What is the association between suicide risk and a history of playing high school football? The CJSM Podcast.

November 2, 2021 by

The concern over the potential long-term negative consequences of playing youth contact sports has grown over the last two decades.  The Clinical Journal of Sport Medicine — this blog and the CJSM podcasts as well — have been a vital forum for publishing the evidence regarding the relative safety of these sports exposures.

The impact of ACL ruptures and other musculoskeletal injuries — with long-term risks of osteoarthritis — give me pause as a pediatric sports medicine physician, but it is the long-term risk of concussions that generate the most concern among my colleagues, parents, and the public at large.  Will my child get CTE like Junior Seau?

In the United States especially, this concern over long-term risk gets wrapped up with medicolegal concerns, resulting in clickable stories such as this: “WIll Injured Kids Sue the Catholic Church Over Youth Football?” It is easy and understandable that fear may soon outrun the current evidence.

The science underpinning such concerns has grown in parallel with the awareness of the safety issues themselves, and in today’s podcast (and in the November 2021 CJSM) we examine a new study investigating the potential association of exposure to football as a high schooler and long-term suicidality risk.

Senior author Dr. Douglas Terry of Vanderbilt University joins us today to report on his team’s findings in their new publication: Playing High School Football is Not Associated with Increased Risk For Suicidality in Early Adulthood.

The principal finding of the study is right there, in the title; as Dr. Terry and I joked on the podcast, the authors definitely did not bury the lede on this manuscript.  They found no association with playing high school football earlier in life and an increased risk of suicidality in early adulthood.  A valuable contribution to the growing literature, indeed.

Mental health in athletes, including concern for suicide, and the long term effects of concussions are among the most pressing issues in sports medicine.  We think you will find a listen to this podcast and a read of the study itself to be invaluable resources to you as engage with these same issues.

Filed under CJSM Podcasts, Concussion in Sport, General Interest, Mental Health in Sport Tagged with

AMSSM Mental Health Position Statement — The CJSM Podcast

February 14, 2020 by 1 Comment

Not often one gets to hang out with TWO past AMSSM presidents. R to L: Cindy Chang M.D. and Margot Putukian M.D.

CJSM has just published a new position statement (and executive summary) from the American Medical Society for Sports Medicine (AMSSM): Mental Health Issues and Psychological Factors in Athletes: Detection, Management, Effect on Performance, and Prevention.

These publications are fruits of a project several years in the making and requiring the labor of several individuals.  The co-chairs of the committee charged to do this work, and the two co-lead authors of the CJSM manuscript, are Cindy Chang M.D. and Margot Putukian M.D.

Drs. Chang and Putukian are, as many of the readers of the blog and listeners of the podcast know, past presidents of the AMSSM. The group they headed has produced an outstanding resource on a topical subject: the mental health of the athletes we treat.

I have always been happy to count Drs. Chang and Putukian, Cindy and Margot, as friends as well as esteemed colleagues.  Moreover, for anyone who knows them personally, it will not come as a surprise that the two have known each other for a long time and share a particularly close bond.

And so it made for a lively conversation to have them both as guests on the podcast so that they could discuss this new position statement.  It’s not often I have two guests to chat up — come to think of it, the last time that happened Dr. Chang teamed up with yet another past-president of the AMSSM, Matt Gammons.

Read the position statement and the executive summary, and find the podcast on our journal website or in our iTunes library.  And if you are heading to Atlanta in April for AMSSM’s 29th annual meeting, we’ll see you all there.

 

Filed under CJSM Podcasts, Mental Health in Sport Tagged with

What to do about heading?

November 1, 2019 by 1 Comment

Heading the ball — photo courtesy of Wikimedia

I have been meaning to write a blog post for over a week, since a bit of breaking sports medicine news occurred with the publication of some research in the New England Journal of Medicine (NEJM).

It took a Tweet this morning to rouse me to action.  I promise it hasn’t been sloth on my part that has slowed my hand, but pleading “I’m busy” to the group of folks who usually will be reading CJSM media is not going to gain much sympathy.

And yes, with fall sports, I sure have been busy.  But I am sure you have too.

I hope, however, not too busy to have missed this piece of research from NEJM: “Neurodegenerative Disease Mortality Among Former Professional Soccer Players.”  There was an accompanying editorial to this study, a piece that is most definitely worth a read too. “Soccer and Mortality — Good News and Bad News”

The published research was a large retrospective cohort study looking at former professional Scottish football (soccer) players: 7676 cases were identified from databases of Scottish football players and 23,028 controls (3:1) from the ‘general population’ were identified using a Scottish ‘Community Health Index.’ Controls were matched to players on the basis of sex, age, and degree of social deprivation.  Of note, all the participants in this study were male.The researchers looked at two dependent outcome variables:  i) cause of death as noted on death certificates and ii) dispensed medications, information for which was obtained from the Scottish national Prescribing Information System.  Follow up information for study participants was for a median of 18 years (for each individual, “Age was used as the time covariate, with follow-up from age 40 years to the date of data censoring, which was either the date of death or the end of the follow up (December 31, 2016), whichever occurred first).”

The researchers report several important findings in this study, to note just a few:

Read more of this post

Filed under Concussion in Sport, Evidence-based Medicine in SEM, Injury Prevention, Mental Health in Sport, Public Health in Sports and Exercise Medicine, Youth Sport Tagged with

Summer Reading

July 10, 2019 by 1 Comment

What are you reading this summer?

Summer can be a time when the pace of work and life slow just a bit, affording us a chance to pick up that book we’ve had sitting on our nightstand or follow through on someone’s suggestion for a ‘must read.’

I have a vacation coming up, during which time I plan to catch up a bit on my pleasure reading. The titles in that reading list are not particularly relevant to our world of sports medicine.  However, I did find the time this past week to read a book I have been ‘meaning to’ for a while, and it’s one I would certainly recommend to all my colleagues in the world of sports medicine.

It is:  “What Made Maddy Run”. 

I found myself engaging with this book on so many levels — as a human being (mental health issues can affect us all), as a former Ivy League athlete, as a consumer and producer of social media, as a father of teenage athletes, and yes, as a sports medicine clinician.  It was a powerful read, a ‘page turner’ — one that has left me thinking long after I turned the last page, the hallmark of a good book, I think.

Madison (Maddy) Holleran was a high level track runner attending Penn, one of her dream schools, as a freshman.  She came from a supporting, loving family, and was endowed with so many gifts. She was the person who ‘had it all.’ Her social media favorite — Instagram — provided the visuals and narrative confirming that.

But.

But, Maddy struggled with anxiety and depression, and she took her life early in the second semester of her first year at university, leaving so many people mourning the loss and full of questions.

The author Kate Fagan stepped into this story and has written such an insightful book on the nexus of youth sports, mental health, and social media.  Ms. Fagan herself is a former NCAA athlete who poignantly discusses her own struggles with mental health in this book.  Indeed, the story is first and foremost’s Maddy’s; but we come to know the struggles of two athletes as we read this book: the author’s and the subject’s. Read more of this post

Filed under Elite sport, Mental Health in Sport, Women in Sport, Youth Sport

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