being contested this evening in Vancouver. The Hamilton Tiger-Cats face off against the Calgary Stampeders, and it promises to be an exciting contest.

We are proud of the diverse background of our many contributors to this peer-reviewed journal, who range from academics to clinicians who are ‘in the trenches.’ One of those on the front-lines is David Levy, M.D., the Medical Director for those Hamilton Tiger-Cats.

His piece from the 2012 CJSM, on a ‘risk-tolerance approach’ to assessing athletes undergoing a pre-participation evaluation (PPE), is always worth a read; perhaps never more so than in light of our most recent CJSM piece on advancing the PPE.  While you’re at it, catch our podcast conversation with William Roberts, lead author of that new PPE statement.

And then sit down to enjoy the Canadian football action.  Good luck to Dr. Levy’s Tiger-Cats, and good luck to their opponents, the Stampeders, as well.

Chris Hughes's avatarClinical Journal of Sport Medicine Blog

This month’s Editorial in CJSM by Levy and Delaney highlights the issue of the role of the Team Physician in the process of the Preparticipation evaluation.

Team Doctors are often called upon to make a decision about the suitability of an individual for return to play. In this role, the burden of responsibility for the decision making process is likely to lie with the clinician, at least in the first instance, whether or not the team manager and the player decide to follow their advice.

Few would argue that the clinician is best placed to make a definitive ‘medical’ decision on return to play decisions since they are likely to have the most educated opinion about decisions related to the health of the player within the team environment. However, the question of where the responsibility should lie with the ultimate decision made is a contentious one.

In the context of…

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Filed under General Interest, Preparticipation Evaluation and Screening Tagged with , ,

Revisiting Bicycle Helmets: Injury Prevention for Kids and More

November 16, 2014 by 1 Comment

A year ago I wrote the blog post below, which I am re-posting today.  I wrote the post to coincide with the publication in the November 2013 CJSM of the Canadian Academy of Sports and Exercise Medicine (CASEM) position statement on mandated bicycle helmet use in Canada.

I was reminded of the statement–and the blog post–today as I came across an article posted on the Facebook page of CASEM related to a recent study published in the New England Journal of Medicine looking at the the causes of head injuries in children.  For those under high school age, falls–including those from bicycles–are an exceedingly common cause of head injury.  One striking statistic from the study, quoted in the article:  for children presenting to the ED with a head injury resulting from a bicycle accident, only 18% were wearing a helmet.

The post I wrote last year generated more responses I think than any other post I have written on this blog, and it warranted several follow up posts .  I was struck by the passion–and quite often, vitriol–of many people writing in.  It wasn’t my first introduction to troll-like behavior on social media, but it was possibly the loudest and most ‘international’ I have experienced to date.

I hope you have a chance to look at the articles contained in the links on this post and the ‘reblog’ below.  I think the approach to injury prevention, specifically relating to bikes and most specifically relating to ‘kids on bikes,’ should be multifactorial:  yes to improved road safety, yes to a different relationship between cars and bikes, yes to a built environment that is more accommodating to bikes and pedestrians–but yes as well to personal protective equipment, like helmets.

As ever, we are interested in your thoughts.  But I say with the utmost politeness:  please note that any post that I find does not contribute to a civilized discussion will not be posted on the discussion board.

All the best.

sportingjim's avatarClinical Journal of Sport Medicine Blog

The November issue of CJSM has been out for a week, and I hope you’ve had a chance to look at our latest offering.  It is also our last offering for 2013 (CJSM is a bimonthly, publishing 6 times a year).  The next time the journal will hit your mailboxes and inboxes will be January 2014.

FIMS 2014 Quebec City, site of the XXXIII FIMS
World Congress of Sports Medicine
CJSM will be there: will you?

2014 promises to be a big year in sports and sports medicine.  The Winter Olympics take place in Sochi, Russia; the FIFA World Cup is in Brazil; and the Commonwealth Games are in Glasgow, Scotland.   On the sports medicine front, the Canadian Academy of Sports and Exercise Medicine (CASEM) hosts the FIMS 2014 World Congress of Sports Medicine in Quebec City, and earlier in the spring the AMSSM annual meeting takes place in…

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Filed under General Interest, Injury Prevention, Public Health in Sports and Exercise Medicine Tagged with , ,

A special day: November 11

November 11, 2014 by

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Poppies in Flanders’ Fields, photo Jean-Paul Grandmont

Veteran’s Day, or Remembrance Day as I understand my friends overseas call this day, is observed today, November 11.  In the United States, it is a time to remember the military service of so many men and women.  It happens on this day for a reason, of course: World War I, which began 100 years ago this year, ended with an armistice that went into effect at 11 a.m. on 11/11, 1918  (hence, yet one more term by which this special day is known:  Armistice Day).

On this day, I think of many men in my family who gave years of their life in this service.  It is a tradition I suspect many of this blog’s readers share, remembering their own relatives in the military.  In my own family my Uncle Ted, my godfather, was an Army Air Corps pilot in World War II (WWII).  After being shot down over enemy lines, he spent years as a POW in a German camp known as Stalag Luft I. If you want to read a story of true heroism, check out his. My father served for several years in the Air Force in the Korean War.  In fact, every single male member in his family served in the American military at some point.

Sports medicine’s attendant issues, as serious as they may be, typically pale in comparison with the injuries the military service-men and -women face.  That said, there is significant overlap between the military and sports worlds, and there is a lot we sports medicine clinicians can learn from our colleagues in military health care.   Many of the premier figures in American sports medicine–Francis O’Connor, M.D,, for instance–are military officers, who do most of their research on active individuals in the military; so much of that work is directly translatable to athletes.  Dr. O’Connor is in fact a past president of this journal’s partner society, the American Medical Society for Sports Medicine (AMSSM).

Much of what guides how I treat primary anterior shoulder dislocations in late adolescent and young adult athletes comes from research out of the United States Military Academy.  In the pages of CJSM itself, we rather frequently publish studies which have used the military as research subjects.  The Incidence of Injury and Physical Performance Adaptations During Military Training is a great example of such a study, published in our May 2003 issue.

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Ted Williams, swearing into the Navy, 1942.

And then, of course, there are the multiple well-known examples of athletes who have led parallel lives as soldiers, or sailors or pilots. The great baseball slugger Ted Williams served two tours of duty as a Marine Corps pilot, in WWII and the Korean War. It is arguable that Teddy Ball Game may have had a chance at being the career home run king in Major League Baseball if he had not ‘lost’ nearly five years to the military.  And the inspiring story of Louis Zamperini, WWII POW and 1936 Olympian, is told in  the movie “Unbroken,” to be released at Christmas.

Some of you may have the day off, and I hope it is restful for you.  Some of you, including myself, will be working.  I hope we all pause to remember the service-men and -women in our lives.  I hope, as well, we all pause to consider how we may work for peace in our world. One hundred years ago this year, “The War to end all Wars” began:  the promise in that epithet surely has not been fulfilled.

All the best–and peace.

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