A Twitter Journal Club

casemI want to alert you to a very interesting innovation which was instituted at the end of 2016 and will continue into this new year:  the Canadian Academy of Sport and Exercise Medicine (CASEM) Twitter-based journal club.

You read that right — a journal club, on Twitter.

We’re all familiar with journal clubs.  In fact, the fellowship in which I teach (Nationwide Children’s Hospital Sports Medicine) just completed its monthly journal club yesterday, with the fellow (sports medicine physician in training, Jonathan Napolitano) leading the group of doctors through a study published in our January 2017 CJSM: Reliability Testing of the Balance Error Scoring System in Children Between the Ages of 5 and 14.

I recently wrote of the vital, and increasing, importance social media plays in the dissemination of sports medicine research.  A Twitter journal club is an example of that phenomenon.

The CASEM Journal Club just got off the ground at the end of 2016, and had as its first selection another CJSM study: Physical Exam Risk Factors for Lower Extremity Injuries in High School Athletes:  A Systematic Review. Seems like both CASEM and I found this to be particularly intriguing.  To wit, I cajoled the lead author of that study, Jimmy Onate, into recording a podcast with me.  And then he pulled duty on the CASEM Journal Club as the guest author, interacting on Twitter with folks from around the globe.  What a great opportunity — to get to ask the author directly the questions one has after reading his/her study.

The study for this month’s CASEM journal club is the same one we deconstructed in our fellowship yesterday:  the reliability of the BESS in a pediatric population  It hits close to my heart.   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.

Clinical 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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Boxing in the Olympics

 

Rio de Janeiro - Robson Conceição derrotou na tarde deste domingo o cubano Lázaro Álvarez e vai a final do boxe categoria peso ligeiro. (Fernando Frazão/Agência Brasil)

The new look to Olympic Men’s Boxing  (photo: Fernando Frazão/Agência Brasil)

With summer holidays and work, I will be honest — I have not been watching too much of the Olympics on the television.  I have made a point to watch Michael Phelps’ last (possibly?) Olympic swim and Usain Bolt’s historic 100m gold medal performance.  I am a former track and field athlete myself, and so I also have witnessed Jamaica’s Elaine Thompson win the women’s 100m and South Africa’s Wade van Niekerk set the 400m world record.  I catch up on news in the newspaper when I wake up (for instance, the story of Anna Sofia Botha is possibly the most heartwarming of these Games).  But watching live TV?  Not so much.

Between the track events, I have caught some of the men’s boxing and I, like possibly many of you CJSM blog readers, have been struck by the absence of head protection.  Our world of sports medicine is big, and I’ll confess I had not been aware of the rules changes going into these Olympics regarding the non-use of this protective equipment for men’s boxing:  since the 1984 Los Angeles Olympics, mandatory headgear has been in place for boxers until now, in Rio.

There has been some controversy over this issue — both when it was introduced as a safety measure, and now in 2016 when it has been removed, also for stated safety reasons:  the incidence of concussions is expected to decline without the headgear in place.  The International Boxing Association (AIBA) made this rule change since the Beijing Olympics, and International Olympic Committee (IOC) spokesman Mark Adams is quoted as saying, “AIBA provided medical and technical data that showed the number of concussions is lower without headgear. They have done a lot of research in the last three years. The rule will go ahead for Rio.”

Some of that research has been published in our journal, including this cross-sectional observational study on the use of head guards in AIBA boxing tournaments.   The results of this study show that referees had to stop matches for head injuries more often when boxers were wearing head gear than when they weren’t.  At the end of the day, after integrating all the available current evidence, it was understood that the headgear was not sufficiently protective to prevent concussions (no surprise there: the holy grail of contact sports may be effective, ‘concussion proof’ head protection), and, instead, promoted more frequent hits to the head — a good example of ‘risk compensation’ in injury prevention.

The CJSM study, authored by a group including lead author Michael Loosemore and senior author Julian Bailes, has already generated a fair amount of debate on social media and commentary in the media, including the New York Times.  We have been receiving a fair number of ‘letters to the editor’ regarding the study since these Olympics have begun, and we will be publishing both the letters and the authors’ responses soon.  A robust debate looking at the evidence, and pointing toward where research must head to resolve this issue — that is a ‘contest’ that will extend beyond Rio and into Tokyo, site of the 2020 summer games.  Stay tuned to the blog and to CJSM to stay abreast of this issue.

Shedding light on the dark

It’s January and winter has at last arrived in North America. It officially started several weeks ago, but it took a while to really get going.  After a balmy December (for most of the country, anyway), the first month of 2016 has given us, as expected, single digit temperatures and snow:  the Minnesota vs. Seattle playoff game earlier this month was the third coldest NFL game in history. This month is also giving us the shortest days of our year north of the equator.

ACSP 2016

ACSP meeting coming up — Come to Surfers’ Paradise if you can!

[sidebar and shout out to our colleagues in the Australasian College of Sports Physicians (ACSP)–I am so looking forward to the warmth and long, sunny days of Surfers’ Paradise, in a mere 4 weeks!!!]

But the days are lengthening, and the sun will get stronger each day, of course. And metaphorically, at least, I can find light in this darkness by sitting down with this month’s edition of CJSM.  You can, too.

Yes, ‘shedding light in the dark,’ that’s the image I hold as I enjoy this privilege of being one of a group of editors managing one of sports medicine’s premier journals.  The on-going process of scientific investigation continues to expose the dark corners of our knowledge base, and journals like ours–disseminating this knowledge via print, internet, and other media vehicles–help practicing sports medicine clinicians bring the latest evidence-based research to the sidelines, training rooms and clinics.

In truth, I recently wrote about being ‘in the dark’ (literally and figuratively) as I watched the movie ‘Concussion’ and reflected on how much we still lack in our understanding of this clinical entity, in almost all aspects:  diagnosis, management, treatment, prognosis.  I am reading now with pleasure three pieces of original research about concussion just in our January issue, bringing their light to bear on the issue:

And as I have begun to prepare my talk for the upcoming ACSP conference (“School sports and youth injury: the promise and the peril”), I find myself leaning heavily on research published in CJSM. To wit: Read more of this post

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