“Primary Care for Sweaty People”

Dr. Carl Stanitski with wife & equestrian athlete, Debbie

I am fortunate to be spending my weekend in Ft. Lauderdale, Florida, where I am attending the 5th Annual Meeting of the Pediatric Research in Sports Medicine (PRiSM) Society Meeting.  This meeting is becoming a major fixture on the pediatric sports medicine calendar, and I have gained so much by joining this organization and attending the proceedings over the last few years.  If you specialize in pediatric sports medicine, the dates January 24 – 26 2019 (next PRISM meeting in Atlanta, Georgia) should be circled on your calendar.

Among the highlights of the meeting was a keynote talk by Dr. Carl Stanitski, Emeritus Professor of Orthopaedic Surgery and Pediatrics at the Medical University of South Carolina.  He, along with other legends like Dr. Lyle Micheli and Dr. Jim Andrews, was a pioneer in pediatric sports medicine in the 1970’s when, as he described it, the initial work being done in this field was derided as ‘primary care for sweaty people.’

My, how this field has grown.  In the USA, the advanced, fellowship training in this discipline has exploded in both the primary care and orthopaedic surgery worlds.In the primary care world alone, there are > 200 programs in operation

Twenty-five years ago, when the field was a lot smaller, Dr. Stanitski and others were already sending up the alarms over increasing sports injury rates seen in young athletes — check out this vintage New York Times article from 1992. The article notes:  “They attribute the rise in such so-called overuse injuries to intensive sports training programs for young children, longer playing seasons and specialty sports camps in which children may spend hours lobbing balls on a tennis court or throwing hundreds of pitches each day.”

Plus ça change….the more things change, they more they stay the same.  These are precisely the issues we still face, 25+ years down the road.  That same sentence in the NY Times could be written today.

CJSM and other journals (JATA, BJSM, AJSM, Sports Health) play major roles in publishing and disseminating the research on the diagnosis, management, treatment and prevention of pediatric sports injuries.  A cursory review of the pages of CJSM over the last few years reveals publications related to pediatric concussions , overuse injuries, and training.

What I walk away from this meeting with, more than ever, is the awareness of how much more we need to go in terms of knowledge translation.  If 25 years ago the leaders in this field were already noting a skyrocketing injury rate, and if there has been a wealth of increasing research in this area, why has the problem only seemed to worsen?

The issue of knowledge translation — of taking the information we researchers produce and we journals publish — is near and dear to the collective hearts of the CJSM editorial board.  As professionals we have to start getting the rubber to meet the road.  One of the reasons why we are so passionate at CJSM about using social media is our goal to spread knowledge widely, to get it in front of the people who can put this into practice.

Join us in this quest by following us on Twitter and Facebook and subscribing to our iTunes podcast feed.

It’s a long way from Boston to Denver — 5 Questions with David Howell

David Howell, alongside one of many of the research posters he has produced

When I now think of my friend, David Howell, I have this beautiful John Denver song in my head:

It’s a long way from LA to Denver
It’s a long time to hang in the sky
It’s a long way home to Starwood in Aspen
A sweet Rocky Mountain paradise
Oh, my sweet Rocky Mountain paradise

Granted, David just moved to Denver from Boston, not LA, but I can’t separate the melody from his journey, and the visions I have of him hanging out in the Rockies…..

David Howell PhD, ATC–and the team of researchers with whom he most recently worked at Children’s Hospital, Boston–has been one of the more prolific authors for CJSM in the last several years.  This summer, he moved to Children’s Hospital, Colorado, where he continues the pioneering research into kids’ sports safety that has been the hallmark of his career.

As lead author of two recently published CJSM studies, he was a natural interview for this, our most recent blog post and contribution to the recurring “5 Questions with CJSM” column.

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1) CJSM just published your new study, “Near Point of Convergence and Gait Deficits in Adolescents after Sport-Related Concussion.”  What would you state are the most important, new contributions to the literature your team made with this study?  And are there specific take-home points that the practicing clinician can use in their assessment of concussed teenagers?

DH: The idea of combining visual and gait-based measures in patients with a concussion was a result of an interdisciplinary collaboration. I was fortunate to work alongside colleagues from optometry/ophthalmology (Aparna Raghuram PhD, OD, and Ankoor Shah, MD, PhD) and sports medicine (William Meehan, MD and Michael O’Brien, MD) on this study. Based on our discussions, we were interested in the value and association of instrumented gait measures and vergence measures, since both have documented value for use within concussion evaluations. Additionally, both tests were relatively easy to administer within the sport concussion clinic at Boston Children’s Hospital. Read more of this post

Mile High at #ACSM17

Speakers at the ACSM Social Media Session (L to R): Angela Smith, Pamela Peeke, Gretchen Reynolds, Felica Stoler, yours truly

I’m curious about how others perceive the cycle of the sports medicine year.  I have my own peculiar calendar, dictated by contingencies such as geography (American) and specialty (academic medicine, pediatric sports medicine specialist).

Summer, soon to be upon us, is the time to enjoy not only a bit of vacation but also ‘catch up’ on research projects and writing assignments that have piled up on my desk.  Fall?  That’s the tsunami season: sports such as football and soccer keep me very busy from August 1 through Thanksgiving.  After a holiday breather, I seem to roll into conference season and various speaking engagements extending through the late spring– PRISM (Dallas) to Rugby Medicine (Las Vegas) to IOC Prevention (Monaco) to AMSSM (San Diego) to, now, ACSM.

To be sure, I’m certainly in the place where I could conduct a survey getting the ‘seasonal perspective’ of hundreds of people from around the globe and of various specialties: the 64th ACSM Annual Meeting (and 8th World Congress on Exercise is Medicine) is a huge affair, renowned for its depth and breadth.  This is the place where I can connect with folks from South Africa to Down Under, and posit collaborative ideas to professionals from athletic trainers to exercise physiologists. I am always blown away by the size of the affair.

These conferences are the places to make new friends, re-connect with established colleagues; they are the places to share a handshake or a hug, share a meal — make the physical connections upon which all true relationships are based.  I celebrate the power of social media, as many of you know, but I see it primarily as the way to facilitate deeper connections–not in the virtual world, but in real life.

And so I felt privileged to kick off #ACSM17 with a session on social media, one shared with both established and new friends: Pamela Peeke, Angela Smith, Felicia Stoler, Gretchen Reynolds.  If you don’t know them, follow them on Twitter, and then introduce yourself if you see them on the ground here in Denver. I felt privileged, as well, to interact with so many in the audience, who asked probing questions and ‘hung around’ for an hour or so after the session.

I landed 24 hours ago. I haven’t hiked the Rockies (yet) and I haven’t indulged in Colorado-legal herbal gummies (yet?), but I’m already feeling a mile high.

I hope you are, likewise, feeling the positive vibe here in Denver.  Share your stories on social media with the hashtag #ACSM17 and promote that vibe.  Then go say hi to an ACSM member you only know on social media. If you see me lurking in some symposium or colloquium, come say hi!  We can always do a selfie!

Enjoy the conference.

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

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