Time Flies


This man would love Surfer’s Paradise, Queensland, Australia: Site of ACSP February 2016

Is Christmas really almost here?

Have my high school football players really finished their seasons, and now wrestlers and basketball players are taking their places in my clinics?

Two months ago I was posting from the South African Sports Medicine Association’s meeting in Johannesburg (SASMA2015), and it feels like yesterday.

And that means that two months from now is…..tomorrow?

Two months from now I might be…..surfing???

I am excited that early in 2016 [in precisely two months] I will have the chance to attend the Australasian College of Sports Physicians (ACSP) annual meeting in Surfer’s Paradise.  I am honored to speak on the topic of youth sports, and will join colleagues such as Roald Bahr, Steven Blair, and more from 12 February to 16 February on the ‘Gold Coast’ of Queensland.

This is a special opportunity to join up with a special group of sports medicine clinicians. ACSP is one of CJSM’s affiliated societies.  With most of our Editorial Board in North America and the UK, we typically have an easier time visiting our other affiliated societies such as the Canadian Academy of Sport and Exercise Medicine (CASEM) and the American Medical Society for Sports Medicine (AMSSM).

So, in 2016, we’ll have at least two of our Editorial Board on site at ACSP, as I will join Hamish Osborne.  Last year, Dr. Osborne–our Dunedin, New Zealand-based Associate Editor– filed a couple of posts live from 2015 ACSP. This year, I’ll share the duties with him!

The Australians and the Kiwis punch above their weight in the worlds of sports and sport medicine.  I think that statement must come as no surprise to readers of this blog.  I’ve had the opportunity on several occasions to write about important contributions the folks Down Under are making in the sports medicine research world.  If you haven’t previously had the chance, listen to our podcast conversation with Alex Donaldson on ‘Footy First,’ an injury prevention intervention for Aussie Rules football. Or read the recent guest post authored by Sheree Bekker of The Australian Centre for Research into Injury in Sport and its Prevention (ACRISP).

So…..two months.  That will fly by!!!  I won’t have any chance to practice any surfing in landlocked Ohio, but I’ll soon enough have to get cracking on developing that talk!

Like Turkey & Gravy: Thanksgiving and the NFL


Male turkey, photo courtesy of Nordelch.

Yep, they ‘go together’ …..well, maybe not like “….rama lama lama ka dinga da dinga dong,” but the fit is surely as tight and traditional as turkey and gravy.

Today is Thanksgiving; I have the day off; and I’ll be sitting down for a feast, both of food and of football.

The day is loaded with gridiron football:  Lions v. Bears, Cowboys v. Eagles, and Seahawks v. 49ers. The colleges, too, have some intriguing games:  can TCU win and perhaps leap into the top 4 of the college football playoff standings?

Whether or not you are a fan of their respective teams, who can’t get interested in the rivalry between Pete Carroll and Jim Harbaugh, which extends back to their days at USC and Stanford.

“We bow to no man, we bow to no program at Stanford football,” said Harbaugh.  And the two men–and programs they run–continue to go after each other at the professional level. The Seahawks/Niners game should be a good one.

Yes, it will be a great day to enjoy football.

It sure has been a difficult season to do the same.

The New York Times ran a very interesting piece in their Sunday magazine earlier this month:  “Is Football the Next Tobacco?” speculating on whether NFL quarterback will go the way of, well, the Marlboro Man.  America, the magazine of the U.S. Jesuits, also ran a thoughtful piece on ‘what will become of football.‘  And going from the angels to the devils, so to speak, the journalists at Vice sports wrote what I think is a very insightful analysis of what they term the ‘concussion-industrial complex.’  The author echoes many of my concerns over the nexus of sport/injury/fear/business that sports-related concussion has come to represent in modern sport.

Even Saturday Night Live has riffed on the subject, with a very funny segment that aired last week and lampooned several aspects of the ‘concussion crisis.’

On the evidence-based, sports medicine side, we continue to contribute to the conversation over how best to diagnose and manage concussions in our athletes.  In our most recent, November journal, we have a Letter to the Editor from the former President of CASEM Pierre Fremont which addresses concerns over an earlier editorial in CJSM on whether it is time to re-think the Zurich consensus statement and guidelines on concussion.  We were able to interview the authors of that statement in our first podcast; that would make an enjoyable listen for this holiday weekend.  And don’t forget to check our “Published On-Line First” section of the journal’s website, which includes a queue of original research articles that are lined up to be published in print in 2015….but can be viewed right now on-line.  The offerings include a study with important findings on what is special about pediatric concussions by Johna Register-Mihalik et al.

The topic of concussion comes up frequently in the blog as well, of course.  Our review of the television documentary, “League of Denial,” is just one of the many posts we have written on sports-related concussions over the last few years.

