Sports Medicine Practitioners Research Articles

ECG measurement parameters of athletes are reliable when made with a smartphone based ECG device

Pre-participation cardiac screening including electrocardiogram (ECG) is a subject of controversy among sports medicine practitioners. Opponents of pre-participation ECG screen site concerns regarding the cost and accuracy of the testing. Recently, a single lead ECG accessory has become available for use with smartphones. The purpose of this study was to evaluate the between and within rater validity and reliability of the Kardia device in recording the ECG parameters rate, rhythm, and PR, QRS, and QT intervals. The ECG parameter made with the smartphone were also compared to same measures made using a 12 lead electrocardiograph.

The Holistic Athletic Healthcare Model: Addressing the Developmental, Social, and Cultural Needs of Collegiate Athletes

Many adolescent and young adult athletes only access the healthcare system through involvement in sports. Yet, many opportunities are missed in the sports medicine environment to provide holistic, quality care for these athletes that assists them in navigating to healthy adults and addresses inequities that impair good health. Since most causes of morbidity and mortality in this age group are related to poor health behaviors, and comprehensive health care services are fragmented, it is imperative that sports medicine healthcare be reimagined to incorporate a social-ecological perspective that holistically addresses the unique medical, social, cultural, and behavioral needs of athletes. We propose a social-ecological perspective that enhances developmental assets as the basis for sports medicine services. This innovative approach - the Holistic Athletic Healthcare Model - involves 1) addressing adolescent developmental needs and the social determinants of health at the individual level, 2) using strength-based approaches and demonstrating cultural competency in health provider relationships, 3) integrating medical care with campus community services, and 4) promoting health equity in the campus environment. Engagement in sports has many benefits beyond winning in the game, and health is more than being injury-free. Sports medicine practitioners and healthcare systems must be proactive in supporting athletes from all backgrounds to become healthy adults.

Dancer Wellness. By M. Virginia Wilmerding and Donna H. Krasnow.

Dancer Wellness is a comprehensive text for dancers and dance educators to better understand health and wellness in the context of their craft. Though not intended for this purpose, this resource may also be a beneficial tool in allowing allied healthcare professionals to repackage knowledge that was obtained in a traditional (sports) medicine context to the otherwise unchartered world of dance medicine and science. As a former dancer turned sports medicine practitioner and researcher, I appreciate what this text has done to bridge the gap by transferring knowledge and skills across disciplines.

Navigating emerging biotechnology interventions in sports and exercise medicine – Where innovation meets the evidence and the patient

Background: With Sport and Exercise Medicine a relatively new medical Specialty and a desire for our community to age healthier, longer and more active, the onus is now on Sport and Exercise Medicine practitioners and the multidisciplinary team to help the community achieve these goals. New advances in biotechnology have given hope to both practitioners and patients to be the magic bullet for degenerative musculoskeletal conditions such as osteoarthritis and tendinopathy. But whilst these emerging interventions show promise, the evidence base is yet to back these claims up. I will explore the history behind autologous interventions for such conditions including blood, platelet rich plasma, tenocyte implants and stem cell interventions for musculoskeletal interventions and the role and challenges the Australasian College of Sport and Exercise Physicians (ACSEP) has had in the evolution of these in current clinical management paradigms.

M. biceps femoris – A wolf in sheep’s clothing: The downside of a lower limb injury prevention training

Both, hamstring and ACL injuries are among the most typical injuries, particularly in change of direction and high speed running sports. They're also difficult to treat. Therefore, in the past few years, sports medicine practitioners and exercise scientists have mainly been focusing on the development and implementation of preventive programs in order to reduce the number of lower limb injuries, mainly by improving knee alignment. A number of studies have been able to prove the success of these training interventions, which are mainly addressing sensorimotor abilities and plyometric activities. The number of non-contact hamstring injuries has nevertheless been on the rise, particularly in sports like soccer and football. Therefore, the purpose of the following article is to introduce the hypothesis that the above-mentioned training interventions have a massive influence on the activation patterns on the targeted muscle group, and on the M. biceps femoris in particular. Muscle function and the resulting internal load are directly related to muscle architecture at the insertion. Training induced adaptations in hamstring activation patterns can thus lead to an increased injury susceptibility. In this case, a simulation model that directly relates to an acute deceleration maneuver provides valuable insights into the function of the biceps femoris muscle, especially when the rate of activity and the muscle geometry at the insertion area are taken into consideration. We conclude that there needs to be a greater individualization of prevention programs, especially in regards to anatomical requirements, in order to further reduce injury rates in elite sports. Moreover, it would also seem reasonable to apply a similar approach to aspects of chronic pain such as chronic non-specific low back pain.

