Search

OBJECTIVES To characterize Primary Care Sports Medicine (PCSM) fellowship opportunities for Pediatrics-trained physicians across all programs in the United States. METHODS Cross-sectional study using data from publicly-available online sources. Data were collected from the Association of American Medical Colleges (AAMC) and American Medical Society for Sports Medicine (AMSSM) online listings of PCSM programs and cross-referenced with individual program websites. Variables such as program location, departmental sponsor, and eligibility criteria specific to pediatricians were collected. RESULTS 202 programs were identified. 196 (97.0%) were ACGME-accredited, of which 75.0% were sponsored by Family Medicine (FM), 9.7% by Physical Medicine and Rehabilitation (PMR), 9.2% by Pediatrics, and 5.1% by Emergency Medicine (EM) departments. Pediatrics-trained physicians were eligible for 133 of 196 (67.9%) programs and 241 of 350 (68.9%) total positions. Eligibility for pediatricians was highest in Pediatrics-sponsored programs (18/18, 100.0%), followed by EM (7/10, 70.0%), FM (98/147, 66.7%), and PMR (9/19, 47.4%). 49 of 133 (36.8%) programs accepting pediatricians had discrepancies regarding eligibility criteria (e.g. did not confirm eligibility criteria on their website, listed conflicting eligibility criteria within or between their website and AMSSM listing, or did not have a website available to cross-reference). CONCLUSIONS Pediatricians are eligible for more than two-thirds of PCSM fellowship programs across the United States, including programs that are not sponsored by Pediatrics departments. Applicants may not be aware of these opportunities given discrepancies regarding eligibility in over one-third of programs. In a field underrepresented by Pediatrics-trained physicians, accurate online information and transparency of eligibility criteria are critical to raise awareness about fellowship opportunities and foster equity with regards to career opportunities for pediatricians in PCSM.

The American Medical Society for Sports Medicine convened a panel of experts to provide an evidence-based, best practice document to assist sports medicine physicians and other members of the athletic care network with the detection, treatment, and prevention of mental health (MH) issues in competitive athletes. This statement discusses how members of the sports medicine team, including team physicians, athletic trainers, and MH providers, work together in providing comprehensive psychological care to athletes. It specifically addresses psychological factors in athletes including personality issues and the psychological response to injury and illness. The statement also examines the athletic culture and environmental factors that commonly impact MH, including sexuality and gender issues, hazing, bullying, sexual misconduct, and transition from sport. Specific MH disorders in athletes, such as eating disorders/disordered eating, depression and suicide, anxiety and stress, overtraining, sleep disorders and attention-deficit/hyperactivity disorder, are reviewed with a focus on detection, management, the effect on performance, and prevention. This document uses the Strength of Recommendation Taxonomy to grade level of evidence.

The American Medical Society for Sports Medicine convened a panel of experts to provide an evidence-based, best practices document to assist sports medicine physicians and other members of the athletic care network with the detection, treatment, and prevention of mental health issues in competitive athletes. This statement discusses how members of the sports medicine team, including team physicians, athletic trainers, and mental health providers, work together in providing comprehensive psychological care to athletes. It specifically addresses psychological factors in athletes including personality issues and the psychological response to injury and illness. The statement also examines the athletic culture and environmental factors that commonly impact mental health, including sexuality and gender issues, hazing, bullying, sexual misconduct, and transition from sport. Specific mental health disorders in athletes, such as eating disorders/disordered eating, depression and suicide, anxiety and stress, overtraining, sleep disorders, and attention-deficit/hyperactivity disorder, are reviewed with a focus on detection, management, the effect on performance, and prevention. This document uses the Strength of Recommendation Taxonomy (SORT) to grade level of evidence.

Background: Slipping rib syndrome (SRS) is an often unrecognized cause of lower chest and upper abdominal pain in children and adolescents. Surgical resection of the cartilaginous portions of the slipping rib often provides permanent pain relief, with the standard surgical approach being an open resection. A minimally invasive approach has not been reported previously; we report a novel laparoscopic technique for the treatment of SRS with satisfactory results. Materials and Methods: A retrospective review of all consecutive pediatric patients who underwent laparoscopic cartilage resection during the year 2019 and open cartilage resection during the year 2018 was included. Following data were recorded: age of patients, length of symptoms, length of procedure, length of cartilage resection, length of stay, resolution of pain, cosmetic acceptability, and postoperative complications. Results: Four patients underwent laparoscopic slipping rib resection without complication during the year 2019. The mean age of symptom onset was 15 (range 14-16) years old, mean length of symptoms was 1.4 (0.5-2.0) years, and mean age at operation was 16.5 (16-18) years old. The average length of the procedure was 72.8 (55-102) minutes, and mean length of cartilage removed was 2.3 (1.9-3.0) cm. Three patients underwent standard open operation during the year 2018. All patients reported complete resolution of their chronic pain at their 6-month follow-up visit. Conclusions: Laparoscopic technique can be used to treat SRS. All patients reported high satisfaction from resolution of chronic pain and the cosmetic appearance of their surgical scars.

