Making a Good Thing Better — The Healthy Sport Index & Youth Sports

I have the great privilege of taking care of many outstanding young athletes in my sports medicine clinics

Youth sports is of special interest to me — I practice pediatric sports medicine at Nationwide Children’s Hospital, and perhaps 90% or more of the patients I see regularly participate in youth sports.

The topic is of great interest to this journal as well:  for example, CJSM will publish later this year a themed issue on topics in youth sports medicine, guest edited by my friend and colleague, pediatrician Alison Brooks M.D. of the American Medical Society for Sports Medicine (AMSSM).

Youth sports has long been recognized as a valuable activity for the individuals and families who choose to participate.  An abundance of evidence points to the health benefits — physical, mental, academic — that can be achieved by children and adolescents engaging in sports.

There has been growing concern over the last decade or two (or three), however, of the potential and possibly growing risks of youth sports.  The concerns range from early youth sports specialization and overuse injuries to early professionalism. The concerns include the youth sports culture itself – a culture manifest in nightmare form by the myriad incidents of abuse seen in USA Gymnastics or Swimming.

On April 12 2019, the AMSSM will be hosting a pre-conference prior to their annual meeting, entitled the Youth Early Sports Specialization Summit (YESSS!)   Among many of the subjects up for discussion is the “Healthy Sport Index (HSI),” an instrument developed by the Aspen Institute’s Project Play initiative and made public in October 2018. The HSI was designed to help kids and families answer the important question:  what sport is right for my child?  As a physician caring for thousands of these athletes a year, I can’t tell you how often I’m posed that question.  Now there is a tool to help.

One of the physicians who served on the Advisory Group for the development of the HSI was Michele LaBotz, M.D. She is a pediatrician and sports medicine physician in a large multi-specialty group in southern Maine, who serves on the American Academy of Pediatrics’ Council on Sports Medicine and Fitness (COSMF) and is a member of the AMSSM.  She kindly volunteered to give an overview on the HSI for the CJSM blog, and we’re delighted we can share her thoughts in the run up to YESSS!

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HEALTHY SPORT INDEX:  A UNIQUE TOOL FOR YOUTH SPORTS

Michele LaBotz MD FAAP

As health care providers, we rightfully emphasize safety and injury risk when discussing sport participation in young athletes.  We recognize the potential risks of sports that are contact vs. non-contact, or those that are high impact vs. low impact.   But, sport selection and participation is about more than just injury risk, and there is under-recognition that different sports exert a variety of influences on young athletes.  The Healthy Sport Index (HSI) presents this information in an appealing format and is a valuable resource for families and other stakeholders when considering sport-related issues in children and adolescents

HSI aggregates evidence-based data on physical activity, psychosocial effects, and safety on the 10 most popular high school sports for boys and girls in the U.S. Read more of this post

CJSM Podcast: Dr. David Howell looks at pediatric concussions

One of the top young guns in the world of pediatric sports medicine research is David Howell, PhD, ATC of Children’s Hospital Colorado, and the University of Colorado School of Medicine.  Dr. Howell has graced the pages of the CJSM blog before and, even more notably, the pages of the journal itself many times.  He has been one of CJSM’s more prolific authors over the last few years.

When we recently published several of his articles within a span of months, I knew it was time to reach out and get him on the podcast.

Listeners will not be disappointed — Dr. Howell is as erudite and lucid a speaker as he is a writer.  Together in this, our newest podcast, he and I discuss “Breaking research developments in pediatric and adolescent concussions.”  We were able to focus on three of his most recent studies published in CJSM:

Dr. Howell’s work continues to fill a significant research gap noted by the Berlin consensus statement on concussion group — the relative lack of evidence for how to diagnose and manage concussions in the under 13 year old crowd.  Not surprisingly, several of these new CJSM studies have received a lot of buzz, most especially the first study in that litany (on Concussion symptom profiles).  As someone who sees concussions in this age group on a nearly daily basis, I have found the results of this published research to be, already, of significant practical use.  The Altmetrics on the paper underscore the importance of the work.

This newest podcast can be found with all of our podcasts here on the CJSM website and here on iTunes  And don’t forget you can subscribe to our podcasts on iTunes so you never miss one.

Thank you, again, Dr. Howell for the continued work you do in the field of sport medicine at large, and in the area of pediatric sport-related concussion in particular.