Emotional labor and professional practice in sports medicine and science.

The aim of this study was to explore how sport medicine and science practitioners manage their emotions through emotional labor when engaging in professional practice in elite sport. To address the research aim a semistructured interview design was adopted. Specifically, eighteen professional sport medicine and science staff provided interviews. The sample comprised sport and exercise psychologists (n=6), strength and conditioning coaches (n=5), physiotherapists (n=5), one sports doctor and one generic sport scientist. Following a process of thematic analysis, the results were organized into the following overarching themes: (a) factors influencing emotional labor enactment, (b) emotional labor enactment, and (c) professional and personal outcomes. The findings provide a novel contribution to understanding the professional demands faced by practitioners and are discussed in relation to the development of professional competencies and the welfare and performance of sport medics and scientists.

Ethics, Evidence Based Sports Medicine, and the Use of Platelet Rich Plasma in the English Premier League

The use of platelet rich plasma (PRP) as a novel treatment is discussed in the context of a qualitative research study comprising 38 interviews with sports medicine practitioners and other stakeholders working within the English Premier League during the 2013–16 seasons. Analysis of the data produced several overarching themes: conservatism versus experimentalism in medical attitudes; therapy perspectives divergence; conflicting versions of appropriate evidence; subcultures; community beliefs/practices; and negotiation of medical decision-making. The contested evidence base for the efficacy of PRP is presented in the context of a broader professional shift towards evidence based medicine within sports medicine. Many of the participants while accepting this shift are still committed to casuistic practices where clinical judgment is flexible and does not recognize a context-free hierarchy of evidentiary standards to ethically justifiable practice. We also discuss a tendency in the data collected to consider the use of deceptive, placebo-like, practices among the clinician participants that challenge dominant understandings of informed consent in medical ethics. We conclude that the complex relation between evidence and ethics requires greater critical scrutiny for this emerging specialism within the medical community.

Modern Materials for Sports and Recreation

Abstract From graphene to next-generation composites to 3D printing, advanced materials and processes are helping sportswear manufacturers, sporting goods companies, and sports medicine practitioners take their game to the next level. This special report reviews some of the most innovative technologies making an impact on today’s sports and recreation industry. Technologies addressed include graphene used in sportswear, new production methods for carbon fiber composites, and 3D printed implants to address knee injuries.

LONG-TERM CONSEQUENCES OF INTERPERSONAL VIOLENCE AGAINST CHILDREN IN SPORT

BackgroundA recent prevalence study in the Netherlands and Belgium showed that 38% of children in sport experienced psychological violence, 11% physical violence, and 14% sexual violence. Ethnic minority, lesbian/gay/bisexual (LGB)...

INJURY RISK AMONG FEMALE SOCCER PLAYERS IN ZIMBABWE

BackgroundWomen soccer is proving to be popular the world over and in African countries as well. However in spite of its popularity there is always the attendant high risk of...

Stroke in a Young Swimmer

Introduction: Arterial dissections are important causes of stroke in the young population. Dissection has been reported in association with some sports. It seems that this report is among the first ones of the cervical arterial dissection in a young swimmer. Case Presentation: A 30-years-old male professional swimmer with no history of any major disease suddenly complained of severe ataxia, moderate headache, neck pain, unilateral left facial weakness, and feelings of tingling and paresthesia on the left side of his body and face a few minutes following head and body stretching exercises in land. There was no history of major head or neck trauma, manipulation, and practicing diving skills in the past. Acute infarction of the left cerebellum was diagnosed after performing brain computed tomography and magnetic resonance imaging (with contrast) studies. Cervical magnetic resonance angiography confirmed left vertebral artery dissection as the cause of infarction. Conclusions: Important differential diagnoses of cervicocephalic arterial dissection include other vascular or neurological causes of head and neck pain and/or local neurological syndromes and other causes of brain ischemia such as cardiac emboli, atherosclerosis, and vasculopathy of brain vessels. It is important that sports medicine practitioners pay attention to this less-diagnosed cause of stroke in young athletes.