The American Medical Society for Sports Medicine (AMSSM) convened a group of experts to develop a position statement addressing the problem of sexual violence in sport. The AMSSM Sexual Violence in Sport Task Force held a series of meetings over 7 months, beginning in July 2019. Following a literature review, the task force used an iterative process and expert consensus to finalize the position statement. The objective of this position statement is to raise awareness of this critical issue among sports medicine physicians and to declare a commitment to engage in collaborative, multidisciplinary solutions to reduce sexual violence in sport.

ObjectiveThe IOC recommends periodic cardiovascular screening of athletes, but the adoption of these recommendations is unknown. The purpose of this investigation was to evaluate and compare cardiovascular screening practices of countries participating in the Rio 2016 Olympic Games.MethodsA list of chief medical officers (CMOs) was compiled by the IOC during the 2016 Olympic Games. CMOs were requested to complete an online survey about cardiovascular screening of their countries’ Olympic athletes. Comparisons of screening practices were made by categorising countries by continent, gross domestic product (GDP) per capita and size of athlete delegation.ResultsCMOs for 117/207 (56.5%) countries participating in the 2016 Olympic Games were identified. 94/117 countries (80.3%) completed the survey, representing 45.4% of all countries and 8805/11 358 (77.5%) of all 2016 Olympic athletes. Most of the countries surveyed (70.2%) perform annual cardiovascular screening. Among the survey respondents, all or most athletes from each country were screened at least once with the following components: personal history (86.2% of countries), family history (85.1%), physical examination (87.2%), resting ECG (74.5%), echocardiogram (31.9%) and stress test (30.8%). Athletes were more likely to be screened with ECG in countries with relatively larger athlete delegation (OR 2.05, 95% CI 1.10 to 3.80, p=0.023) and with higher GDP per capita (OR 1.69, 95% CI 1.11 to 2.57, p=0.014).ConclusionMost of the responding countries perform annual cardiovascular screening of Olympic athletes, but there are differences in the components used. Athletes from countries with larger athlete delegations and higher GDP per capita were more likely to be screened with ECG.

The 2009 IOC Consensus Statement on Periodic Health Evaluation (PHE) of Elite Athletes recommends a 12-lead ECG, but the frequency of the PHE elements is not defined.1 In 2011, the International Paralympic Committee (IPC) approved the IPC Medical Code, which describes the need for routine PHE based on the latest medical knowledge.2 However, the components and frequency of screening are also not delineated. Recent research has evaluated the cardiovascular (CV) screening practices of Olympic athletes, but there are limited data regarding CV screening of Paralympic athletes.3 4 This study aimed to investigate current practices for CV screening of Paralympic athletes. Chief medical officers (CMOs) for National Paralympic Committees of the PyeongChang 2018 Paralympic Winter Games were identified by the IPC and surveyed regarding the CV screening practices of their respective teams. The primary outcome was the utilisation of CV screening components as part of the PHE. The secondary outcomes were the frequency of performing the CV screening components. A total of 35 of the 49 (71.4%) countries …

Cardiovascular screening in athletes has been a source of controversy within the sports medicine community. Annual screening inclusive of ECG is currently required by all major professional sports leagues in the USA and recommended by the IOC.1 In 2016, the American Medical Society for Sports Medicine (AMSSM) published a statement on cardiovascular screening, recognising knowledge gaps and advocating for medical providers caring for competitive athletes to consider important factors when determining an individualised cardiovascular screening strategy. These include the risk of sudden cardiac arrest (SCA) in the specific athlete population, the available resources and cardiology infrastructure for screening and secondary evaluations.2 The purpose of this investigation was to determine the cardiovascular screening practices of the US National Governing Bodies (NGBs) and National Paralympic Committees (NPCs). This study was approved by the Institutional Review Board from the …

