Atypical Presentations of Exertional Collapse.

Exertional collapse associated with sickle trait (ECAST) is an underrecognized cause of exertional collapse triggered by complex mechanisms involving acidosis, rhabdomyolysis, and arrhythmias, all of which create sickling, vaso-occlusive problems, and ultimately end organ failure. Three cases are described in young athletes, as well as 12 other examples of ECAST noted in case reports and news sources. Exertional collapse associated with sickle trait can be differentiated from other common causes of collapse (exertional heat syndrome, acute cardiac events, and asthma) because it is a conscious collapse without neurological changes, occurs early in workout with only mildly elevated body temperature, and involves muscle pain and weakness but not cramping.

Ultrasound Diagnosis of Calf Injuries.

Context: The medial head of the gastrocnemius is the third most commonly strained muscle in elite athletes after the biceps femoris and rectus femoris. The differential diagnosis of posterior calf injury includes musculoskeletal and nonmusculoskeletal causes. Classically, delineation of these injuries from one another relied primarily on historical features and physical examination findings.

Sternal stress fracture in a middle-aged woman.

A middle-aged premenopausal woman presented with 3 months of right chest wall pain after beginning a new weight training programme. Examination was significant only for mild-to-moderate tenderness to palpation over the right pectoral muscle and sternoclavicular joint. In-office musculoskeletal ultrasound scan, chest X-ray and shoulder X-rays were unremarkable.

AMSSM Position Statement on Cardiovascular Preparticipation Screening in Athletes: Current evidence, knowledge gaps, recommendations and future directions.

Cardiovascular screening in young athletes is widely recommended and routinely performed prior to participation in competitive sports. While there is general agreement that early detection of cardiac conditions at risk for sudden cardiac arrest and death (SCA/D) is an important objective, the optimal strategy for cardiovascular screening in athletes remains an issue of considerable debate. At the centre of the controversy is the addition of a resting ECG to the standard preparticipation evaluation using history and physical examination.

AMSSM Position Statement on Cardiovascular Preparticipation Screening in Athletes: Current Evidence, Knowledge Gaps, Recommendations and Future Directions.

Cardiovascular screening in young athletes is widely recommended and routinely performed prior to participation in competitive sports. While there is general agreement that early detection of cardiac conditions at risk for sudden cardiac arrest and death (SCA/D) is an important objective, the optimal strategy for cardiovascular screening in athletes remains an issue of considerable debate. At the center of the controversy is the addition of a resting electrocardiogram (ECG) to the standard preparticipation evaluation using history and physical examination.

Muscular Calf Injuries in Runners.

Calf pain is a common complaint among runners of all ages but is most frequent in masters athletes. This article focuses on injuries to the triceps surae or true 'calf muscles.' The most common calf injury is a tear of the medial gastrocnemius muscle (Tennis Leg) but other structures including the lateral gastrocnemius, plantaris and soleus also may be the cause of muscular pain.

AMSSM Position Statement on Cardiovascular Preparticipation Screening in Athletes: Current Evidence, Knowledge Gaps, Recommendations, and Future Directions.

Cardiovascular (CV) screening in young athletes is widely recommended and routinely performed before participation in competitive sports. While there is general agreement that early detection of cardiac conditions at risk for sudden cardiac arrest and death (SCA/D) is an important objective, the optimal strategy for CV screening in athletes remains an issue of considerable debate. At the center of the controversy is the addition of a resting electrocardiogram (ECG) to the standard preparticipation evaluation using history and physical examination.

Wheezing after respiratory tract infection in athletes.

Wheezing is a commonly encountered complaint by patients seen in sports medicine practice. Wheezes are a continuous musical sound heard best on expiration and can originate from one or more of several defined anatomical locations in the human airway. While common causes of wheezing include exercise-induced bronchoconstriction, postnasal drip, and asthma, wheezing also follows specific respiratory infections and can persist for months after the onset of symptoms.

Presence of automated external defibrillators in North Carolina public middle schools.

Background: Automated external defibrillators (AEDs) have been used in the school setting to successfully resuscitate students, staff, and visitors. All public high schools in North Carolina have an AED. However, the number of North Carolina public middle schools with an AED is unknown.

Running injuries - changing trends and demographics.

Running injuries are common. Recently the demographic has changed, in that most runners in road races are older and injuries now include those more common in master runners. In particular, Achilles/calf injuries, iliotibial band injury, meniscus injury, and muscle injuries to the hamstrings and quadriceps represent higher percentages of the overall injury mix in recent epidemiologic studies compared with earlier ones.

Prevention of running injuries.

Evidence for preventive strategies to lessen running injuries is needed as these occur in 40%-50% of runners on an annual basis. Many factors influence running injuries, but strong evidence for prevention only exists for training modification primarily by reducing weekly mileage. Two anatomical factors - cavus feet and leg length inequality - demonstrate a link to injury.

Peripheral nerve entrapment and injury in the upper extremity.

Peripheral nerve injury of the upper extremity commonly occurs in patients who participate in recreational (e.g., sports) and occupational activities.

Diabetes in sports.

Context: Exercise is recommended for individuals with diabetes mellitus, and several facets of the disease must be considered when managing the diabetic athlete. The purpose of this article is to review diabetes care in the context of sports participation.

Evidence Acquisition: Relevant studies were identified through a literature search of MEDLINE and the Cochrane database, as well as manual review of reference lists of identified sources.

Evidence-based treatment of hamstring tears.

Hamstring tears are exceedingly common in a variety of athletic populations and contribute to a significant amount of morbidity and time lost from sport. Many modifiable and nonmodifiable risk factors have been identified with hamstring injury. There is strong evidence that Nordic hamstring exercises can decrease the risk of hamstring injury, limited evidence that sports specific anaerobic interval training and isokinetic strengthening can reduce injury rates, and limited evidence that daily static stretching after injury can increase recovery rate.

The effect of anabolic steroids on the gastrointestinal system, kidneys, and adrenal glands.

Over the past several decades we have seen an increase in the prevalence of anabolic steroid use by athletes. Because use of anabolic steroids is illicit, much of our knowledge of their side effects is derived from case reports, retrospective studies, or comparisons with studies in other similar patient groups. It has been shown that high-dose anabolic steroids have an effect on lowering high-density lipoprotein, increasing low-density lipoprotein, and increasing the atherogenic-promoting apolipoprotein A.

Basic biomechanics of the lower extremity.

This article describes common principles of biomechanics for running, jumping, and kicking. These activities form the basis for much of sports activity. Understanding human movement allows the physician to prescribe appropriate prevention, treatment, and rehabilitation to patients.

Hypertension in the athlete.

Athletes with hypertension are frequently encountered in clinical settings and during preparticipation examinations. This common condition merits special attention in athletes, as they have particular physiologic and sport-specific demands. Awareness of the pressor response to both isometric and isotonic exercise is valuable in managing hypertensive athletes.

Healing heel pain: help for plantar fasciitis.

If your feet, especially the heels and arches, hurt when you step out of bed in the morning, you may have plantar fasciitis. It may take 6 months or longer for the pain to go away, but there are some things you can do in the meantime to cope with the pain and heal faster.

Plantar fasciitis: prescribing effective treatments.

Plantar fasciitis is one of the most common painful disorders experienced by people in running and jumping sports. While the prognosis for recovery with conservative care remains excellent-more than 90% of athletes ultimately respond-the prolonged duration of symptoms affects sports participation. Studies that examined various treatment options found mixed results, so finding the most effective treatment can be challenging.