Hip Joint Pathology as a Leading Cause of Groin Pain in the Sporting Population

Background: Chronic hip and groin pain offers a diagnostic challenge for the sports medicine practitioner. Recent consensus suggests diagnostic categorization based on 5 clinical entities: hip joint–, adductor-, pubic bone stress injury–, iliopsoas-, or abdominal wall–related pathology. However, their prevalence patterns and coexistence in an active population are unclear. Purpose: This study presents a descriptive epidemiology based on a large sample of active individuals with long-standing pain in the hip and groin region. The objectives were to examine the prevalence of key clinical entities, document coexisting pathologies, and present prevalence patterns based on key demographics. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A retrospective review was conducted of clinical records of all hip and groin injuries seen between January 2006 and December 2011 under the care of a single experienced sports medicine consultant. In all cases, imaging was undertaken by a team of specialist musculoskeletal radiologists. Diagnoses were categorized according to 5 clinical entities using contemporary diagnostic nomenclature. The chi-square test was used to compare observed and expected frequencies across each subgroup’s prevalence figures based on sex, age, and sports participation. Results: Full medical records were retrieved from 894 patients with chronic hip and groin pain. The majority of patients were male (73%), aged between 26 and 30 years, and participating in footballing codes (soccer, rugby, and Gaelic sports) or running. A total of 24 combinations of clinical entities were found. There were significant differences (P < .001) in prevalence patterns based on age, sex, and sports activity. Adductor-related pain or pubic bone stress injury rarely presented in isolation. Hip joint pathology was the most common clinical entity (55.98%) and was significantly more likely to present in isolation. The majority of hip joint pathologies related to femoroacetabular impingement (40%), labral tears (33%), and osteoarthritis (24%). These figures were significantly different across male and female patients (P < .001), with a higher percentage of cases of femoroacetabular impingement and labral tears in male and female patients, respectively. Conclusion: Chronic hip and groin pain is often associated with multiple clinical entities. Hip joint pathology is the most common clinical entity and is most likely to relate to femoroacetabular impingement, labral tears, and osteoarthritis. These pathologies seem to be associated with secondary breakdown of surrounding structures; however, underpinning mechanisms are unclear.

Sports Medicine - Open.

Dear Sports Medicine and Exercise Researchers, It is with great pleasure that Springer announces the launch of Sports Medicine - Open, a new peer-reviewed, online-only, open-access journal designed to provide an avenue for publication of original research in the field of sports and exercise medicine. Sports Medicine - Open is a sister publication of Sports Medicine, which has been published since 1984 by Adis and is now part of the Springer journal portfolio. The original Sports Medicine journal has been a leading publication in sports and exercise medicine for 30 years and has consistently been one of the most highly ranked vehicles for publication of review articles in the field. This focus on reviews has left little scope for the inclusion of original research, although Sports Medicine regularly receives submissions of original research articles. The launch of a sister journal to Sports Medicine, publishing original research, aims to provide the first top-tier open-access avenue for these papers. Given the well-regarded Sports Medicine brand and the community of top-tier researchers that support the journal, we believe that Sports Medicine - Open will fill a gap for our target audience of sports medicine practitioners, physiotherapists, exercise scientists/physiologists, team doctors, and trainers. Sports Medicine - Open will have similar aims and scope to those of the original Sports Medicine journal but with a different, complementary focus. Specifically, Sports Medicine - Open aims to publish original medical and scientific research in the following areas: Sporting performance enhancement Medical syndromes associated with sport and exercise Injury prevention and treatment Exercise for rehabilitation and health The application of physiological and biomechanical principles to specific sports Sports Medicine - Open will also consider publication of a smaller number of high-interest, definitive reviews. To ensure consistency and continuity of the editorial services associated with the original Sports Medicine journal, Sports Medicine - Open will be managed by an expanded team based on the editorial staff responsible for the original journal. Thus, authors will enjoy the benefits of publishing in a journal following the strong publishing practices of Sports Medicine, with the same editorial and publishing expertise and experience associated with that journal. Springer publishes more than 2,200 journals, including over 500 in its Medicine Journal Collection. The successful integration of the Adis portfolio of journals into the Springer production systems and custom-built platforms (SpringerLink, Springer for R&D, and Springer for Hospitals & Health) means that authors now have: Easy article submission, peer review, and tracking processes Shorter time to publication Unparalleled article visibility, worldwide reach and discoverability Convenient, global, online access of readers to their work These benefits of the Springer organization will flow into the new Sports Medicine - Open journal from its inception. Therefore, our final message is a simple one: if you have an original research article in the sports and exercise field that you believe would be a candidate for publication in Sports Medicine - Open, please submit your manuscript to us for an assessment. With the support of both the community of researchers who publish review articles in the original Sports Medicine journal, and the large number of other readers and followers of the journal, we believe that we can quickly establish a journal that provides a high-quality, open-access option for researchers in the field. We ask you, particularly if you are a ‘friend’ of the original Sports Medicine journal, to keep Sports Medicine - Open in mind when considering where to submit your original research. Yours sincerely Roger Olney and Steve McMillan, Editors editorial@sportsmedicine-open.com

