The new issue and a podcast to boot

jsm-podcast-bg-12016 is coming to a close, and that’s really hard for me to believe.  November brings with it our last issue of the year, and it is a good one……a good way to close out a memorable year.

Our highlighted Critical Review article this month concerns the subject of risk factors for lower extremity injury among high school athletes.  The lead author is James (Jimmy) Onate, PhD, ATC, FANA, from the Ohio State University.

The Buckeyes publish frequently in our pages — co-authors on this paper include former ACSM president Tom Best and current OSU Head Team Physician Jim Borchers, both of who are well-represented in the pages of CJSM.  Jimmy Onate is another in that lineage of great clinician-researchers.

Jimmy Onate, PhD, ATC

Jimmy Onate, PhD, ATC

I had an enjoyable conversation with Jimmy on the pros/cons of using the pre-participation evaluation (PPE) as a potential tool for screening high school athletes for risk of lower extremity injury.  I hope you enjoy it as much as I did.

The iTunes link for the podcast is here.

ECG for the PPE? A conversation with Dr. Jonathan Drezner

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Dr. Jonathan Drezner in South Africa. Photo courtesy Alison Brooks.

Highlighting the just-published issue of CJSM is the new American Medical Society for Sports Medicine (AMSSM) position statement on cardiovascular preparticipation screening in young athletes.  The position statement is an invaluable contribution to the ongoing discussion over the pros and cons of adding the ECG to the preparticipation evaluation/examination (PPE) to prevent sudden cardiac death/arrest (SCD/SCA).

Those familiar with this debate will be familiar as well with the lead author of the statement, Dr. Jonathan Drezner. Dr. Drezner is a Professor in the Department of Family Medicine at the University of Washington and a team physician for the Seattle Seahawks of the NFL.  Dr. Drezner has published frequently in our pages, most often on the subjects of the PPE and screening for SCD/SCA.

The debate over the role of ECG in the PPE is one of the more contentious in sports medicine.  We look forward to seeing how the AMSSM statement will contribute to the direction that debate will take.  jsm-podcast-bg-1

You can gain added perspective on the statement and the controversy by listening to our newest podcast — a conversation with Dr. Drezner himself.  You can access the podcast both on iTunes and you can find it on our CJSM website as well.

Enjoy the discussion, and be sure to check out the statement itself, freely available in the 2016 September CJSM.

 

Boxing in the Olympics

 

Rio de Janeiro - Robson Conceição derrotou na tarde deste domingo o cubano Lázaro Álvarez e vai a final do boxe categoria peso ligeiro. (Fernando Frazão/Agência Brasil)

The new look to Olympic Men’s Boxing  (photo: Fernando Frazão/Agência Brasil)

With summer holidays and work, I will be honest — I have not been watching too much of the Olympics on the television.  I have made a point to watch Michael Phelps’ last (possibly?) Olympic swim and Usain Bolt’s historic 100m gold medal performance.  I am a former track and field athlete myself, and so I also have witnessed Jamaica’s Elaine Thompson win the women’s 100m and South Africa’s Wade van Niekerk set the 400m world record.  I catch up on news in the newspaper when I wake up (for instance, the story of Anna Sofia Botha is possibly the most heartwarming of these Games).  But watching live TV?  Not so much.

Between the track events, I have caught some of the men’s boxing and I, like possibly many of you CJSM blog readers, have been struck by the absence of head protection.  Our world of sports medicine is big, and I’ll confess I had not been aware of the rules changes going into these Olympics regarding the non-use of this protective equipment for men’s boxing:  since the 1984 Los Angeles Olympics, mandatory headgear has been in place for boxers until now, in Rio.

There has been some controversy over this issue — both when it was introduced as a safety measure, and now in 2016 when it has been removed, also for stated safety reasons:  the incidence of concussions is expected to decline without the headgear in place.  The International Boxing Association (AIBA) made this rule change since the Beijing Olympics, and International Olympic Committee (IOC) spokesman Mark Adams is quoted as saying, “AIBA provided medical and technical data that showed the number of concussions is lower without headgear. They have done a lot of research in the last three years. The rule will go ahead for Rio.”

Some of that research has been published in our journal, including this cross-sectional observational study on the use of head guards in AIBA boxing tournaments.   The results of this study show that referees had to stop matches for head injuries more often when boxers were wearing head gear than when they weren’t.  At the end of the day, after integrating all the available current evidence, it was understood that the headgear was not sufficiently protective to prevent concussions (no surprise there: the holy grail of contact sports may be effective, ‘concussion proof’ head protection), and, instead, promoted more frequent hits to the head — a good example of ‘risk compensation’ in injury prevention.

The CJSM study, authored by a group including lead author Michael Loosemore and senior author Julian Bailes, has already generated a fair amount of debate on social media and commentary in the media, including the New York Times.  We have been receiving a fair number of ‘letters to the editor’ regarding the study since these Olympics have begun, and we will be publishing both the letters and the authors’ responses soon.  A robust debate looking at the evidence, and pointing toward where research must head to resolve this issue — that is a ‘contest’ that will extend beyond Rio and into Tokyo, site of the 2020 summer games.  Stay tuned to the blog and to CJSM to stay abreast of this issue.

CJSM Podcast 15 — Dr. Lyle Micheli on ACL Injuries in Young Athletes

jsm-podcast-bg-1Today we have as our guest on the podcast Dr. Lyle Micheli, the Director of Sports Medicine at Boston Children’s Hospital and Clinical Professor of Orthopaedic Surgery, Harvard Medical School.

Dr. Micheli is one of the godfathers of sports medicine, with a career that began in the sixties and shows no signs of slowing down.  He still outworks almost any other physician I know, and still performs high volumes of surgical procedures, including ACL reconstructions, the subject of this podcast.

He also finds the time to have published innumerable manuscripts, and CJSM has been the recipient of many of his excellent studies.

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L to R: Myself; Dr. Lyle Micheli, Dr. Pierre d’Hemecourt (Boston Children’s), Dr. Jeff Vaughn (Phoenix Children’s)

The focus of the podcast is on a study just published in our July 2016 CJSM, Return to Sport after Anterior Cruciate Ligament Reconstruction in the Skeletally Immature Athlete.  We had the chance to discuss how ACL injury management in the young athlete has changed over the course of his career, and we got to explore with Dr. Micheli the radical new direction in which ACL injury treatment may be headed:  with repair, as opposed to reconstruction — the Bridge-enhanced ACL Repair (BEAR) trial is a hot topic in the world of orthopaedic sports medicine.

You can access the podcast at iTunes (where you can also subscribe to all our podcasts for free) or on our journal’s main website. And the study on CJSM is free. Let us know what you think!