CJSM Blog Journal Club — NMT to prevent ankle sprains in youth soccer and basketball athletes

Our Jr. Assoc Editor Dr Zaremski — already awarded an AMSSM Travelling Fellowship. Is there something bigger in his future?

It’s July, and our fourth edition of 2018 has just published.  One of the headlining pieces of original research we have in this edition is new work from the Sport Injury Prevention Centre in Calgary, Alberta Canada (chaired by Caroline Emery, the well-known researcher and author): Prevention of Ankle Sprain Injuries in Youth Soccer Cland Basketball: Effectiveness of a Neuromuscular Training Program

Our Jr. Assoc. Editor Jason L Zaremski, MD  is today reprising his role as guest author for the CJSM blog journal club  and will take us through his read of the study.  Join in the conversation over this important new, original research by reading the article, the journal club post below, and sharing your thoughts in the ‘reply’ section below this post, or on Twitter at @cjsmonline 

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Clinical Journal of Sport Medicine Blog Journal Club

Jason L Zaremski, MD, CAQSM, FACSM, FAAPMR

Title: Owoeye OBA, Palacios-Derflingher LM, Emery CA. Prevention of Ankle Sprain Injuries in Youth Soccer and Basketball: Effectiveness of a Neuromuscular Training Program and Examining Risk Factors.

Introduction:  The summer Journal Club commentary for the Clinical Journal of Sports Medicine will be an analysis of the new research examining the effects of injury reduction of ankle sprains in soccer and basketball using neuromuscular training (NMT) program in youth athletes. The secondary objective of this study included the evaluation of risk factors for Ankle Sprain Injury (ASI).

Methods:  This study was a secondary data analysis from 3 cohort studies and 2 randomized control trials (RCTs) over the course of 1 season of player in soccer and basketball from 2005-2011. There were a total of 2265 patients aged 11-18 years that play soccer and basketball in Alberta, Canada. Player characteristics (sex, age, weight, height, BMI, sport exposure time, previous ASI, previous lower extremity injury with and without ASI) were divided based upon if a player participated in a NMT program or did not. Frequency between all variables was very similar except for No NMT between females (n=952) and males (n=439) and sport participation without exposure to NMT (soccer = 965, basketball = 426). Average age, weight, height, and BMI were all similar. Exposure time for the NMT group was 72.56 (70.98-74.15) hours versus 62.92 (61.48-64.37) hours for No NMT group.

Secondary Data Analysis Studies: Read more of this post

CJSM Blog Journal Club — is Low-intensity Pulsed Ultrasound an Effective Treatment in Spondylolysis?

Spondylolysis in the adolescent athlete — what to do?

Symptomatic isthmic spondylolysis in the adolescent athlete — for many of us in the world of primary care sports medicine who have a large pediatric/adolescent patient base, this is one of the more common clinical entities we treat.

I’ve written previously about some of the controversies surrounding this condition, and I have had the pleasure of seeing some of the spondylolysis research I’ve conducted published in the pages of CJSM.

Recently published “On Line first” in CJSM is research coming from a Japanese center renowned for its work in this area:  Low-intensity Pulsed Ultrasound (LIPUS)for Early-stage Lumbar Spondylolysis in Young Athletes.

I’m delighted to introduce again our Junior Associate Editor, Jason Zaremski, M.D., who is pioneering our on-line CJSM journal club.  He’ll take us through this new study and help us decide:  LIPUS — should we be using it in our clinical practice when treating an adolescent-athlete with early-stage, or ‘acute,’ isthmic spondylolysis?

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Clinical Journal of Sports Medicine

Online Journal Club

Jason Zaremski, M.D.

Jason L Zaremski, MD, CAQSM, FACSM, FAAPMR

Title: Tsukada M, Takiuchi T, and Watanabe K. Low-Intensity Pulsed Ultrasound for Early-Stage Lumbar Spondylolysis in Young Athletes. Clin J Sport Med. Published Ahead of Print October 10, 2017. doi: 10.1097/JSM.0000000000000531.

Introduction:

The spring Journal Club commentary for the Clinical Journal of Sports Medicine will be a review of new research examining the effects of pulsed ultrasound for early-stage lumbar spondylolysis in young athletes. This is a retrospective case control therapeutic study with level three evidence. The specific aims of the study were 1) to determine differences in median time to return to previous sports activity with and without the use of low intensity pulses ultrasound (LIPUS); and 2) to determine if healing rates are improved with LIPUS. Read more of this post

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