Sport medicine and sport science practitioners' experiences of organizational change.

Despite the emergence of and widespread uptake of a growing range of medical and scientific professions in elite sport, such environs present a volatile professional domain characterized by change and unprecedentedly high turnover of personnel. This study explored sport medicine and science practitioners' experiences of organizational change using a longitudinal design over a 2-year period. Specifically, data were collected in three temporally defined phases via 49 semi-structured interviews with 20 sport medics and scientists employed by three organizations competing in the top tiers of English football and cricket. The findings indicated that change occurred over four distinct stages; anticipation and uncertainty, upheaval and realization, integration and experimentation, normalization and learning. Moreover, these data highlight salient emotional, behavioral, and attitudinal experiences of medics and scientists, the existence of poor employment practices, and direct and indirect implications for on-field performance following organizational change. The findings are discussed in line with advances to extant change theory and applied implications for prospective sport medics and scientists, sport organizations, and professional bodies responsible for the training and development of neophyte practitioners.

Sports medicine ultrasound (US) beyond the musculoskeletal system: use in the abdomen, solid organs, lung, heart and eye

The use of point-of-care ultrasound (US) by non-radiologists is not new and the expansion into sports medicine practice is relatively young. US has been used extensively to evaluate the musculoskeletal...

Determination of the Criterion-Related Validity of Hip Joint Angle Test for Estimating Hamstring Flexibility Using a Contemporary Statistical Approach

To examine the criterion-related validity of the horizontal hip joint angle (H-HJA) test and vertical hip joint angle (V-HJA) test for estimating hamstring flexibility measured through the passive straight-leg raise (PSLR) test using contemporary statistical measures. Validity study. Controlled laboratory environment. One hundred thirty-eight professional trampoline gymnasts (61 women and 77 men). Hamstring flexibility. Each participant performed 2 trials of H-HJA, V-HJA, and PSLR tests in a randomized order. The criterion-related validity of H-HJA and V-HJA tests was measured through the estimation equation, typical error of the estimate (TEEST), validity correlation (β), and their respective confidence limits. The findings from this study suggest that although H-HJA and V-HJA tests showed moderate to high validity scores for estimating hamstring flexibility (standardized TEEST = 0.63; β = 0.80), the TEEST statistic reported for both tests was not narrow enough for clinical purposes (H-HJA = 10.3 degrees; V-HJA = 9.5 degrees). Subsequently, the predicted likely thresholds for the true values that were generated were too wide (H-HJA = predicted value ± 13.2 degrees; V-HJA = predicted value ± 12.2 degrees). The results suggest that although the HJA test showed moderate to high validity scores for estimating hamstring flexibility, the prediction intervals between the HJA and PSLR tests are not strong enough to suggest that clinicians and sport medicine practitioners should use the HJA and PSLR tests interchangeably as gold standard measurement tools to evaluate and detect short hamstring muscle flexibility.

