The Global Sports Medicine Community — the CJSM Summer Podcast

As I write this post, the third round of the US Open Golf tournament is taking place as is Euro2020 (a year after being suspended), and Father’s Day is about to be celebrated in the United States.  That means summer is ‘full on’ in the Northern Hemisphere.

Which also means plenty of folks are taking vacation and it has become hard to track down some authors to join me for a podcast!!!

Lemonade courtesy of Wikimedia

Mixing metaphors:  the old adage has it that you make lemonade out of lemons, and since lemonade is an unofficial drink of summer, you all get a special summer treat with this, the 49th podcast for the journal.

I am using this moment to try out a special podcast format I’ve been toying with in my head.  I’m striking out getting guests for this podcast, and so I’ll serve you up ‘me’ as a guest!

Let me know if you think I’m lemonade….or a lemon!

I’ve been an admirer of the American Journal of Sports Medicine’s ‘5 in 5’ podcast for several years.  The hosts zip through five of the manuscripts in a recent edition of AJSM in approximately five minutes.  It’s a brilliant way to get some snack bite size information and I encourage the readers of CJSM and the listeners of our podcast to check out AJSM’s podcast.

With a tip of a hat to our eminent colleagues at AJSM, I have decided to call today’s podcast “2 in 10”: Read more of this post

The Cardiovascular PPE

One of the more popular articles in our November 2015 CJSM has been “Limitations of Current AHA Guidelines and Proposal of New Guidelines for the Preparticipation Examination of Athletes,” from a group of authors who are in the Division of Cardiovascular Medicine at Stanford University.  This is also one of the studies that have been picked by the Editor-in-chief to be freely available, and so if you click on that link you can read not just the abstract, but the study itself.

The authors set out “To examine the prevalence of athletes who screen positive with the preparticipation examination guidelines from the American Heart Association, the AHA 12-elements, in combination with 3 screening electrocardiogram (ECG) criteria.”  

The topic of screening to prevent sudden cardiac death (SCD) in athletes, in particular young athletes, is a perennial ‘hot button’ issue in our field — we’ve written about the issue here in the blog, and we have published several studies on the subject in the journal.  As most readers of the blog will know, in the USA (in contradistinction to Europe, Japan, Israel and elsewhere), there  is no recommendation for inclusion of an ECG in PPE screening.

There are many interesting aspects to the Stanford study.  The main outcome measures in the screen of 1596 high school and college athletes were i) the 8 personal and family history questions from the AHA 12-elements; and ii) ECGs using three separate criteria for interpretation: Seattle criteria, Stanford criteria, and European Society of Cardiology (ESC) criteria.  The different criteria had different rates of abnormal ECGs, but what was most concerning was the nearly 25% of athletes who screened ‘positive’ using AHA questions.

The authors conclude, “In a patient population without any adverse cardiovascular events, the currently recommended AHA 12-elements have an unacceptably high rate of false positives. Newer screening guidelines are needed, with fewer false positives and evidence-based updates.”

What do you think?  Take the poll, and let us know!

And We’re Off……


The author and colleague attending
to downed football player

The college football season began here in the USA last night, and the high school football season begins here in Ohio tonight.  I’ll be on the sidelines tonight and every week for the next 10 weeks….or more, if the team I cover makes the playoffs. Ohio Dominican University, the college whose sports our group covers, has been picked to do well this year, and I think the Panthers will, if they stay injury-free.    I hope all the players we’re involved with, high school and college, can stay as safe as can be expected.

The American football season represents the busiest time of our year. This stands to reason, of course, as both injury and participation rates in the sport consistently ‘top the charts’ in almost any study looking into the matter.  My friend and colleague R. Dawn Comstock, Ph.D., whom I mention frequently in these blog posts because of the many articles she has published, authored one such study in the Journal of Athletic Training, 2008:  ‘An Epidemiologic Comparison of High School Sports Injuries Sustained in Practice and Competition.’  Of all the sports studied, football had the highest competition and practice injury rates: 12.09 and 2.54 per 1000 athlete-exposures, respectively.  And as for participation, over 1 million high schoolers and nearly 80,000 college  students play football each year.   Combine these high participation rates and injury rates, and you have lots of bodies to attend to in the fall here in America.

It can be a brutal sport.  Boden et al. published a fine study in the American Journal of Sports Medicine this spring, “Fatalities in High School and College Football Players,” where he and his colleagues looked at the epidemiologic data from the National Center for Catastrophic Sports Injury Research from 1990 to 2010.  They found that football is associated with the highest number of fatalities for any sport reported to the Center, with 243 fatalities reported during the study period.  The reported rates of fatality were 1.0 per 100,000 participants.  They found, too, that college football was riskier, with 2.5 deaths per 100,000 participants for collegiate athletes, as compared with 0.9 deaths per 100,000 in high schoolers.

The theme for August here at the CJSM blog and at the mother journal herself has been “Concussion.”  The blog posts for this month have all focused on this issue, and the journal has made freely available this month a set of ten high quality concussion research articles it has published recently in a special concussion “collection.”  And so I would be remiss, with two days left in this month, if I did not briefly mention concussion injury rates in the sport of football.  Again, I will turn to the exceedingly productive Dr. Comstock, who reported in 2007 on “Concussions Among United States High School and Collegiate Athletes.”  Once again, the sport of football tops the injury rate charts, with Comstock’s group reporting rates for high school football players of  1.55 per 1000 athlete exposures; for the collegiate players the rates, as they are for fatalities, are higher, with 3.02 concussions per 1000 athlete exposures.

Time to start reviewing the Zurich consensus statement on Concussion in Sport.

With August’s end, we won’t stop talking about concussion, of course.  It is one of the most newsworthy items in the current field of clinical sports medicine, and I can tell you (having had a sneak peek at the upcoming September edition), that there are some excellent original research articles on the subject being published in CJSM in the next week.  I also have a “Question and Answer” blog post with the illustrious William Meehan, M.D., Director of the Sports Concussion Clinic at Boston Children’s Hospital, coming for the blog in September.  So keep your eyes on these pages, the journal’s website, and follow us on Twitter @cjsmonline (join the 2000+ who already do).  We’ll keep you up-to-date on the news and research relevant to you in your clinical practice of sports medicine.


Friday Night Lights,
may you and yours be safe this season.

I sign off knowing that many of the readers of this blog will be on sidelines and in training rooms this fall, and I wish you all good luck.  All the fall sports, and especially football, will keep you busy I know.  May you, and the athletes you care for, enjoy health–or recover quickly from injury–under the lights this fall.

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