Quarter of a century up! What have we been talking about?

The CJSM Blog reaches its 25th blog post today since our launch back in June earlier this year. For those of you who have been on board with us since the beginning, we’d like to thank you for your interest and hope that you have found the content interesting on our journey in the World of Sport Medicine.

For those of you who may have joined us a little more recently, this is as good a time as any for a recap of some of the topics we’ve been talking about so far.

Our most recent post focuses on MRI use during clinical assessment by sports clinicians and asks the question, ‘Do Sports Medicine Clinicians overuse MRI scanning?’ This issue was recently highlighted in an article in the New York Times, with perhaps a premature conclusion being reached that MRI scans are indeed overused by Sports Medicine clinicians. What do you think? Come and let us know, and don’t forget to vote on our home page quick poll.
Just prior to that, the issue of concussion in sport was discussed relating to an incident in the recent Rugby World Cup Final where a player who left the pitch due to what looked to be a concussive injury was allowed back onto the field of play only to go off again shortly afterwards. In the context of the sideline assessment of concussion and return to play guidelines, the question asked was, ‘do we practice what we preach?’
The hype surrounding the use of platelet-rich plasma was highlighted back in august when, in the context of a recently published systematic review article in CJSM, we asked the question ‘Is PRP a magic bullet or a damp squib?’
A little earlier, the controversy surrounding the mandatory use of cycle helmets for recreational cyclists was discussed in a post which generated the most number of comments from our readers so far, some with very strong opinions either for or against mandatory use. Our quick poll on the topic was hugely against legislation and enforcement of cycle helmets, with a massive 81% of 137 responders saying ‘no’ to legislation.
Some of our other discussions have focussed on cardiac screening, pre-game hyper-hydration, ‘home or away’ care for athletes, and pre-participation evaluation. Other posts have highlighted sporting events such as the Women’s Football World Cup, Wimbledon Tennis, Le Tour de France, Boxing, Ice Hockey, Rodeo, and the Olympic preparation events in the UK, with associated information signposted relating to particular injuries in different sports. We’ve also mentioned e-learning apps for anatomy, the Ovid Sports Concussion Webinar, Ramadan and the 2012 Olympics, Abuse and Bullying in Sport and several other topics along the way.
We hope that you’re enjoying the ride. In the meantime, don’t be shy – come and share your thoughts with us on the blog. It’s not too late to add your contributions to any of our posts so far, and we’d love to hear from you. The more discussion we have, the more we’ll learn from each other. This blog belongs to all of us.
CJSM would like to know what issues you would like to see discussed on the blog. Let us know, and we’ll do our best to highlight your preferred topics of discussion related to Sport and Exercise Medicine.
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CJSM makes an even bigger impact

We are pleased to report that the Clinical Journal of Sport Medicine saw an increase in its 2010 Impact Factor, with a new figure of 2.110.

CJSM is now at #17 amongst all journals in the Orthopaedics category, a rise from #25 last year, and at #25 amongst all journals in the Sport Science category which represents a leap from #32 last year.

The message is simple – if you want your research in the field of Sport and Exercise Medicine to be cited, CJSM is the place to publish.

The concept of the Impact Factor was first introduced by Eugene Garfield in 1955, the founder of the Institute for Scientific Information which is now part of Thomson Reuters. For those of you who would like to learn a little more about Impact Factors, a good place to start is the Thomson Reuters Web of Knowledge website which goes into some detail in explaining the concept of the Impact Factor . Interested readers can find out more about the history and meaning of the Impact Factor from Garfield’s presentation given at the International Congress on Peer Review and Biomedical Publication in Chicago, 2005 which is freely available as a pdf file online (requires Adobe Acrobat Reader to view, available for free here).

The Clinical Journal of Sport Medicine – making a real impact in the world of Sport and Exercise Medicine.

A feat too far for Haye?

Injuries to the feet of prominent athletes have caused some high-profile headlines over the last few years. In the UK, most football fans will remember the National crisis over David Beckham and Wayne Rooney who both had metatarsal injuries prior to important International football tournaments.

There was yet another cause for much discussion and debate following the World Heavyweight Championship boxing clash at the weekend between Wladamir Klitschko and David Haye in Hamburg, when Haye implicated a recent foot injury in his downfall.

Haye mentioned that he had sustained an injury to his right little toe approximately three weeks prior to the fight which had interfered with his preparation, causing him to stop his pre-fight sparring. He also said that he had had a local anaesthetic injection just before the clash with Klitchsko, which was the reason for his late entry to the ring on the night. Haye told viewers that the toe injury had caused him to have problems pushing off in order to land his right hand punches, which he thought had possibly affected the outcome of the fight.

The issue was highighted by Haye himself the day after the fight on Twitter, when he posted this picture taken by himself of his feet, showing the external appearance of the alleged injury to his right little toe. This suggests a fracture of the proximal phalanx, but I have not seen an x-ray to confirm this. He was also to show off his injured toe at the post-fight press conference.

Perhaps predictably, Haye’s claims were met with derision by many prominent people involved in the sport including boxers and journalists who thought that he was making excuses for his ineffective performance in the fight. Klitschko himself thought that Haye had opened himself to being criticised as a ‘sore loser,’ and when showed the offending toe by Haye laughed saying ‘it’s a bee sting.’ However, some individuals, notably including the former World Heavyweight Champion UK boxer Frank Bruno, stated that they felt that the injury would have significantly hampered Haye during the fight and that he should not have fought.

The debate as to whether or not Haye’s injury affected the outcome of the fight rests largely on an understanding of the biomechanics of boxing, including the effect of the injury on posture and mobility around the ring, plus the effect on the delivery of punches and their power, together with an understanding of the principle of the kinetic chain. Torsion and ground reaction forces are important factors to consider. Haye claimed that he was unable to ‘explode off my foot with the Hayemaker’ (right-handed power punch), which would imply a problem most likely with initially shifting his weight towards the front and lateral border of his right foot whilst in a semi-crouching position in preparation to push forwards and upwards through the medial border of the right foot whilst throwing a full right-handed punch.

However, it is perhaps hard to imagine why it was this particular position which would have caused most of his problems as he would be required to adopt very similar positions whilst manouvering around the ring and dodging and weaving during defensive manouvres. The former Liverpool Football Club Physiotherapist, Mark Leather, wrote in the Mail Online that he felt that ‘the biomechanics of his (Haye’s) argument do not stand up.’  However, I could find nothing on the effect of toe injuries on the biomechanics of boxing and on performance in the literature, and nothing specifically on foot biomechanics as related to performance in boxing.

There are, of course, other considerations pertaining to Haye’s injury, for example the effectiveness of local anaesthetics and protective orthoses. Psychological factors must also be considered, including the effect on the performance of a boxer entering the ring for a World Heavyweight Championship fight with an injury.

At least Haye has a sense of humour about it all. Having been subjected to derision by many in the media and on Twitter, he had the ability to make a few quips, claiming to have been offered a movie role in next year’s remake of ‘Scarface’ playing Toe-ny Montana!

What do you think? Was Haye making excuses, or do you think that he had a point? CJSM would love to hear your views.

(image taken by David Haye and posted on Twitter here)

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