Team Physicians: On your mark, get set….go!

August 12, 2015 by

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The sidelines–where so many of us like to be.

It’s still full-on summer in North America. The temps can exceed 40 C (104 F) in some parts, and the geese haven’t flown anywhere…..but fall is in the air, as team sports are in the midst of two-a-days and the hitting has begun! My clinics have shown an uptick in patient numbers, as the injured are trickling in. I have yet to stand on a sideline, but will do so in two weeks. It’s a good time to review the Team Physician Consensus Statement (see below) published a couple of years ago.

From the challenges of making real-time, sideline decisions regarding our athletes to the development of emergency action plans, those of us in clinical sports medicine will find a lot to help us in this statement.  In CJSM we have published over the years several manuscripts of great importance to the team doc.  We have explored whether return to play decisions are the responsibility ultimately of the team physician to variation in physician practice in those return to play decisions to more.  On this blog, we’ve covered the spectrum with interviews of team physicians from the Ohio State Buckeyes (Jim Borchers) to the Michigan Wolverines (Bruce Miller)…….

The health and welfare of our athletes is our primary obligation; in keeping our eye on this ‘ball’ there are several others we need to juggle–the needs of the team, the decisions of coaches and managers, the desires of parents if we are taking care of youth athletes……As our seasons progress, be sure to follow us here on the blog and on twitter @cjsmonline. And stay tuned to cjsportmed.com for studies released ahead of print, our ever-growing body of podcasts. We will try to help you navigate this juggling act.  All the best!

sportingjim's avatarClinical Journal of Sport Medicine Blog

Earlier this week, several sports medicine organizations released a statement with which all sports medicine clinicians should familiarize themselves:  the “Team Physician Consensus Statement:  2013 Update.”

The Statement represents, in its own words, “…an ongoing project-based alliance” of the major professional associations associated with sports medicine  in the United States.  These include the American Academy of FamilyPhysicians (AAFP), the American Academy of Orthopaedic Surgons (AAOS), the American College of Sports Medicine (ACSM), the American Orthopaedic Society for Sports Medicine (AOSSM), the American Osteopathic Academy of Sports Medicine (AOASM), and this journal’s affiliated professional group, the American Medical Society for Sports Medicine (AMSSM).

This is an update of a statement first published in 2000.  It includes sections which define the role of ‘team physician’;  describe the requisite education and qualifications; enumerate the medical and adminstrative duties and responsibilities; and explore the relevant ethical and medicolegal issues.

The entire statement is worth a read, but I find…

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Filed under Ethics and probity in SEM, General Interest, Safeguarding in Sport

Football. Texas style.

August 4, 2015 by 1 Comment

grand prairie texas weather

It’s big–and HOT–in Texas.

The Lone Start state, in August.  Grand Prairie, Texas–next to Arlington, within sight of Cowboy Stadium (alright, so it’s officially AT&T stadium).  Deep in the heart and soul of American Football, that’s where my month began.

In addition to being an Associate Editor of CJSM, one of the hats I wear is as a Director sitting on the Board of a non-profit youth sport safety advocacy group, MomsTeam Institute. Yesterday, I participated in the group’s outreach to a youth football organization in Texas:  the Grand Prairie Youth Football Assocation (GPYFA).  The Chief Executive of MomsTeam, Brooke deLench, has organized a week long session to address issues of football and cheerleading safety; this week is preparatory to longitudinal work including injury surveillance to determine if certain interventions can lower injury rates in the 1000+ youth athletes participating in GPYFA sports.  Brooke has coined the term “SmartTeams, PlaySafe” to emphasize the important role education, knowledge transfer, and implementation can play in the world of youth sports.

Yesterday, I was one of a few individuals speaking to the coaches and parents of GPYFA.  My charge was to talk about preventing and identifying heat illness and overuse injuries, and review the pre-participation evaluation (PPE) with the assembled crowd.

s grand prairie hs weight room

The weight room in South Grand Prairie High School It’s superior to a lot of college facilities I have seen.

The venue was South Grand Prairie High School, a magnificent structure with a beautiful, large auditorium, and just around the corner a magnificent and huge weight room and indoor turf facility. Boy, they do things big in Texas, they really do.

As I prepared for this talk, I found myself time and again dipping into the CJSM well–on the subject of youth overuse injury, I leaned heavily on the AMSSM position statement from Di Fiori et al. published in the January 2014 CJSM. When I touched on the topic of Exercise-Associated Hyponatremia, I turned to the 3rd International Consensus Statement and the podcast I just conducted with lead author, Dr. Tamara Hew. The PPE?  Of course, I would consult the joint ACSM/FIMS statement (CJSM Nov. 2014) and the podcast I conducted with its lead author, Dr. William Roberts.

It does indeed excite me to share with you all the resources this journal has.  As an educator and public health advocate, as well as a clinician, I use CJSM in a very real and practical sense.  Day in, day out.

My time in Texas was brief, but MomsTeam’s work will continue.  I am hopeful that our work will help these children and their families navigate some of the risks that are associated with the many, many benefits of youth sports such as football and cheer.  For one, I hope my talk helps prevent any cases of exertional heat illness (EHI) in this group. The forecast for  this week in Grand Prairie has the thermometer hitting 106F (41C)!!!  At least I think the humidity on an August day in Texas may be a little bit less than that seen in, say, Qatar, site of the 2022 World Cup.

