Sports Medicine Research: In the Lab & In the Field (Sports Med Res)
Wednesday, July 30, 2014

The Devil Is In The Details…If You Can Get The Details Out

Why university athletes choose not to reveal their concussion symptoms during a practice or game

Delaney JS, Lamfookon C, Bloom GA, Al-Kashmiri A, and Correa JA. Clin J Sport Med. 2014. [Epub ahead of Print].

Take Home Message: Over 75% of surveyed collegiate athletes, who believed they sustained a concussion in the past year, reported not seeking proper medical attention for that concussion. The most common reason athletes reported not seeking proper medical attention was not believing the concussion was severe enough to warrant stopping the activity to seek out a medical professional.

Concussions are a common injury among athletes. While many concussions occur each year, many go unreported and undiagnosed. If clinicians could gain a better understanding of why athletes do not report, or underreport potential concussions, then clinicians may be able to better educate athletes on the importance of reporting concussion symptoms, which could lead to better concussion management. Therefore, Delaney and colleagues completed a retrospective survey study to identify why athletes who believe they had a concussion would not seek proper medical attention.
Monday, July 28, 2014

Inter-association Guidelines: Independent Medical Care for College Student-Athletes, Diagnosis and Management of Sport-Related Concussion, and Year-Round Football Practice Contact

Inter-association Guidelines: Independent Medical Care for College Student-Athletes, Diagnosis and Management of Sport-Related Concussion, and Year-Round Football Practice Contact

Diagnosis and Management of Sport-Related Concussion Guidelines
Year-Round Football Practice Contact Guidelines
Independent Medical Care for College Student-Athletes Guidelines

The NCAA and College Athletic Trainers’ Society have coordinated with several organizations and other key personnel to develop three new inter-association guidelines that address independent medical care for college student-athletes, diagnosis and management of sport-related concussion, and year-round football practice contact. Highlights of these documents are available from the NCAA Sport Science Institute. These documents have been endorsed by the National Athletic Trainers’ Association, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, American Osteopathic Academy for Sports Medicine, and several other organizations.

View 59 other recent position statements, consensus statements, guidelines, and recommendations related to sports medicine.
Wednesday, July 23, 2014

Despite the Hype: Many Former NFL Athletes May Have Normal Neurological Function and Structure

Is there chronic brain damage in retired NFL players? Neurology, neuropsychology, and neurology examinations of 45 retired players

Casson IR., Viano DC., Haacke EM.,Kou Z., LeStrange DG. Sports Health 2014;ahead of print.

Take Home Message: Neuropsychological impairments were found in some players; however, the majority of retired NFL players had no clinical signs of chronic brain damage. Some retired players had lesions found on brain imaging tests and these were associated with the number of previous concussions.

Evidence of neuropathology in the brains of deceased football players has led to widespread concern for retired players. Survey studies have suggested that depression and cognitive problems occur in retired NFL players; however, there is not much information reported on the neurological, neuropsychological, and neuroradiological examination of living, retired NFL players. Therefore, the authors performed clinical neurological, neuropsychological, and neuroroadiological examinations on 45 living, retired NFL players (on average 46 years of age, 31kg/m2 BMI, 6.8 years of playing experience, and 34 reported 3+ previous concussions).
Monday, July 21, 2014

It’s Only One Little Muscle Group…The Impact of Lumbar Multifidus Size on Lower Extremity Injury

Small Multifidus Size Predicts Football Injuries.

Hides JA, Stanton WR, Mendis MD, Franettovich MM, and Sexton MJ. Orthopaedic Journal of Sports Medicine June 2014 2: 2325967114537588, first published on June 16, 2014 doi:10.1177/2325967114537588 http://ojs.sagepub.com/content/2/6/2325967114537588.full.pdf+html

Take Home Message: Smaller lumbar multifidus size during preseason and the competitive season was associated with lower extremity injury in Australian Football. Additionally, lumbar multifidus asymmetry, limb kicking dominance and a history of low back pain were also associated with increased lower extremity injury.