Football and feast:  whether you are enjoying this Thursday as the Thanksgiving holiday in the United States, or getting closer to your weekend elsewhere…..I hope you all have a restful and safe few days ahead of you.  For all of us here at CJSM, I can tell you this Thanksgiving how thankful we are to have you engaged with this journal in advancing the research into the health and safety of the athletes we al care for.

All the best.

Revisiting Bicycle Helmets: Injury Prevention for Kids and More

A year ago I wrote the blog post below, which I am re-posting today.  I wrote the post to coincide with the publication in the November 2013 CJSM of the Canadian Academy of Sports and Exercise Medicine (CASEM) position statement on mandated bicycle helmet use in Canada.

I was reminded of the statement–and the blog post–today as I came across an article posted on the Facebook page of CASEM related to a recent study published in the New England Journal of Medicine looking at the the causes of head injuries in children.  For those under high school age, falls–including those from bicycles–are an exceedingly common cause of head injury.  One striking statistic from the study, quoted in the article:  for children presenting to the ED with a head injury resulting from a bicycle accident, only 18% were wearing a helmet.

The post I wrote last year generated more responses I think than any other post I have written on this blog, and it warranted several follow up posts .  I was struck by the passion–and quite often, vitriol–of many people writing in.  It wasn’t my first introduction to troll-like behavior on social media, but it was possibly the loudest and most ‘international’ I have experienced to date.

I hope you have a chance to look at the articles contained in the links on this post and the ‘reblog’ below.  I think the approach to injury prevention, specifically relating to bikes and most specifically relating to ‘kids on bikes,’ should be multifactorial:  yes to improved road safety, yes to a different relationship between cars and bikes, yes to a built environment that is more accommodating to bikes and pedestrians–but yes as well to personal protective equipment, like helmets.

As ever, we are interested in your thoughts.  But I say with the utmost politeness:  please note that any post that I find does not contribute to a civilized discussion will not be posted on the discussion board.

All the best.

Clinical Journal of Sport Medicine Blog

The November issue of CJSM has been out for a week, and I hope you’ve had a chance to look at our latest offering.  It is also our last offering for 2013 (CJSM is a bimonthly, publishing 6 times a year).  The next time the journal will hit your mailboxes and inboxes will be January 2014.

FIMS 2014 Quebec City, site of the XXXIII FIMS
World Congress of Sports Medicine
CJSM will be there: will you?

2014 promises to be a big year in sports and sports medicine.  The Winter Olympics take place in Sochi, Russia; the FIFA World Cup is in Brazil; and the Commonwealth Games are in Glasgow, Scotland.   On the sports medicine front, the Canadian Academy of Sports and Exercise Medicine (CASEM) hosts the FIMS 2014 World Congress of Sports Medicine in Quebec City, and earlier in the spring the AMSSM annual meeting takes place in…

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ACL Injury Prevention

photo (30)

Dr. Timothy Hewett, in action

I had the good fortune (and space in my clinic schedule) to attend a lecture given earlier this month by Tim Hewett, PhD, FACSM.  Dr. Hewett is a man of many titles.  I know him best as the Director of Research and Director of the Sports Health & Performance Institute at Ohio State University Sports Medicine, and his talk was on “Understanding and Preventing First and Second ACL Injuries.”

If you have never heard Tim speak, you are missing out on a treat.  I learn so much from his talks: ranging from the ones I catch at the annual American College of Sports Medicine (ACSM) gatherings to the ones I occasionally can attend here in Columbus, Ohio, the city we both call home.

It stands to reason: the man has authored over 248 peer reviewed articles and has been awarded millions of dollars of grant money.  We have had the fortune here at CJSM to have published a number of his manuscripts, including one in the most recent September 2014 journal (on gender differences in hip abduction/adduction) and one in 2012 on  the incidence of ACL re-injury after primary reconstruction.

acl rupture post reconstruction deidentified

Oh, my reconstructed ACL: Where have you gone?

The issue of primary- and secondary-prevention of ACL injury is huge. We’ve lived, for instance,  through a virtual epidemic of ACL ruptures in the NBA over the past couple years.  Derrick Rose is returning (yet again) to the hardcourt after his terrible injury in the 2012 playoffs, and that’s great news for the Bulls and fans of great basketball in general.   In his talk Dr. Hewett suggested that at least part of this statistical uptick  in ACL injuries was likely due to the NBA lockout, resulting in an abbreviated 2011 – 2012 season preceded by an ‘abnormal’ preseason.  “These teams have a very structured offseason training program where they do a lot of injury prevention-type neuromuscular training”  (NMT), Hewett has been quoted in interviews.  The absence of such pre-season NMT work, he thinks, is associated with the litany of ACL injuries seen that season, capped off by Derrick Rose’s.

ACL injury prevention is both needed and achievable.  In his lecture, Dr. Hewett stated that there is evidence to suggest that anywhere from 50% to 100% of patients who sustain an ACL rupture go on to develop osteoarthritis (OA) of the knee, even in those who go on to have an ACL reconstruction (ACLR) Read more of this post

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