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.

Concussions around the globe

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Brandenburg Gate, Berlin

How do you get from Bethesda, MD to San Francisco to Berlin all in a month, during the busiest time of your year?

I don’t know — but my good friend Christina Master does.

Dr. Chistina Master is an esteemed colleague from Children’s Hospital, Philadelphia (CHOP), whom I am privileged to see at some medical conferences we both frequent, including the American Medical Society for Sports Medicine (AMSSM) and Pediatric Research in Sports Medicine (PRISM) meetings.   She is an associate professor of clinical pediatrics at the Perelman School of Medicine at the University of Pennsylvania, a prolific researcher, and a busy clinician with a focus on pediatric sports medicine.

She is also an avid runner and, it seems, world traveler.  A definite ‘must follow’ on Twitter if you want to stay up to date on pediatric sports medicine (or just enjoy her many photos of the beautiful trails on which she runs, or the great dining spots she hits on her travels). #OnTheMove may be the hashtag that best describes her!

Not being able to attend any one of the three fantastic meetings she hit this October, I asked her to share with the CJSM readership her reflections on the current state of concussion understanding from around the globe.  What follows are her first hand reports from the proceedings of the National Institutes of Health (NIH) Pediatric Concussion Workshop (Bethesda), the American Academy of Pediatrics (AAP) Council on Sports Medicine & Fitness meeting (San Francisco), and the “Concussion in Sports Group” (Berlin)

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Dr. Christina Master (2nd from left) with some friends from CHOP

October is usually a busy month for concussions with all the fall sports in full swing. This October was also busy for concussions in a different way, with three important meetings focusing on the topic.  In mid October, the NIH convened a Pediatric Concussion Workshop, gathering an interdisciplinary group of researchers, clinicians and stakeholders together in Bethesda, MD to discuss the current state of the evidence in our understanding of pediatric concussion, particularly in those younger than high school.  It was an honor to present along with Bill Meehan and Kevin Guskiewicz among other experts at this workshop.  Topics addressed included Read more of this post

Dreams of South Africa

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With Wayne Viljoen (@BokSmart), one of the authors of new rugby research in CJSM

It was just a year ago that I was preparing to travel to South Africa on an American Medical Society for Sports Medicine (AMSSM) Travelling Fellowship — dreams of Cape Town and safaris danced in my mind [see post reblogged below].

I haven’t stopped dreaming of South Africa. Should I ever have a mental lapse and not think of the Rainbow Nation for a day or two, I have only to turn to my Twitter feed or my medical journals to be reminded — the country punches well above its weight in both sports and sports medicine. I enjoy reading of the exploits of current South African Sports Medicine Association (SASMA) President Phathokuhle Zondi as she takes care of Paralympic athletes in Rio, for instance — she is a definite follow on Twitter….

And I most certainly enjoyed reading some recent rugby research just published in our September 2016 CJSM: Incidence and Factors Associated With Concussion Injuries at the 2011 to 2014 South African Rugby Union Youth Week Tournaments.  It was a delight to read this epidemiological study, whose authors include good friends Sharief Hendricks, Clint Redhead, and Wayne Viljoen — researchers all of whom most definitely have made their mark internationally.

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Partying with Sharief Hendricks (@Sharief_H), author of new rugby research in CJSM, in Johannesburg

In the authors’ words, the “….study provides the first published incidence of concussion, per player-match-hours, in South African youth rugby union and falls well within what was previously published elsewhere for youth rugby.”  They found the incidence of concussion in youth rugby to be 6.8/1000 player match-hours.  Importantly, and what for me was new information, was that under-13s and under-16s had higher incidence rates than under-18s.  The younger kids were at greater risk for concussion.  This may have important implications for rules and policy making in youth rugby.

For anyone with an interest in rugby, or South African sports and sports medicine, the study, in our newest edition of CJSM, is a definite read.  And it’s never too early to start dreaming of the 2017 SASMA biennial congress, which will take place in Cape Town 2017.  To stay ‘in the know’ for the timing and details of that pre-eminent conference, follow President Phathokuhle Zondi and SASMA itself on Twitter.

sportingjim's avatarClinical Journal of Sport Medicine Blog

IMG_1630Every so often, sports takes a back seat to other world events. So too for sports medicine.

We all know this, whether in our personal lives or in our interactions with the world at large.  There is the NFL player who is torn between performance on Sunday and ‘being there’ for his young daughter with leukemia.  There are cases where the athlete him- or herself is felled with illness–think of Lou Gehrig and amyotrophic sclerosis.  The issues of who won the last game, the intricacies of a salary negotiation, or the season missed from a knee injury pale in comparison with such ‘real world’ contingencies.

In sports medicine we sometimes experience directly the intersection between serious illness and athletics.  I think immediately of the young gymnast I saw with anterior knee pain that turned out not to be Osgood-Schlatter’s but osteogenic sarcoma of the tibia…….a ‘game changing’ event…

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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.