Musculoskeletal injuries to the lower extremity are common during preseason and in-season competitions. If we could identify modifiable factors associated with these injuries then it may allow us to develop injury prevention programs. Stabilizing muscles of the lumbo-pelvic region may contribute to lower extremity injury risk but this needs to be verified in larger studies across both preseason and competitive seasons. The authors assessed ~260 Australian Football League players to determine whether the size, asymmetry, and ability to contract the lumbar multifidus were related to new lower extremity injuries during preseason and competitive season. They also attempted to establish combinations of factors to best predict injury.
Wednesday, July 16, 2014

Feel Like Phoning-In Your Concussion Symptoms? Not so Fast

Utilization of a Text-Messaging Robot to Assess Intraday Variation in Concussion Symptom Severity Scores.

Anthony CA, and Peterson AR. Clin J Sport Med. 2014. [Epub ahead of Print].

Take Home Message: Athletes who have sustained a concussion exhibit a wide range of symptom severity scores when surveyed through text-messaging at various times during the day.

Following a concussion, athletes are often assessed with the Post Concussion Symptom Score (PCSS), a symptom severity checklist. While the PCSS has been shown to be valid and reliable, there has been no evaluation of the effect that survey frequency has on results and whether the scores vary overtime within a day. Therefore, Anthony and Peterson completed a prospective cohort study of 14 athletes (14 to 22 years of age) who sustained a concussion to determine how much PCSS scores vary within a day.
Monday, July 14, 2014

Pitching: We Can Have too Much of a Good Thing

Risk-Prone Pitching Activities and Injuries in Youth Baseball: Findings From a National Sample

Jingzhen Yang, Barton J. Mann, Joseph H. Guettler, Jeffrey R. Dugas, James J. Irrgang, Glenn S. Fleisig and John P. Albright. Am J Sports Med 2014 42:1456.

Take Home Message:  Young pitchers who engage in “risk-prone” pitching activities are more likely to report arm tiredness and pain, which is related to shoulder and elbow injuries.

Millions of children play youth baseball each year and many players adopt early sport specialization, which means they are playing long competitive seasons, training year round, and play in multiple leagues. Unfortunately, many young baseball players suffer elbow and shoulder injuries. To optimize pitching recommendations and prevention programs it is important for us to understand the pitching activities of youth players and how these activities relate to injuries.  Therefore, Yang and colleagues surveyed youth pitchers (9 to 18 years of age) to describe 1) “risk-prone” baseball-related activities that do not meet the American Sports Medicine Institute (ASMI) recommendations, 2) age differences in reported pitching-related arm problems and injuries, 3) the relationship between “risk-prone” activities and pitching-related arm problems, and 4) how reported arm problems relate to pitching-related injuries.
Wednesday, July 9, 2014

If You’re Not Using the SCAT-2 For On-Field Concussion Diagnosis Maybe You Should Be

Prospective Clinical Assessment Using Sideline Concussion Assessment Tool-2 Testing in Evaluation of Sport-Related Concussion in College Athletes

Putukian M., Echemendia R., Dettwiler-Danspeckgruber Duliba T., Bruce J., Furtado JL., Murugavel M. Clin J Sport Med. 2014: ahead of print.

Take Home Message: The SCAT-2 tool composite score is useful in sports-related concussion assessment in a college setting due to its high sensitivity and specificity especially if you can compare a post injury score with a baseline measure.

Medical personnel use acute concussion assessment sideline tools, such as the SCAT-2, to make on-field decisions; however, the sensitivity and specificity of the SCAT-2 with and without baseline SCAT-2 measures are unclear. For medical personnel to determine an on-field concussion prognosis we need to know the accuracy (i.e., sensitivity & specificity) of the SCAT-2 concussion assessment tool. Therefore, the authors evaluated the utility of the SCAT-2 (with and without baseline testing) for the assessment of sports-related concussion in college athletes. They also assessed potential modifiers that could influence SCAT-2 scores (age, sex, history of concussion, loss of consciousness, depression & anxiety).