Management of Low Bone Mass in Female Athletes

As female athletic participation has increased, the positive effects of exercise on health have become evident. However, with this growth in sports activity, a set of health problems unique to the female athlete has emerged. The female athlete triad and its components can occur in females of all ages in every sport. The Female Athlete Triad poses serious health risks, both short and long term, to the overall well-being of affected individuals. Sustained low energy availability can impair health, causing many medical complications within the skeletal, endocrine, cardiovascular, reproductive, and central nervous systems. With the surge of females participating in athletics within the past 10 to 15 years, it is both conceivable and likely that the prevalence of this syndrome will continue to grow. Therefore, it is imperative that appropriate screening and diagnostic measures are enacted by a multidisciplinary team of health care providers, counselors, teachers, and dieticians in order to provide the proper care to affected athletes. Initial awareness should take place within the educational confines of elementary and high schools. Screening for female athletes exhibiting risk factors for the triad should also take place at the time of sports physicals. If one component of the triad is identified, the clinician should take the time to effectively workup the other. Treatment for each component of the triad includes both pharmacological and nonpharmacological measures, with emphasis placed upon increased energy availability and overall improved nutritional health. Using this all-encompassing type of approach, sports medicine practitioners should feel empowered to continue to promote the lifelong well-being of female athletes in the years to come.

Talking With Parents of High School Football Players About Chronic Traumatic Encephalopathy

Over the past decade, athletic-related chronic traumatic encephalopathy (CTE) has garnered a great deal of attention in the popular press and, more recently, in the scientific press. With increasing frequency, sports medicine practitioners and providers are faced with questions from the parents of high school football players about CTE and the risk posed to children who participate in this or other contact or collision sports. The purpose of this review was to summarize the research on CTE in an attempt to provide some evidence-based answers to frequently asked questions in clinics from parents. Addressed are (1) the definitions of CTE and its symptoms, (2) the evidence for CTE in football, (3) abnormal tau protein, (4) the use of neuroimaging in CTE diagnosis, (5) risk for CTE, (6) CTE diagnosis in youth, (7) CTE and its relationship to suicide, and (8) contact and collision sports as a risk factor for permanent brain injury or death.

Where are all the female participants in Sports and Exercise Medicine research?

The aim of this study is to estimate the ratio of male and female participants in Sports and Exercise Medicine research. Original research articles published in three major Sports and Exercise Medicine journals (Medicine and Science in Sports and Exercise, British Journal of Sports Medicine and American Journal of Sports Medicine) over a three-year period were examined. Each article was screened to determine the following: total number of participants, the number of female participants and the number of male participants. The percentage of females and males per article in each of the journals was also calculated. Cross tabulations and Chi-square analysis were used to compare the gender representation of participants within each of the journals. Data were extracted from 1382 articles involving a total of 6,076,580 participants. A total of 2,366,968 (39%) participants were female and 3,709,612 (61%) were male. The average percentage of female participants per article across the journals ranged from 35% to 37%. Females were significantly under-represented across all of the journals (χ2 = 23,566, df = 2, p < 0.00001). In conclusion, Sports and Exercise Medicine practitioners should be cognisant of sexual dimorphism and gender disparity in the current literature.

A simplified version of the weight-bearing ankle lunge test: Description and test–retest reliability

The purpose of this study was twofold: (1) to describe a new version of the weight-bearing ankle lunge test (WBLT) that is simple to administer, that allows clinicians and sports medicine practitioners to directly assess (in degrees) the ankle dorsiflexion range of motion in a very short period of time while adopting a comfortable testing position; as well as (2) to determine the test–retest reliability of the ankle dorsiflexion range of motion measure obtained from the new version of the WBLT. A total of 50 active adults completed this study. All participants performed the new version of the WBLT on three different occasions, with a two-week interval between testing sessions. Reliability was examined through the change in the mean between consecutive pairs of testing sessions (ChM), standard error of measurement (SEM), minimal detectable change at 95% confidence interval (MDC95), and intraclass correlation coefficient (ICC2,k). The findings showed negligible or trivial ChM values for all the flexibility measures analysed (<1°). Furthermore, the SEM and MDC95 scores for the ankle dorsiflexion measure were 1.3 and 3.8 respectively, and the ICC2k was 0.95. Therefore, this study demonstrated that the ankle dorsiflexion measure obtained from the new version of the WBLT has excellent test–retest reliability scores. Thus, an observed change larger than 3.8° from baseline scores after performing a treatment would indicate that a real change in ankle dorsiflexion range of motion was likely.