Introduction Wolff-Parkinson-White (WPW) syndrome is a congenital abnormality that involves an accessory pathway between the atria and the ventricles in addition to the normal atrioventricular node-His pathway. This extra pathway can conduct electrical impulses to the ventricles more quickly and can cause pre-excitation arrhythmias to occur [1]. Three percent to 4% of WPW cases are familial and inherited as an autosomal dominant trait. WPW syndrome has a frequency of 1.5 to 3.1 per 1000 persons in Western countries [2]. The incidence of WPW is higher in men than in women, and it can occur at any age [3]. Therefore, it is inevitable that WPW syndrome can pose a major risk to the small fraction of athletes that have inherited the condition. The following two case reports describe the evaluation of possible WPW syndrome in two Division I collegiate athletes, a female softball player and a female water polo player. Quick detection of the syndrome is vital, and this should be followed by risk stratification and treatment according to the guidelines established by the 36th Bethesda Conference.

The two most troublesome skin infections in wrestlers are herpes gladiatorum and tinea gladiatorum. Determining whether athletes should or should not be disqualified from practice or competition because of these infections requires some expertise. Recommendations are presented to assist the practitioner in the care of these conditions in wrestlers and other athletes who have frequent skin-to-skin contact.

Background Cardiac screening in athletes has recently been a focus of investigation and debate among the sports medicine community. Athletic associations and organizations, including the International Olympic Committee, have issued recommendations regarding screening practices in an effort to prevent sudden cardiac death in sport. Objective To examine cardiovascular screening strategies among Olympic-level athletic teams. Design Cross-sectional survey. Setting United States National Governing Bodies (NGBs) and National Paralympic Committees (NPCs). Participants Medical team members for US NGBs and NPCs. Interventions Medical team members were surveyed regarding the cardiovascular screening practices of their respective teams. Main Outcome Measurements The screening components and screening frequency performed by US NGBs and NPCs. Results Medical team members for 49/72 (68%) of the US NGBs and NPCs were identified and contact information was obtained through various sources. 42/49 teams (86%) completed the assessment (34 from NGBs and 8 from NPCs). Twenty-one of 42 teams (50%) reported that there was a periodic health evaluation requirement that directed the cardiovascular screening components, frequency, and/or provider. The following screening components were reported as being performed at least once in all or most athletes: personal history (91% of teams), family history (86%), physical exam (81%), electrocardiogram (33%), echocardiogram (5%), and stress test (2%). For teams who did not screen athletes with ECG, the most frequently cited reasons were lack of ECG equipment (40%), lack of evidence (33%), and lack of consensus regarding follow-up testing (20%). Conclusion The US NGBs and NPCs are a heterogeneous collection of athletic teams that have varying approaches to cardiovascular screening. Lack of infrastructure appears to be the biggest barrier to implementing advanced screening protocols. Results from this investigation can be used to support efforts to provide consistent cardiovascular screening practices to NGB and NPC athletes with the goal of preventing tragedy from sudden cardiac death.

> “…we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character…” Romans 5: 3–4 Promoting fitness and keeping people active is a major focus of sports medicine professionals. Regular exercise reduces the incidence of, and prevents, many diseases and improves quality of life across the lifespan.1,–,3 The American Medical Society for Sports Medicine (AMSSM) is an organisation of primary care sports medicine physicians that is dedicated to promoting safe participation in regular exercise for all people. Phiddipides may have been the first true endurance athlete, running several hundred miles to relay news during the Persian/Greek War 2500 years ago. Following the Athenian victory at the Battle of Marathon, he ran 26 miles to announce the victory and upon completion of his run, died. From this tragedy, the marathon running event was born. As more and more people complete marathons, the public mystique of the marathon as a way to differentiate oneself from ‘normal’ athletes is wearing off, and endurance athletes are pushing the envelope farther and longer in a quest for greatness. …

Sports that require skin-to-skin contact between competitors, such as wrestling, create environments where infections can spread. Skin screening checks are made before any wrestling competition, but this usually doesn't happen with other sports. Two of the most common skin infections are herpes gladiatorum (caused by the same virus that causes cold sores) and tinea gladiatorum, also known as ringworm (caused by a fungus). These skin infections can spread rapidly among teammates, coaches, and opponents, so it is very important to treat the infection as soon as it is discovered. Athletes who have active skin infections can be disqualified from competition and withheld from practice.