Rugby 7’s

January 22, 2014 by 1 Comment

Rugbyball2

Looking forward to some sport
and some sun this weekend.

As I write, it’s early in the morning on another cold day here in the eastern half of the United States.  The “Polar Vortex” has descended again and I think colleagues in places like New York City and Philadelphia may be enjoying a ‘snow day’ today.

But if there are not an associated ‘blizzard’ of plane flight cancellations, I should be enjoying some balmy weather by tomorrow:  I’m heading to the USA Sports Medicine Rugby Conference and International Rugby 7’s tournament in Las Vegas.

As I had mentioned in my previous post about the upcoming FIMS/CASEM conference in June, among the many very interesting speakers headlining the USA Rugby event in Vegas:  Rob Cantu will be talking about “Short Term and Long Term Results of Repetitive Sub-Concussive and Concussive Head Injury” and Ann McKee will discuss “Emerging Concepts in Chronic Traumatic Encephalopathy” (CTE).

I’ll get a chance to listen to some great panelists and moderate some sessions, and then I’ll get the chance to watch same great sport at Sam Boyd Stadium.   I’ll be sure to share the highlights in my next post.

And, of course, I’ll get to enjoy ‘Vegas’.  But I won’t be blogging about that.  What happens in Vegas…..

I’ve previously had the occasion to write in this blog about rugby union as well as other football codes, such as Aussie rules football. I’ve had, as well, the opportunity to interview one of USA Rugby’s Team Physicians, Dr. Bruce Miller, who has been a guest on one of our “5 Questions with CJSM” posts.

Both rugby union and rugby league have featured regularly as sports we’ve studied in the pages of the journal itself.  Last year we looked at injury prevention in rugby union; in 2012 we looked at shoulder instability in professional rugby players; and also in 2012 we looked at the proportion of time-loss and non-time-loss injuries  in first team rugby league.  This brief sampling just scratches the surface of the multiple offerings we’ve had about these great sports over the years.

But CJSM has not had any study or article on Rugby 7’s, the variant of rugby union with 7 players as opposed to 15 on a side; shorter halves; and the version of rugby which will be making its debut as an Olympic sport in two short years in Rio.  We will have to rectify that!  I suspect as the prominence of this version of the sport increases over time, we’ll be seeing more manuscript submissions focusing on the injuries and injury patterns unique to it.  In the mean time, I may just have to look for some study collaborators in between my gaming—er, my studies at the conference.

sam boyd stadium

Sam Boyd Stadium, in Las Vegas:
site of the IRB Sevens Tournament stop
in the U.S.

More soon!

Filed under General Interest Tagged with , ,

2014 International/Canadian Sports Medicine Conference

January 16, 2014 by 1 Comment

FIMS 2014

First stop on the 2014 conference
circuit is Vegas, but in the summer
we’ll be enjoying the charms of
Vieux-Québec for FIMS/CASEM 2014

Turning the corner into the start of a new year, some of us can flag a little bit:  the holidays are behind us;  in the Northern Hemisphere the days remain short.

I find myself thinking about some of the travel and conferences I have planned for 2014.  For instance, in a little more than a week I’ll be heading to Vegas for the USA Rugby Sports Medicine conference.  Among the many very interesting speakers, Rob Cantu will be talking about “Short Term and Long Term Results of Repetitive Sub-Concussive and Concussive Head Injury” and Ann McKee will discuss “Emerging Concepts in Chronic Traumatic Encephalopathy” (CTE).

Among Dr. Cantu’s many, many contributions to the concussion literature, he is one of the authors on the Zurich 2012 Consensus Statement on Concussion in Sport.  Dr. McKee has done extensive work in the area of CTE, and we discussed some of that work in a blog post last fall.

I’ll be posting from Vegas on the highlights of the rugby conference.  Today, I wanted to share with you my enthusiasm for a conference coming up later in the year.  Early this summer, the XXXIII International Federation of Sports Medicine (FIMS) World Congress will take place in Quebec City, QC, Canada June 18-21, 2014.  This will be a joint venture with the Canadian Academy of Sports and Exercise Medicine (CASEM), which will be holding its annual conference at the same time.

The conference agenda is still being developed, and if you’re interested in submitting an abstract for consideration you still have a little time:  the deadline for abstract submission is January 31.  Get cracking on that!  I’ve got an abstract in myself, and hoping to hear a thumbs up from the education committee.

The CASEM conference is always a great one, and to have FIMS joining in on the education and fun makes the event doubly alluring.  Although the details are still in the works, the publisher and some of the editors for CJSM plan on giving a talk at the joint conference.  Our Executive Editor Christopher Hughes and myself will offer advice to potential submitting authors on how best to get their work published in CJSM.  We’ll also be discussing how authors can use resources such as our video abstracts to enhance and promote their work on all this journal’s media channels.

800px-Stonehenge_Summer_Solstice_eve_02

While they celebrate the solstice in Stonhenge,
we’ll be enjoying CASEM/FIMS2014 in Quebec!

So, we’re hoping to see you in Quebec City in June.  Until then, we’ll be dreaming of crepes and strolls on the bluffs overlooking the St. Lawrence, and the long, long days that will be all of ours to enjoy in Quebec come the conference, which coincides with the summer solstice.