As I flew home, I read the recent Sports Illustrated story on the 25 anniversary of the release of the iconic book,’ Friday Night Lights.’  I mused on the importance of youth football not just in Texas, but in the United States in general.  With 3.5 million players age 6 – 13 in this country (CJSM 2013), the sport keeps a LOT of kids active.  With the season now upon us, let’s all keep working on making this sport, and all sports, safer for our young athletes.  With the work done in this and other journals of sports medicine, we’ll continue to generate the evidence to support the decisions that will further this cause.

 

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CAS vs. IAAF — the Dutee Chand decision

July 28, 2015 by

The Court of Arbitration in Sport (CAS) made a major ruling yesterday with broad implications. Dutee Chand, an Indian sprinter, had been fighting the International Association of Athletics Federation (IAAF) policy which would have required her to undergo surgery, take medicine, and agree to other interventions if she were to compete as a female. Ms. Chand has naturally higher levels of testeosterone than most women; she had never identified in her life as anything but female.  She and her legal team fought the IAAF policy in the CAS, and won.

The CAS questioned the advantage of naturally high levels of testosterone in women’s sport, and ruled that Ms. Chand must be allowed by the IAAF to compete as a woman, essentially overturning the current IAAF policy. A New York Times article makes for fascinating reading.

This is a victory for Ms. Chand, and many would argue that it is a victory for women’s sport, and for sport in general. Nevertheless, many athletes, including marathoner Paula Radcliffe, supported the IAAF policy and worry that women’s sport may now be conducted on a less level playing field, if you will.

Issues of gender in society are front page news this summer in the USA. Sports, as a mirror of society at large, offer up a narrative within this larger story — the Dutee Chand story has been ongoing for well over a year, and we’ve discussed her story and the overall story of ‘Too Much T’ at different times here in the blog.

We thought we’d repost (below) a very popular commentary which includes discussion of this issue of testosterone in women’s sport: ‘The Sports Gene: How Olympians are made (or born).’ And we thought we’d include a poll on what you, the reader, think of this most recent CAS decision on IAAF policy. Vote, and let us know what you think!

Take Our Poll

sportingjim's avatarClinical Journal of Sport Medicine Blog

The venues at Sochi are still, it seems, a work in progress.  Nevertheless, before the week’s end, we will (should?) see the Winter Olympic games start up.  Soon, we’ll get to watch some of the finest athletes in the world compete at their sport.

There has been a lot of talk about the on-going construction at the most expensive games in Olympic history, as well as the issue of gay rights and cultural sensibilities in Russia;  and there have been worries about the potential for terrorism.  But soon, when the competitions begin, I hope the focus will justifiably be on the athletes on the snow and ice.

Or in Tweet speak: #LetGamesBegin

I’ve not been consciously preparing for this elite sporting event, but rather coincidentally recently picked up a book that highlights elite athletes and has received a great deal of positive ‘buzz’:  The Sports…

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CJSM Changes

July 21, 2015 by

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The CJSM Team (L to R): yours truly, Executive Editor Chris Hughes, Publisher Kivmars Bowling

2015 has been a very good year for CJSM.  As we pass the halfway point, I think it is time to sit back and reflect for a brief moment.

We are celebrating our 25th anniversary at CJSM:  yes, 2015 represents our 25th year as a leading sports medicine journal!  We were ‘born’ 25 years ago on January 1 1991. Check out our first issue here.  I must confess, I only recognize the name of one of the authors, and it turns out he is a good friend of mine, and a frequent contributor to the journal and visitor here on the blog.

Dr. Avery Faigenbaum, who knew you were so long in the tooth?  I suspect you had a little less gray hair when you authored ‘Physiologic and symptomatic responses of cardiac patients to resistance exercise?’ Thank you for that submission and thank you for the continued work you have done in your career on the health benefits of resistance exercise.  In my world of pediatric sports medicine, your work has been huge.  I am old enough to remember the old saw that lifting weights as a child would stunt growth or cause physeal injury.  Dr. Faigenbaum’s work here in the pages of CJSM and elsewhere has helped disabuse mainstream thinking of these notions.

But enough about Dr. Faigenbaum and more about CJSM!  🙂

We anticipate some more celebrating as we approach our 25th birthday.  Our Executive Editor and Publisher have some things in the works as we turn the corner toward our next quarter century.  Keep your eyes open for these celebratory flourishes!

We have also begun a Continuing Medical Education (CME) program for selected articles in the journal and have just named an Associate Editor for CME:  Holly Benjamin, M.D.   The Editorial Board is honored to have her join the crew. Dr. Benjamin has played major roles in one of our partner societies, the American Medical Society for Sports Medicine (AMSSM), as well as the American Academy of Pediatrics (AAP).  With her leadership, we anticipate some exciting CME offerings for readers with upcoming featured studies.

Finally, as I finish my coffee and wrap up these reflections, I am happy to say that our podcast efforts, which began just a year ago, continue to expand and will be a significant part of our overall mission as we head into these next 25 years. The world of media in general, and sports medicine journals in particular, is changing all the time.  Journals, blogs, podcasts, social media, CME, eTOC….on and on it goes.

Who knows how we’ll all be interacting in 25 years?

 

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