Effects of Legislation on Sports-Related Concussion.

Following the lead of Washington state and passage of the Lystedt Law in 2009, all states now have sports concussion laws designed to help protect youth athletes. This article examines the 3 basic tenets of youth sports concussion laws, challenges in implementation of state laws, and the first measures of success. Some of the major differences among state laws are also discussed.

Evaluation and treatment of the concussed athlete - update.

Athletes with sports related concussions are increasingly seeking medical care for management and guidance for return to play. This article aims to provide an updated review of the management of youth sports concussions including preseason planning, on the field identification of concussion, clinical management of acute concussion, and discussion of prolonged symptoms including headache.

The million dollar question: When should an athlete retire after concussion?

Management of acute concussions is guided by consensus statement, and the return-to-play process begins when an athlete's symptoms and examination return to baseline. This process may be relatively clear if symptoms resolve within the normal time frame following a first or second concussion. This decision-making process is more complicated in an athlete with prolonged unresolved symptoms, multiple concussions both with and without prolonged recovery, or a structural brain injury.

Counseling athletes on the risk of chronic traumatic encephalopathy.

Context: Chronic traumatic encephalopathy (CTE) is a rare progressive neurologic disorder that can manifest as a combination of cognitive, mood and behavioral, and neurologic symptoms. Despite clinically apparent symptoms, there is no imaging or other diagnostic test that can confirm diagnosis in living subjects. Diagnosis can only be confirmed postmortem by specific histopathologic features within the brain tissue identified on autopsy.

Exercise in the older adult: from the sedentary elderly to the masters athlete.

The diverse exercise goals of the aging population present several challenges to physicians. Whereas some Masters athletes aim to set personal time records, sedentary elderly persons may look to exercise to help maintain independence and combat functional decline. This review article examines the common cardiovascular and neuromuscular physiological changes associated with aging and how regular exercise is used to improve physiological parameters and functional abilities.

Radiating upper limb pain in the contact sport athlete: an update on transient quadriparesis and stingers.

Participation in contact sports exposes the athlete to a risk of cervical spine injury. Temporary neurological injuries manifesting as radiating arm pain or paresthesias, such as transient quadriparesis and stingers, present unique challenges for the sports medicine physician and will be reviewed in detail. The initial management of these conditions must recognize signs and symptoms of spinal cord injury and prevent further neurological sequelae.

Radiologic evaluation of the neck: a review of radiography, ultrasonography, computed tomography, magnetic resonance imaging, and other imaging modalities for neck pain.

The patient with neck pain may pose a diagnostic dilemma for the treating physician. As with other areas of medicine, imaging is guided by the history and physical examination. The steady advance of 3-dimensional, functional, and nuclear medicine studies make it increasingly important that the ordering physician be aware of the potential benefits and disadvantages of imaging options.