Don’t put away those ice scrapers just yet, but there’s a whiff of summer in the air……

Filed under General Interest Tagged with ,

Articular Cartilage Pathology: What to do?

January 12, 2014 by 2 Comments

A syringe delivering PRP:
A silver bullet for osteoarthritis?

My fall was so busy, I’m finally getting back to doing a sequel of a post I wrote in early October:  Osteoarthritis Part I.

I’m finally writing “Part II.”

The proximal impetus for finally attending to this item on my personal ‘to do’ list?  The new, January 2014 edition of the Clinical Journal of Sports Medicine has a couple of very fine articles on the treatment of articular cartilage pathology. One of the studies, “Treatment of Cartilage Defects of the Knee: Expanding on the Existing Algorithm,” is a general review I hope to post about in the near future.  The study that is in my line of fire today explores the uses of platelet-rich plasma (PRP) in the treatment of osteoarthritis and cartilage defects: “Platelet-rich Plasma in the Management of Articular Cartilage Pathology:  A Systematic Review.”

I found this review to be incredibly helpful.  It begins with an overview of articular cartilage pathology and a reminder of the frustrations in treating a tissue that has a limited inherent healing capacity.   Rarely can articular cartilage repair itself.  And when injury penetrates subchondral bone, underlying marrow cells can be stimulated to provide some repair, but inevitably the fibrocartilage that results is a biomechanically inferior substitute for native, articular hyaline cartilage.

ocd for blog 2

OCD of the medial femoral condyle:
what will this joint look like in 2044?

The review notes the increasing incidence of chondral and osteochondral lesions, something as a pediatric sports medicine specialist I can attest to.  The 10 year old with knee OCD I am treating today:  I often wonder what their knee will be like in 30 years?

The authors note:   “Several treatment modalities are available, including microfracture, autologous chondrocyte transplatation, and autograft and allograft osteochondral transplantation.  However, the reported resulst with these procedures have been variable and are not guaranteed to prevent symptomatic degenerative disease at long-term follow up.”

In other words, the hunt is on for an effective, definitive treatment of articular cartilage injury.  Might PRP be the answer?

The brief answer:  we need to learn much, much more about PRP, and probably about articular cartilage, too.

Let’s start with the limitations.  Read more of this post

Filed under Evidence-based Medicine in SEM, General Interest, Patient Outcome Measures Tagged with , ,

5 Questions with Dr. John DiFiori, AMSSM President

January 7, 2014 by 1 Comment

amssm overuse

Screen Shot of AMSSM
Infographic on
Youth Sport and Burnout

January represents the new year here at CJSM, as it does of course for all of you in the blogosphere.  But what really excites us is not the opportunity to set new year’s resolutions:  it’s  the new issue of the CJSM, and that’s what I want to share with you today.

There is a lot on offer in this issue, including studies exploring treatments of articular cartilage pathology, a study of functional ankle instability, and a journal club exploring the relative of benefits of PRP and ESWT on chronic patellar tendinopathy.

The lead study is a systematic review and position statement on the issue of youth sports, with an evidence-based  focus on the phenomena of overuse injuries.  This blog reviewed the statement in an earlier post.  It’s an important study, and we want to make sure as many people as possible get a chance to read it.

And so, we feel fortunate to have had the chance over the holidays to chat with the lead author of the paper, Dr. John DiFiori, and ask him ’5 questions’ about his recent work.

_______________________________________

1) CJSM: Dr. DiFiori, you are the lead author of the new American Medical Society for Sports Medicine (AMSSM) position statement on ’overuse injuries and burnout in youth sports.’  Can you tell us a bit about the genesis of this statement?  When was it first conceived?  How long did it take to go from initial conception to publication?  How did you gather together the group of experts who are authors on this statement?

JD: Given all of the issues currently surrounding youth sports, the AMSSM leadership felt that a position statement focusing on overuse injuries and burnout would be timely, and would help to address many of the concerns held by sports medicine professionals, as well parents, coaches, and the young athletes themselves. In late 2011, a nominating process was completed, and I was asked by AMSSM to lead this project. The six outstanding members of the writing group were identified through a similar process, based on their clinical expertise, and their record of educational and scholarly contributions in this area.

We began to develop the content areas and search strategy in early 2012. We endeavored to have the paper be as evidenced-based as possible. To this end, we utilized a systematic search process, followed by author review, to identify relevant literature. The writing process, multiple re-writes and editing to ensure accurate information, took about 1 year. Because of the length of the process, we performed another systematic literature search in mid 2013 to ensure the paper would be as up to date as possible. The draft then underwent critical review by several expert external reviewers, who provided some very valuable suggestions. Following this, the paper underwent another round of review by the AMSSM Board of Directors. And then it was off to CJSM. So, all in all it was a very thorough process. Hopefully the result is a document that will be a solid resource for the sports medicine community.

2) CJSM: The statement is a comprehensive review of some of the major phenomena in the world of youth sport:  overuse, early specialization, over scheduling, burnout. What do you think are some of the underlying forces driving these phenomena?  Are there different pressures being brought to bear on the modern youth athlete we didn’t see a generation ago?  And if so, what are they? Read more of this post

Filed under Youth Sport Tagged with , ,

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